The Clinical Efficacy And Mechanism Of "Qiang Gan Xiao Zhi" Prescription Combined With Acupoint Embedding In The Treatment Of Non-alcoholic Fatty Hepatitis

Objective:The subject objective to avaluate the clinical efficacy and safety of“QiangGanXiaoZhi”decoction combined with acupoint embedding in the treatment of non-alcoholic fatty liver.By animal experimental study NASH rats to explore its action mechanism,provide objective basis for clinical treatment.Methods:1)clinical observation:Select 132patients with NASH who met the inclusion criteria,were randomly divided into the treatment group?33cases?,33cases in Chinese medicine control group,33cases in the western medicine control group and 33cases in acupoint embedding control group.The treatment group was treat with“QiangGanXiaoZhi”decoction day 1 agent,sonner and later,and acupoint embedding 1 time per week.the Chinese medicine control group was given a single dose of“QiangGanXiaoZhi”decoction,day 1 agent,sonner and later.In acupoint embedding control group,the treatment of acupoint embedding once a week.Patients in the western medicine control group were treated with vitamin E soft capsule,each 100mg,3 times a day;In the other four groups patients were with diet and proper exercise therapy;treatment 3months.After couse of the treatment,symptoms and signs,liver function,blood fat,Liver hardness,fat attenuation degree of hardness value changes,safety and adverse reactions were observed and evaluated.2)Experimental study:95SPF SD rats,and 10 rats were randomly divided into the normal contol group,and the other rats were induced to the model of NASH with high fat diet that was made up cholesterol?2%?,lard?40%?,standard feed?58%?.NASH rats were divided into 7 groups:the model group,the group of chinese medicine in high dose combine with acupoint embedding,middle dose and low combine with acupoint embedding,the group of acupoint embedding,chinese medicine group and western medicine group.the group of chinese medicine combine with acupoint embedding was treated with QiangGanXiaoZhi”decoction in high dose?medium and low dose combined with acupoint.the group of chinese medicine was treated with QiangGanXiaoZhi”decoction in medium dose.the acupoint embedding group was treated with acupoint embedding.the western medicine group was treated with vitamin E soft capsule.Treat once a week for 4 weeks.At the end of 16^th,all rats were put to death,_the following items were detected:Liver function?ALT?AST?,blood lipid?TG?TC?HDL-C?LDL-C?by automatic biochemical analyzer;the histopathology was observed in high magnification.the serum Il-6,Il-1?and TNF-?levels in NASH rats were detected by ELISA,and the expression of IKK,Nf-kBP65,il-6 and il-1 was detected by Western Bolt.Result:1)Clinical observation:Due to lost to follow-up,no treatment is required,8cases were wed out during observation process.The real effective cases were 90cases.?1?Clinical symptom score:the total effective rate of the treatment group and the control group?Chinese medicine group,western medicine group,and acupoint embedding the group?was93.8%,56.7%,53.3%and 76.7%respectively.The total efficiency of the treatment group was better than that of control groups?P<0.01?.?2?the changes of blood lipids:4 groups before and after treatment,TG?TC?LDL-C were statistically significant?P<0.01?,before and after treatment,LDL-C level of treatment group and acupoint embedding control group have significant?P<0.05?,chinese medicine control group and western medicine control group have no significant?P>0.05?,After treatment,the blood lipid?TG,TC,HDL-C,LDL-C?in the treatment group was significantly improved compared with the control groups,and the difference was statistically significant?P<0.01 or P<0.05?.?3?Liver function:groups before and after treatment,ALT?AST?GGT levels were statistically significant?P<0.01?,and the treatment group ALT?AST?GGT levels lower than control groups?P<0.01orP<0.05?.?4?Liver hardness and fat attenuation comparison:four groups Liver hardness and fat attenuation after treatment was obviously improved,the difference statistically significant?P<0.01 or P<0.05?,after treatment,the treatment group of Liver hardness level significantly lower than control groups?P<0.01 or P<0.05?,the treatment group of fat attenuation is obviously better than control groups?P<0.01?.?5?Chinese medicine symptom score comparison:after treatment,the treatment group?control groups of chinese medicine?western medicine?acupoint embedding scores were 2.85±1.48?6.68±1.70?6.93±1.92?4.16±1.42,the treatment group was better than control groups?P<0.01?.?6?Security assessment:the clinical trial found no significant adverse reactions and side effects,safety index were normal.2)Experimental study:?1?General conditions and pathology.Morphology:Model group compared with the blank group,the color with the liver was yellow and volume increased,then there was visible fat vacuoles and inflammatory cell infiltration in the cytoplasm according to light microscopy of liver tissue,which proves the success of NASH model.Compared with the model group,in the treatment group,the histopathology showed that the fatty inflammation and lipid deposition of liver tissue were improved.?2?Liver functions:Compared with the blank group,the serum ALT and AST levels of the model group were significantly increased?P<0.01?.the serum ALT and AST levelswere improved in each treatment group?P<0.01?,and the group of“QiangGanXiao Zhi”prescription in high dose combine with acupoint embedding was significantly improved?P<0.01?.?3?serum lipid level:Compared with the blank group,the serum TG?TC?LDL-C of the model group significantly increased?P<0.01?,All the treatment groups could reduce the level of TG,TC and LDL-C in rats?P<0.01 or P<0.05?,“QiangGanXiaoZhi”decoction in high dose combine with acupoint embedding was significantly improved?P<0.01?.There was no significant difference in HDL-C level between the blank group,the model group and the treatment group?P>0.05?.?4?The serum of rat was detected by ELISA:Compared with the blank group,the serum IL-1??IL-6?TNF-?of the model group were significantly increased?P<0.01?,Compared with the model group,the indexes of the treatment group were all decreased?P<0.01?.The reduction was most obvious in“QiangGanXiaoZhi”decoction in high dose combine with acupoint embedding?P<0.01??5?Western bolt detection:Comparison with the black group,IKK?Nf-kBP65?IL-1??IL-6 of the model group significantly increased?P<0.01?,comparison with the model groups whereas the index decreased significantly in all the intervention?P<0.01 or P<0.05?,in which“QiangGanXiaoZhi”decoction in high dose combine with acupoint embedding decreased more significantly?P<0.01?.Conclutions:“QiangGanXiaoZhi”decoction combine with acupoint embedding therapy is significant for the clinical efficacy of NASH patients.“QiangGanXiaoZhi”decoctioncombinewithacupoint embedding therapy can improve clinical symptoms,liver function,blood fat,liver?KPA?,fat attenuation degree of hardness value in the treatment of NASH,There were no side effects and adverse events occurring during theprocess.Throughanimalexperiments,itwasshownthat“QiangGanXiaoZhi”decoction in high dose combine with acupoint embedding therapy can Improve the fatty degeneration of liver tissue in NASH rats and promote fat metabolism in rats.By regulating the IKK/Nf-kB signaling pathway,inhibiting lipid peroxidation and reducing the expression of inflammatory cytokines can help to repair and protect the liver.