A Clinical Observation About The Effect Of Tanshi Fang Combined With Health Management On Non-alcoholic Steatohepatitis

Objective To observe the clinical efficacy of Tanshi Fang combined with healthmanagement which based on the “Gan Hao”application in the treatmentof non-alcoholic steatohepatitis(phlegm-dampness type),and evaluate its application security.Methods The 90 patients who were chosen from the liver outpatient department of Hubei provincial hospital of traditional Chinese medicine all diagnosed as non-alcoholic steatohepatitis and belonged to phlegm-dampness type in the traditional Chinese medicine(TCM)syndrome classification from November 2014 to November 2016.All of the patients randomly divided into three groups which were WM(western medicine)group,TCM group and combined treatment(TCM combined with health management)group.The WM group was treated with two Polyene phosphatidylcholine capsules three times per day and oral health education was used.The TCM group was given one small box of Tanshi Fang granules twice per day and oral health education as well.The combined treatment group was given one dose of Tanshi Fang granules twice per day and health management which contained the guidance of diet and exercise offered by “Gan Hao”application.The treatment would last 3 months totally,and our observations and measurements including TCM syndrome integral,waist-to-hip ratio,body mass index,fat attenuation parameters,liver function tests(liver enzyme blood levels),blood lipids,ultrasonic imaging before and after the 3 months treatment.In addition,we checked the vital signs and electrocardiogram(ECG),renal function,blood routine,urine routine and stool routine of TCM group and combined treatment group in the process of the treatment of 0,1,2,3 months.Finally,we used SPSS17.0 software system to anlyze the data and compared the clinical curative effect of the three groups and evaluated the safety of Tanshi Fang.Results(1)Before the treatment,all the observation indexes were no statistically significant difference(P>0.05)in the 90 patients with non-alcoholic fatty liver.(2)After the treatment,the results of the comparison within groups are as follows.1.The TCM syndrome integral,ALT,AST,GGT of WM group decreased compared with before treatment,the difference was statistically significant(P<0.05).The changes of other indicators were not statistcally significant(P>0.05).(P>0.05).2.The TCM syndrome integral,ALT,AST,GGT,TG,LDL-C,FAI of TCM group were lower than before treatment,the difference were statistically significant(P<0.05).The changes of other indicators were not statistcally significant(P>0.05).3.The TCM syndrome integral,ALT,AST,GGT,TC,TG,LDL-C,FAI,WHR,BMI of the combined treatment group were lower than before treatment,there were statistcally significant difference(P<0.05).And HDL-C rose,the difference were statistically significant(P<0.05).And the ultrasonic imaging degree was reduced,the difference was also statistically significant(P<0.05).(3)After the treatment,the results of the comparison among groups are as follows.1.The comparison of total effective rateThe total effective rate of WM group,TCM group and combined treatment group was 40.0%,46.7%,83.3% respectively.The total effective rate of TCM group compared with WM group,the difference was not statistically significant(P>0.05).The total effective rate of combined treatment group was higher than both WM group and TCM group.the difference was statistically significant(P<0.05).2.The comparison of obesity index and FAIThe BMI and WHR of TCM group compared with WM group,the difference was not statistically significant(P>0.05).But the FAI of TCM group was lower than WM group,the difference was statistically significant(P<0.05).The BMI ?WHR and FAI of combined treatment group was lower than both WM group and TCM group.the difference was statistically significant(P<0.05).3.The comparison of liver function tests(liver enzyme blood levels)The ALT,AST,GGT of TCM group compared with WM group was lower,the difference was statistically significant(P<0.05).The ALT,AST,GGT of combined treatment group compared with TCM group.there was no statistically significant difference(P>0.05).4.The comparison of blood lipidsThe TG,LDL-C of TCM group were lower than WM group,the difference was statistically significant(P<0.05).The HDL-C of TCM group was higher than WM group,the difference was statistically significant(P<0.05).The TC,TG,LDL-Cof the combined treatment group compared with TCM group.there was statistically significant difference(P<0.05).The HDL-C of combined treatment group was higher than TCM group.there was statistically significant difference(P<0.05).5.The comparison of ultrasonic imaging degreeThe ultrasonic imaging degree of TCM group compared with WM group,the difference was not statistically significant(P>0.05).The ultrasonic imaging degree of combined treatment group compared with both WM group and TCM group was reduced,the difference was statistically significant(P<0.05).6.The comparison of the TCM syndrome integralThe TCM syndrome integral of both TCM group and combined treatment group was lower than WM group.there was statistically significant difference(P<0.05).The TCM syndrome integral of combined treatment group compared with TCM group.there was no statistically significant difference(P>0.05).(4)Safety evaluationThe vital signs of both TCM group and combined treatment group were stable and there were no abnormal change in ECG,renal function,blood routine,urine routine and stool routine in the process of the treatment of 0,1,2,3 months.Conclusions 1.The overall effect of Tanshi Fang combined with health management which contained the guidance of diet and exercise offered by “Gan Hao”application in treatment of nonalcoholic steatohepatitis was better than both the Tanshi Fang group and polyene phosphatidylcholine capsules group.Its role was reflected in improving the clinical symptoms of patients,waist-hip-ratio,body mass index,fat attenuation parameters,liver function,blood lipids and liver ultrasound imaging;Its advantage lay in improving the waist to hip ratio,body mass index,fat attenuation parameters,blood lipid index(TC),expression of hepatic ultrasonography.In short,it has a good therapeutic effect on nonalcoholic steatohepatitis.2.Tanshi Fang can effectively improve clinical symptoms of patients,liver function,blood fat index(TG,LDL-C,HDL-C)and reduce fat attenuation parameters.3.In the course of treatment,there were no obvious adverse reactions related to the Tanshi Fang,which argued the applation of Tanshi Fang for treatment of nonalcoholic steatohepatitis with good safety.