Xiaozhi Qinggan Decoction Of NAFLD(Phlegm And Blood Stasis Type) Clinical Curative Effect And The Exploratory Study Of Relevant Mechanisms

Background:Nonalcoholic fatty liver disease is a kind of metabolic stress associated with insulin resistance and genetic susceptibility to liver damage.It has become the leading causes of chronic liver disease in the developed countries and become clinical common and frequently-occurring disease in our country.Other than directly or by promoting both the progress of the liver disease,Lead to liver failure and hepatocellular carcinoma(HCC),NAFLD is also involved in the pathogenesis of diseases such as type 2 diabetes and atherosclerosis.Active treatment of the disease can reduce the occurrence of liver fibrosis and cirrhosis of the liver,and reducing the occurrence of the metabolic syndrome and heart,cerebrovascular events.Traditional Chinese medicine treatment of this disease has accumulated rich clinical experience,the curative effect is remarkable.The clinic is generally thought the pathological factors of this disease is phlegm and congestion.The most common syndromes of this disease is phlegm and blood stasis.Xiaozhi Qinggan decoction is the clinical effective prescription treatment of NAFLD liver disease from Xiyuan Hospital.In view of the establishment of the pathological basis of phlegm and blood stasis.After the pre-basic research(acute toxicity,pharmacodynamics)and the clinical observation have proved its efficacy,it is an effective prescription in clinical treatment of NAFLD.Objective:According to traditional Chinese medicine theory and clinical practice,combined with modern medicine,to observe the effective prescription Xiaozhi Qinggan decoction on NAFLD in patients with clinical efficacy:biochemistry improvement rate(liver function,blood lipids),ameliorative rate of symptom,signs disappeared rate,imaging change rate(b-mode ultrasound).Testing and through the relevant indicators to explore its possible mechanism:anti-inflammatory(TNF-?),reducing lipid(TC,TG,FFA)and oxidation-resistance(MDA,SOD),against insulin resistance(HOMA IR,adiponectin).Methods:This clinical study come from the project of Beijing Science and Technology Development of Chinese Medicine(2014-JJ42).In this clinical study,the principle of random allocation is adopted.60 cases are diagnosed as NAFLD phlegm obstruction blood stasis type by Xiyuan Hospital,and they are divided into 30 cases in the control group and 30 cases in the treatment group.The treatment group to Xiaozhi Qinggan decoction,take one bag(100ml)two times a day,16 weeks of treatment.The control group to polyene phosphatidylcholine capsules,Take two capsules(456mg)three times a day,16 weeks of treatment.Observation indexes including age,gender,height,weight,waist circumference,syndrome,abdominal ultrasound,blood lipid,liver function,fasting blood glucose,insulin,TNF-?,MDA,SOD,FFA,adiponectin,etc.To observe the two groups of treatment differences.Results:1.The total effective rate of the treatment group is 86.7%and the total effective rate of control group is 76.7%,After the treatment of 8 and 16 weeks,no significant adverse reactions.Compared treatment group with control group at the total effective rate,the treatment group is significantly better than the control group(P<0.05).2.Comparison of two groups after treatment symptoms and signs:The curative effect of treatment group in the rib-side distention and oppression or pain,abdominal distension,loss of appetite,nausea,belching,obesity and so on,the treatment group is significantly better than the control group(P<0.05);compared with the control group,loose stools,fatigue and other symptoms and signs are not significant difference(P>0.05).3.Two groups after treatment liver function compared with each other:the effect of treatment group in the AST,GGT is significantly better than the control group(P<0.05);ALT,TBIL on the gap is not big,no comparison(P>0.05).The improvement of liver function after treatment in the treatment group is better than the control group.4.Two groups after treatment blood lipids compared with each other:the effect of treatment group TC,TG is significantly better than the control group(P<0.05);HDL-C,LDL-C on the gap is not big,no comparison(P>0.05).5.The two groups after treatment of inflammation,necrosis and comparison of the related indexes of blood lipids:after treatment in the treatment group,patients with insulin,TNF-?,SOD,MDA,FFA and IR index is very significantly improved(P<0.01).Fasting blood glucose and ADP are obviously improved(P<0.05).The control group after treatment,patients with MDA,IR index is very significantly improved(P<0.01).Fasting blood glucose,insulin and TNF-?,SOD,FFA,ADP are obviously improved(P<0.05).The two groups after treatment compared to each other,the effect of the treatment group in MDA,ADP,and the treatment group is very significantly better than the control group(P<0.01);SOD,FFA on the curative effect of treatment group is significantly better than the control group(P<0.05);in the fasting blood glucose,insulin and TNF-a,IR index on the curative effect of treatment group and control group the difference is small,no comparison(P>0.05).Conclusion:1.The treatment group used Xiaozhi Qinggan Decoction in the treatment of NAFLD(phlegm and bloodstasis type),the clinical curative effect significantly better than the control group used the polyene phosphatidyl choline capsules.2.This prescription effect for the treatment of NAFLD may be related to anti-inflammatory(TNF-?),reducing lipid(TC,TG,FFA),oxidation-resistance(MDA,SOD)and against insulin resistance(HOMA IR,adipon-ectin).