| Objective:To observe the clinical curative effect and advantage of Qinggantiaozhi Decoction on nonalcoholic steatohepatitis, and explore the mechanism of it by animal experiment.Methods:Clinical observation: 70 patients with nonalcoholic steatohepatitis (NASH) were divided into two groups in random: the treated group with Qinggantiaozhi Decoction and the control group with silybin. It was 4 weeks for a course of treatment, and the total course of treatment was 8 weeks. In the course of treatment, the items that we had observed with all patients were sings and symptoms, biochemical indexes including alanine aminotransferase (ALT), aspartate aminotransferase (AST),γglutamyltransferase (γ-GT), total cholesterol (TC) and triglyceride (TG), and the B-type ultrasonic inspection of liver. Empirical study: 70 Wistar rats, and 10 rats were divided to the normal control group, and the other 60 rats were induced to the model of NASH with high fat diet that was made up based animal feed (88%), lard (10%), cholesterol (1.5%) and bile salt (0.5%). The 60 rats were divided into five groups in average: model groups, the groups of Qinggantiaozhi Decoction in low dose, middle dose and high dose, and the contrast group of silybin. In the five groups, except the model group, others were treated by corresponding medicine. After 12 weeks, all rats were put to death, and the following items were detected: the index of Lee's through measuring the body weight and length of rats; the serum levels of ALT, AST and alkaline phosphatase (ALP); the serum contents of TC, TG, free fatty acids (FFA) and leptin; the serum contents of fasting blood glucose (FBG) and fasting insulin (FINS), and to calculate the insulin resistant index (IRI) and the insulin sensitive index (ISI) with them. The contents of tumor necrosis factor-alpha (TNFα) and malondialdehyde (MDA) and the activity of superoxide dismutase (SOD) were detected in the liver tissue homogenate. The liver histopathology was observed by hematoxylin and eosin (HE) staining. The B cell lymphoma/leukemia-2 (Bcl-2), CD14 and cytochrome P450ⅡE1 (CYP2E1) were expressed on the liver tissue by immunohistochemistry staining, the amylon, fat and hemosiderin were expressed on the liver tissue by specific staining. All a b o v e p o s i t i v e r e s u l t s w e r e a n a l y z e d b y q u a n t i t a t i v e a n a l y s i s .Results:After all clinical data were counted with statistics, we found that, to compare with prior treatment, in post treatment all indexes in the patients of two groups are improved on different degree (P<0.05,P<0.01), and the clinical synthetic curative effect in treated group is better than that in contrast group (P<0.05). To the improvement of indexes of liver function, there is no difference between two groups (P>0.05), but the clinical sings and symptoms, contents of blood-fat and the manifestation of B-type ultrasonic inspection in liver are all improved better in treated group than those in contrast group (P<0.05,P<0.01). After to analyze the experimental data, we found that, all above indexes in model group are abnormal compared with those in normal group (P<0.05,P<0.01), but the indexes are all improved in treated groups than those in model group (P<0.05,P<0.01). The indexes of TG, FFA, FBG, INS, IRI, ISI and TNFαare all improved better in high dose group of Qinggantiaozhi Decoction than those in silybin group (P<0.05,P<0.01), and for others, there are similar curative effects between Qinggantiaozhi Decoction groups and silybin group, however, there is still a tendency that curative effect in Qinggantiaozhi Decoction groups is better than that in silybin group.Conclusion:There are several mechanisms on Qinggantiaozhi Decoction preventing and curing NASH. The first one is to correct disordered blood-fat and reduce the deposition of fat in hepatic cell through improving the resistance of insulin and leptin, promoting metabolism of FFA and TG in hepatic cell. The second one is to lessen hepatic cell degeneration and to promote cytothesis through depressing the lipid peroxidatic reaction, elevating antioxygen, decreasing the active expression of CYP2E1, lessening inflammatory cell to infiltrate, restraining the activation of kupffer, reducing the release of cytokine especial TNFαand suppressing apoptosis of hepatic cell. Based on above mechanisms, Qinggantiaozhi Decoction can improve sings and symptoms, serum biochemical indexes and the display of fatty liver of patients with NASH, and compared with silybin, Qinggantiaozhi Decoction have better curative effect to restrain the initiating agent of NASH. |
PDF Full Text Request