| 1 Systematic Review for Traditional Chinese Medicine Treatment of Non-alcoholic Steatohepatitis Clinical ResearchObjective:Through the systematic review of Chinese medicine clinical research of NASH,to provide scientific evidence-based medical evidence for Chinese medicine clinical,so that the results of research can be promoted and applied.Methods:1.Non-alcoholic steatohepatitis, NASH, Chinese medicine, Chinese medicine for the electronic search keywords; 2.By the two researchers according to inclusion, exclusion criteria were screened, get to meet the requirements of the literature; 3. Data extraction of included literature; 4. Evaluate the quality of included studies and used software Revman4.2 to Meta-analysis.Results:1.There are 152 articles were retrieved,22 of them are included.2. After evaluateing the quality of the reserches, it is not difficult found that there are many design flaws in the traditional Chinese medicine clinical study of NASH,such as estimation of sample size, randomized, blinded, long-term effect and so on.Many of them lack of substantial evidence, according to international quality evaluation criteria, in the 22 studies,18 is a low quality studies,4 are medium-quality studies.3. After the systematic review and Meta analysis, summarized characteristics of Chinese treatment of NASH effect as follows:①The theory of Liver treatment in Chinese medicine is not better than the treatment of western medicine in the fact of the recovery rate,total efficiency,liver function(ALT,AST,GGT),lipid (TG, TG, LDL-C, HDL-C).②The theory of Liver and spleen treatment in Chinese medicine is better than the treatment of western medicine in the function of improving the recovery rate, total efficiency,liver function,lipid,but In aspects of TG and HDL-C, Chinese medicine does not have the advantage than Western medicine.③The theory of Liver and spleen and kidney treatment in Chinese medicine are better than the treatment of western medicine,nomatter in the aspects of the recovery rate,total efficiency,liver function,lipids.④Only 2 articles researched the theory of Liver and kidney treatment,the analysis suggested that,compare with western medicine,this treatment in Chinese medicine can enhance the recovery rate, total efficiency, and improve the liver function, regulate LDL-C,HDL-C,except the treatment of TCandTG.Conclusions:1.The treatment of Chinese medicine for non-alcoholic steatohepatitis have significant effects.2.The theory of liver and spleen and kidney treatment of Chinese medicine is better than reatment of western medicine.3. Chinese medicine no serious adverse reactions.However, Chinese medicine treatment of NASH still have many problems of clinical research,many of the reserches are low quality studies,so these conclusions need further large sample multi-center well-designed RCT to verify.2 The Influence of Traditional Chinese Medicine on lipid metabolic factors and Mitochondrion DNA RepairenzymesObjective:Through the research of the influence of traditional Chinese medicine on lipid metabolic factors and Mitochondrion DNA Repairenzymes in non-alcoholic Steatohepatitis(NASH)rats,To investigate the pathogenesy of NASH and the mechanism that JianPiBuShen herbs and HuoXueJiangZhuo herbs prevent and treat NASH rats.Methods:Give high fat diet to prepare the model of NASH,except the model group and blank group,the other rats were treated by different TCM prescriptions and Essentiale, All the rats were executed after the therapy of 10 weeks,detected the liver functions,lipids in blood,lipid metabolic factors and mitochondrion DNA repair enzymes in liver,finally we analysed data.Results:1. The hepatocellular fatty degeneration:There were obviously differences among the blank group and the model group(p<0.01).Compared with model group, the hepatocellular fatty degeneration in treatment group had significant diference (p<0.01). The hepatocellular fatty degeneratio of the Essentiale group were raised obviously compared to the blank group(p<0.01).There's no significant difference between different theory of treatment of Chinese medicine(p>0.05).2. The hepatocellular scorces of the severity of inflammation:The model group were raised obviously compared to the group of the blank group (p<0.01). Compared with model group, the hepatocellular scorces of the severity of inflammation in treatment group were decreased (p<0.01). Compared with the Essentiale group,the combination herbs of JianPiBuShen herbs and HuoXueJiangZhuo herbs can decreased the hepatocellular scorces of the severity of inflammation obviously (p<0.01). There were no distinct differences among the treatment groups(p>0.05).3.The liver function:AS,ALT,GGT,ALP of the model group were raised obviously compared to the blank group (p<0.01); The treatment groups was lower than that of the model group (p<0.01); ALT of HuoXueJiangZhuo herbs group and the blank group has distinct difference(p<0.01); AST,GGT of the three Chinese medicine treatment group and the blank group has distinct difference(p<0.01),but they have no different in ALP(p<0.01);GGT of the Essentiale group is lower than the he three Chinese medicine treatment group(p<0.01).4.The lipids in the blood:The blood lipids of the model group were raised obviously compared to the blank group (p<0.01); Compared with the blank group,The blood lipids in each treatment group were incresced significantly(p<0.01); There were distinct differences among the three Chinese medicine treatment group and the Essentiale group(p<0.01);5.The expression of mitochondrion DNA repair enzymes mRNA in hepatic issue: The expression of three kinds of mitochondrion DNA repair enzymes in the model group were raised obviously compared to the blank group (p<0.01); The expression in the three Chinese medicine treatment group were raised obviously compared to the model group (p<0.01), the Essentiale group was lower compared to the model group (p<0.01); There were no distinct differences among the three Chinese medicine treatment group(p>0.05).6.The expression of PPARaand PGC-1αmRNA in hepatic issue:The expression of PPARaand PGC-lainthe model group were decreased obviously compared to the blank group (p<0.01); The expression in each treatment group were raised obviously compared to the model group (p<0.01); The expression in the three Chinese medicine treatment group were higher than the Essentiale group(p<0.01); There were no distinct differences among the three Chinese medicine treatment group(p>0.05).7.The expression of SREBP-1 c,SCAP mRNA in hepatic issue:The expression of SREBP-1c,SCAP inthe'model group were increased obviously compared to the blank group (p<0.01);The expression in each treatment group were decreased obviously compared to the model group (p<0.01);There were distinct differences among the JianPiBuShen herbs,HuoXueJiangZhuo herbs and the Essentiale group (p<0.01);The SREBP-1c in the combination herbs of JianPiBuShen herbs and HuoXueJiangZhuo herbs were increased obviously compared to the Essentiale group (p<0.01),The SCAP in the combination herbs of JianPiBuShen herbs and HuoXueJiangZhuo herbs were increased obviously compared to the Essentiale group(p<0.05); There were no distinct differences among the three Chinese medicine treatment group(p>0.05).Conclusions:1. In this study, high fat diet rat model of NASH was successfully copied,the method is simple, and similar to human NASH.2.The Chinese medicine can improve the general state of rats and liver pathology, decreased liver function, regulated blood lipids of NASH rats.3.On the one hand,the Chinese medicine restrained the expression of SREBP-1c,SCAP and increased the expression of PPARα,PGC-lain hepatic issue;On the other hand,it can increased the expression of mitochondrion DNA repair enzymes mRNA in hepatic issue. The Chinese medicine Can regulate lipids and enhance liver itself-repair to prevent and treat the non-alcoholic steatohepatitis.
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