Observation On The Curative Effect Of Adding Or Subtracting Zishui Qinggan Yin In Treating Non-alcoholic Steatohepatitis

Objective: The purpose of this paper is to investigate the clinical efficacy and safety of the treatment of non-alcoholic steatohepatitis(NASH)with liver and kidney yin deficiency and turbid toxicity,and to provide a theoretical basis and practical basis for the treatment of NASH in Chinese medicine.Methods: Sixty patients who met the criteria of liver and kidney yin deficiency and turbid toxicity internalization type NASH were included,and they were randomly divided into the control group and the observation group.The control group was treated orally with silymarin capsules,and the observation group was treated with Chinese herbal medicine with the addition and subtraction of Zhishui Qinggan Yin.The efficacy of the patients’ TCM clinical symptoms,serum biochemical indexes(liver function indexes,blood lipids,blood glucose and uric acid),controlled attenuation parameters(CAP)by liver transient elastography and abdominal ultrasound were observed before and after treatment for 12 weeks,and the results were analyzed.Results: 1.Comparison of the efficacy and total points of TCM symptoms:the efficiency of TCM symptoms treatment reached 86.78% in the observation group and 73.33% in the control group,and both groups showed improvement in symptoms points compared with those before treatment,with significant differences(P<0.01).The difference was statistically significant(P<0.05);the observation group had a more significant improvement in the evidence points after treatment(P<0.05).2.Comparison of weight and BMI: After treatment,weight and BMI decre ased in both groups compared with before,with significant differences(P<0.01),and the decrease was more significant in the observation group,with significant differences(P<0.01).3.Comparison of liver function indexes(ALT,AST,GGT): the indexes o f both groups decreased compared with those before treatment,with signif icant differences(P<0.01);the decrease was more obvious in the observa tion group,with statistically significant differences(P<0.05 or P<0.01).4.Comparison of lipids,blood glucose and uric acid: after treatment,TG,TC and GLU decreased and HDL-C increased in both groups compared with before,with significant differences(P < 0.01);TG,TC and GLU decreased more significantly and HDL-C increased more significantly in the observation group,with statistically significant differences(P<0.01).The treatment regimens in both groups did not improve UA significantly,and the differences were not statistically significant(P>0.05).5.Improvement of liver ultrasound and CAP value: After treatment,the liver ultrasound images of both groups improved compared with the previous ones,with an efficiency of 80.00% in the observation group and 50.00% in the control group;the CAP measurement values of both groups decreased compared with the previous ones after treatment,and the difference was significant(P<0.01).In the observation group,the liver ultrasound images improved more significantly(P<0.05)and the CAP values decreased more significantly(P<0.01).Conclusion:The treatment of liver-kidney yin deficiency and turbid toxin internalization type NASH with the addition and subtraction of Zishui Qinggan Yin has better efficacy in improving patients’ TCM symptoms,liver ultrasound and CAP values,weight and BMI,liver function index,blood lipids and blood glucose,and is worthy of clinical promotion and application.