Clinical And Experimental Study Of Qizhu Decoction In The Treatment Of Obese Nonalcoholic Fatty Liver Disease

1.Clinical ResearchObjective To observe the effects of "Qizhu Fang" on liver fat controlled attenuation parameter(CAP),liver enzymes,anthropological indexes,glucose and lipid metabolism,insulin sensitivity indexes and TCM symptoms in obese nonalcoholic fatty liver disease(NAFLD)influences.Methods Obese patients with NAFLD were randomly divided into the control group(40 cases)and the observation group(38 cases).The control group received polyene phosphatidylcholine capsules(Yi Shanfu)three times a day for 12 weeks;the observation group received Qizhufang granules,one dose a day for 12 weeks;both groups adopted lifestyle control.Observe CAP?LSM,ALT?AST?GGT?TC?TG?HDL-C?LDL-C?BW?BMI?FP?FPG?FINS?HOMA-IR?index changes and the TCM symptom.Results ? FibroTouch test and liver enzyme test:liver CAP,LSM,ALT,AST,and GGT in the two groups were significantly lower than before treatment(P<0.05,P<0.01);ALT,AST,and GGT were lower in the observation group after treatment In the control group(P<0.05)·?Anthropological indicators:BW,BMI,and FP decreased significantly after treatment in both groups(P<0.05,.P<0.01).? Glycolipid metabolism and insulin sensitivity indicators:TC,TG,FINS,and HOMA-IR decreased significantly after treatment in the two groups(P<0.01);LDL-C in the observation group decreased significantly and HDL-C after treatment It was higher than before treatment(P<0.05,P<0.01);TC in observation group was lower than that in control group after treatment(P<0.05).?Efficacy of TCM Symptoms:The single TCM symptoms of the two groups were significantly improved after treatment in the two groups(P<0.05,P<0.01).The observation group was significantly relieved of body drowsiness,sticky stools,dry mouth and bitterness,and fatigue after treatment(P<0.05).Conclusion The observation group has more advantages in reducing ALT,AST,GGT,LDL-C,and TC.At the same time,the observation group can significantly improve body weight,sticky stools,dry mouth,bitter mouth,fatigue and other symptoms.2.Experimental ResearchObjective To observe the efficacy of Qizhu Decoction in the intervention of high-fat diet model NAFLD mice,and to explore the mechanism of Qizhu Decoction in improving liver inflammation and lipid metabolism in high-fat diet model NAFLD mice.Methods 1.C57 BL/6 mice were divided into blank group,model group,observation group,traditional Chinese medicine control group and western medicine control group,and were fed with ordinary feed and high-fat diet for 12 weeks to establish NAFLD mouse models.The observation group was given Qizhu Decoction,the Chinese medicine control group was given Hedan capsules,and the western medicine control group was given polyene phosphatidylcholine for 4 weeks of intervention,and the blank group and model group were given water for 4 weeks.Observe the general condition,liver morphology,HE staining of liver tissue,organ coefficient,liver function and lipid metabolism in mice of different groups.2.C57 BL/6 mice were divided into blank group,model group and Qizhu Decoction group,and fed with ordinary feed and high-fat diet for 12 weeks to establish a NAFLD mouse model.Qizhu Decoction group was administered for 4 weeks,the blank group and model group were given water for 4 weeks.To detect the expression of liver TLR4,IL-6 and FXR/SHR,SREBP-1mRNA by rt-PCR;Western-blot Western blot test expression of liver TLR4,MyD88,NF-?B p65 and p-p65 protein.Results 1.?Comparison of body weight and organ coefficients:Compared with the blank group,the body weight,wet liver weight,and spleen wet weight of each group were significantly increased after the intervention(P<0.05,P<0.01);the body weight of the observation group mice compared with the control group,there was a significant decrease(P<0.01).The liver wet weight,liver coefficient,spleen wet weight,and spleen coefficient of the observation group were not significantly different from those of the control group.The liver wet weight and liver coefficient of the observation group decreased trend.?Observation of pathological morphology:Compared with the model group,different drug intervention groups can improve liver fat deposition,and the observation group has a significant improvement.?Liver function and uric acid:The liver function and uric acid of the different drug intervention groups were improved compared with the model group(P<0.05,P<0.01).The ALT,AST,and UC in the observation group were significantly lower than those in the control group(P<0.05,P<0.01).? Lipid metabolism index:Different drug intervention groups have different degrees of improvement in lipid metabolism compared with the model group,among which the HDL-C,LDL-C,TC,and TG in the observation group have significantly decreased compared with the model group(P<0.05,P<0.01);TG in the observation group decreased significantly compared with the Chinese medicine control group,and LDL-C,TC,TG in the observation group decreased significantly compared with the western medicine control group(P<0.05,P<0.01).2.?Compared with the blank group,the liver levels FXR?SHR?SREBP-1?TLR4 and IL-6 mRNA in the model group and Qizhu Decoction group were significantly increased.The liver levels of TLR4,IL-6,and SREBP-1 mRNA in the Qizhu Decoction intervention group were lower than those in the model group,and the levels of FXR and SHRmRNA were higher than those in the model group(P<0.05,P<0.01).?Compared with the blank group,the expression levels of TLR4,MyD88,and p-p65 in the liver of the model group and Qizhu Decoction group were significantly increased.The expressions of TLR4,MyD88,and p-p65 in the liver of mice in the Qizhu Decoction intervention group were significantly lower than those in the model group(P<0.01).Conclusion Qizhu Decoction can significantly improve the body weight,liver function,lipid metabolism and uric acid level of high-fat diet model NAFLD mice.It is through the regulation of lipid metabolism related signals FXR/SHR,SREBP-1,and inhibition of NF-?B mediated liver inflammatory pathway to achieve liver protection.