| Objective: To observe the clinical curative effect of Bushen Jiangzhuo Decoction on nonalcoholic steatohepatitis,and explore its mechanism..Methods:Theoretical discussion: to review the understanding of non-alcoholic steatohepatitis in modern medicine and Chinese medicine.To discusses the pathogenesis and treatment of the non-alcoholic steatohepatitis with the characteristics and clinical manifestations of TCM " kidney deficiency and turbidity ".Clinical observation:60 patients who met the inclusion criteria were randomly divided into the experimental group and the control group,30 cases in each group.The experimental group was given Bushen Jiangzhuo decoction,and the control group was treated with Silibinin Capsules for 2 months.The changes of body weight,BMI,TG,TC,ALT,AST,TCM symptom quantization,color ultrasound and safety indicators were observed in the two groups before and after treatment..Experimental study:A rat model of nonalcoholic steatohepatitis was established by high-fat diet induction.Blank control group and model control group were administrated with normal saline,wnile different dose of Chinese medicine and silybin group were given corresponding dose of medicine.After 8 weeks,weight,liver index,TG,TC,ALT,AST,FBG and FINS were detected in each group,and IRI and ISI were calculated.The contents of FFA,SOD,MDA,LP,ADP and TNF-alpha in liver tissue were detected.The expression level of JNK/ insulin signaling pathway protein in liver tissue was detected by Western blot.Result:Clinical observation:Compared with those before treatment,the observation indexes of all two groups improved to different degrees after treatment(P<0.05,P<0.01),the clinical efficacy of the experimental group was significantly better than that of the control group(P<0.01).There was no significant difference between the two groups in the improvement of ALT and AST(P>0.05).The improvement of blood lipid,color Doppler ultrasonography and TCM symptom scores in the experimental group were all better than those in the control group(P<0.05,P<0.01)..Animal experiments:After 12 weeks of high-fat diet induction,the model of nonalcoholic steatohepatitis in rats was successfully established.In body weight,liver index,serum TG,TC,ALT,AST and pathological changes of liver tissue,compared with the blank control group,the indexes of the model control group were obviously abnormal(P<0.01).Compared with the model control group,the indexes of each drug group improved to different degrees(P<0.05,P<0.01).Compared with the western medicine group,each index of Chinese medicine high-dose group improved significantly(P<0.01).In the level of FFA,SOD,MDA in liver tissue and FBG,FINS,IRI and ISI in serum,compared with the blank control group,the rats in the model control group were significantly abnormal(P<0.01).Compared with the model control group,the indexes of each drug group improved to different degrees(P<0.05,P<0.01).Compared with silibinin group,all indexes in Chinese high dose group improved significantly(P<0.01).In the levels of LP,ADP,TNF-alpha and expression of JNK,p JNK,and p-IRs-1 in liver tissue,compared with the blank control group,the indexes of the rats in the model control group were obviously abnormal(P<0.01).Compared with the model control group,the indexes of each drug group were improved(P<0.05,P<0.01).Compared with the silibinin group,the indexes of the high dose group were improved significantly(P<0.01).There was no significant difference in the expression of IR alpha in liver tissues between rats in each group(P>0.05).Conclusion:1.kidney asthenia and turbidity are important pathogenesis of nonalcoholic steatohepatitis.the method of Bushen Jiangzhuo can be applied to the treatment of this disease.2.Bushen Jiangzhuo decoction has a definite effect on nonalcoholic steatohepatitis.3.The mechanism of Bushen Zhuozhuo decoction may play a role in the treatment of nonalcoholic steatohepatitis by regulating the content of adipocytokines and inhibiting the activation of JNK signaling pathway,improving the activity of insulin receptor substrate to enhance the signal transduction after insulin receptor,improving insulin resistance and oxidative stress level. |
