The Clinical Literature Evaluation Of The Combined Treatment Of Traditional Chinese And Western Medicine In Liver Failure And Integrative Experimental Study Of Liver Injury By The Yuganjiedu Decoction

Objective:Under the guidance of TCM theory, first applied Meta-analysis to evaluate integrative Medicine in the treatment of liver failure, to help improve efficacy for Integrative Medicine clinical efficacy for the treatment of liver failure, to make a more objective and credible evaluation, and provide the basis for clinical treatment decisions; Secondly, to explore the treatment effect and mechanism of the Yuganjiedu decoction on the D-galactosamine and carbon tetrachloride-induced acute liver injury in experimental animal models. To provide real scientific basis for the Chinese medicine treatment of acute liver injury.Methods:About the Meta-analysis:in strict accordance with the method of systematic reviews of evidence-based medicine, the use of electronic and manual search methods, a comprehensive collection of Integrative Medicine in the treatment of liver failure clinical randomized controlled trials (RCTs); and filter according to the literature selection criteria:using the Jadad scorecriteria to evaluate the methodological quality of included studies; to collect relevant data for the homogeneity test and meta-analysis, and publication bias and sensitivity analysis.Experimental Study:Yuganjiedu decoction on D-galactosamine (D-GalN) and carbon tetrachloride (CCL4)-induced acute liver injury in rats, intervention, detection of biochemical, immunological, pathology, the cellular pathways and other indicators of research more liver detoxification treatment of liver injury in rats mechanisms.Results:The literature search and screening, met the inclusion criteria of randomized controlled trials of treatment of hepatic failure17, a total of1192patients,17were methodological treatment is C-class. Meta-analysis for the treatment of liver failure, medical intervention in the treatment group are more efficient than the simple TCM and Western medicine treatment control group.Experimental Study:Yuganjiedu decoction on the D-galactosamine and carbon tetrachloride induced acute liver injury in rats have a therapeutic effect. Yuganjiedu decoction, the middle dose group elevated transaminases, bilirubin levels, improve blood coagulation, compared with model group was statistically significant(P<0.05), can regulate plasma proinflammatory cytokine tumor necrosis factor-alpha (TNF-alpha), interleukin prime-1(IL-1), white blood cells interleukin-6(IL-6), interleukin-8(1L-8) content, the elevated pro-inflammatory cytokines decreased, and was statistically significant (P<0.05). Can improve the pathological changes of acute liver injury in rat liver tissue bridging the lesion area, and reduce the severity of the liver cells. Yuganjiedu decoction on D-Amino galactose-induced acute liver injury in rats, the nuclear factor NF-kappa B (nuclear factor-kappa B) signaling pathway also have a certain impact.Conclusion(1) TCM intervention treatment group, liver failure clinical efficiency than pure TCM and Western medicine treatment control group; into the quality of literature, research methods, and other reasons, the exact effect of Integrative treatment of hepatic failure has yet to be confirmed, should be designed to more rigorous multi-center, randomized controlled trials.(2) Yuganjiedu decoction of high dose to reduce the D-galactosamine and carbon tetrachloride induced rat liver cell injury, lower plasma transaminase and total bilirubin, with a protective drop enzyme. At the same time in the pathological aspects, the two can significantly improve the pathological changes of liver tissue, reduce the area of the lesion, reducing the degree of liver damage. Can regulate a series of pro-inflammatory cytokines play a hepatoprotective role by regulating the body’s inflammatory response. More, Yuganjiedu decoction low-dose group there are certain the hepatoprotective JiangMei role, but the difference between the results of its indicators, the effect is difficult to evaluation.Yuganjiedu decoction of high-dose group on D-Amino galactose-induced acute liver injury in rats, nuclear factor-KB signaling pathway also have a certain impact, possibly through modulation of cytokines-cell signal transduction pathways play a the hepatoprotective the role.