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Tuesday, 3 December 2013

Cirrhosis - Treatments of Alcohol causes of Cirrhosis

Cirrhosis is defined as a condition of irreversible scarring liver as a result of liver tissue by fibrosis due to final phase of chronic liver diseases of that can lead to poor function of the liver and liver failure. According to the statistics, Number of discharges with chronic liver disease or cirrhosis as the first-listed diagnosis: 101,000 in 2009 and Deaths per 100,000 population: 10.3 in 2010(a). Hepatitis B infection cause of the disease is very prevalent in South-East Asia.
Treatments
A. Treatments of cirrhosis depend not on the underline causes and stage of the diseases
A.1. Alcohol causes of cirrhosis 
A.1.2. In conventional medicine perspective
If the the disease is caused by excessive alcohol drinking, patients will be asked to stop drinking. with help from the professional teams and certain medication. The long-term management of alcoholic liver disease stresses the following(67).
(1) Abstinence of alcohol (Grade 1A), with referral to an alcoholic rehabilitation program;
(2) Adequate nutritional support (Grade 1B), emphasizing multiple feedings and a referral to a nutritionist; (3) Routine screening in alcoholic cirrhosis to prevent complications;
(4) Timely referral to a liver transplant program for those with decompensated cirrhosis;
(5) Avoid pharmacologic therapies, as these medications have shown no benefit.
But according to the study by the Catholic University of Rome, in the intervention to achieve alcohol abstinence represents the most effective treatment for alcohol-dependent patients with liver cirrhosis by investigating the effectiveness and safety of Baclofen,  is a GABA(B) receptor agonist in achieving and maintaining alcohol abstinence in patients with liver cirrhosis, showed that baclofen is effective at promoting alcohol abstinence in alcohol-dependent patients with liver cirrhosis. The drug is well tolerated and could have an important role in treatment of these individuals(68).

A.1.2. In herbal medicine perspective 
1. Kudzu (Pueraria lobata) and St. John's Wort 
In the study to summarizes the findings of the effects on alcohol intake in alcohol-preferring rats of extracts or purified compounds from two of the most promising herbs: kudzu (Pueraria lobata) and St. John's Wort (Hypericum perforatum), a symposium presented at the 2002 RSA meeting in San Francisco. found that
(1) Introduction to the symposium, by David Y. W. Lee and David H. Overstreet; (2) Effects of daidzin on alcohol intake-search for mechanisms of action, by Wing-Ming Keung; (3) Long-term suppressive effects of puerarin on alcohol drinking in rats, by David Overstreet and David Y. W. Lee; (4) St. John's Wort extract reduces alcohol intake in FH and P rats, by Amir Rezvani and David Overstreet; and (5) extracts reduce alcohol intake in Marchigian Sardinian alcohol-preferring rats, by Maurizio Massi(69).

2. Pueraria lobata, Tabernanthe iboga, Panax ginseng, Salvia miltiorrhiza and Hypericum perforatum
In the study to  review the most relevant experimental data on the reducing effect of some medicinal herbs on voluntary alcohol intake in animal models of alcoholism, showed that Pueraria lobata, Tabernanthe iboga, Panax ginseng, Salvia miltiorrhiza and Hypericum perforatum proved to be effective in decreasing alcohol consumption. Reduction of alcohol absorption from the gastrointestinal system appears to be a common feature among most of the above plants(70).

3. Other herbs
According to the study by, A number of medicinal plants and pure natural compounds are reported to have preventive and therapeutic effects on alcoholism and alcohol dependency, but their constituents, efficacy and mechanism of action are mostly unknown so far. Recently, kudzu [Pueraria lobata (Willd.) Ohwi], St. John's wort (Hypericum perforatum L.), danshen (Salvia miltiorrhiza Bge.), ginseng (Panax ginseng C.A. Mey.), Japanese raisin tree (Hovenia dulcis Thunb.), ibogaine (Tabernanthe iboga H. Bn.), evening primrose (Oenothera biennis L.), prickly pear fruit (Opuntia ficus indica (L.) Mill.), purple passionflower (Passiflora incarnata L.), thyme (Thymus vulgaris L.), fenugreek seed (Trigonella foenum-graecum L.), ginger (Zingiber officinale Roscoe) and many others drew the attention of researchers. Can, therefore, drugs of natural origin be helpful in the treatment of alcoholism or in decreasing alcohol consumption?(71)

A.1.3. In TCM medicine perspective
Alcohol has long been used as a daily beverage in China and around the world. It is a medicinal substance with various biological activities. According to study by Peking University, in the summarized clinical and primary studies concerning various remedies of TCM for alcohol abuse, including herbal components (such as Kudzu/Pueraria Lobata, Pediculus melo, Hypericumpperforatum L.), decoctions and acupuncture(72).
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Sources
Sources
(a) http://www.cdc.gov/nchs/fastats/liverdis.htm

(67) http://www.ncbi.nlm.nih.gov/pubmed/23101981
(68) http://www.ncbi.nlm.nih.gov/pubmed/18068515
(69) http://www.ncbi.nlm.nih.gov/pubmed/12605067
(70) http://www.ncbi.nlm.nih.gov/pubmed/10930711
(71) http://www.ncbi.nlm.nih.gov/pubmed/22474979
(72) http://www.ncbi.nlm.nih.gov/pubmed/21213394