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
Obesity and Fatty liver
The prevalence of overweight and obesity are increasing in World wide,
especially in the Emerging world, as a result of recently economic
prosperity.
Obesity is defined as a medical condition of excess
body fat accumulated overtime. Overweight is a condition of
excess body weight relatively to the height. According to the Body
Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight,
while a BMI of over 30 is an indication of obesity. In US, 68% of
population are either overweight or
obese. According to the study by Department of Pediatrics, Nanjing
Maternity and Child Health Care Hospital, for age-specific subgroup
analyses, both overweight and obesity
increased more rapidly in the toddler stage than in other developmental
stages. Toddlers and urban boys were at particularly high risk; the prevalence in these groups increased more rapidly than in their counterparts(73a)).
The Obesity Society and the American Society of Hypertension agreed to jointly sponsor a position paper on obesity-related
hypertension to be published jointly in the journals of each
society(2). Other researchers suggested that in light of the worldwide
epidemic of obesity, and in recognition of hypertension as a major factor in the cardiovascular morbidity and mortality associated with obesity(73b).
Recent study showed that evidence has emerged for an association between genetic variability at the APOA5 locus and increased risk of obesity and metabolic syndrome(73c).
Fatty liver disease is defined as a condition of
accumulation of fat in the liver, including people who drink little or no
alcohol (Non alcohol fatty disease) or who are excessive alcohol drinking (Alcohol fatty liver disease). The disease can even occur after a short period of heavy drinking (acute alcoholic liver disease). More than 15 million people in the U.S. either abuse or overuse alcohol with fatty liver diseases with fat makes up 5-10 percent of liver weight.
Non-alcoholic fatty liver disease
(NAFLD) encompasses a wide spectrum of clinical conditions, actually
representing an emerging disease of great clinical interest(73).
There is no standard treatment in conventional medicine. If you are
obese, you are advised to lose weight. If excessive drinking alcohol is
the cause, you are advised to stop drinking.
Some researchers suggested that Vitamin E plus C combination treatment is a safe, inexpensive and effective treatment option in patients with fatty liver
disease, with results comparable to those obtained with ursodeoxycholic
acid(74). But some researchers suggested that Neither vitamin E nor
metformin was superior to placebo in attaining the
primary outcome of sustained reduction in ALT level in patients with
pediatric NAFLD(75).
In traditional Chinese medicine, fatty liver is associated closely to
obesity, as a result of over intake of "bad" fat and excessive alcohol
drinking. Even though fatty liver is a result of too much fat, but
trying to
eliminate all fats from the diet won't help to prevent or relieve the
disease as malnutrition can also trigger fatty liver as fat and protein
stored elsewhere in the body move to the
liver for storage and conversion to energy as needed. That's why some
women who eat almost nothing but vegetables can also develop fatty
liver(76).
Many traditional Chinese medicine practitioners believe, no way that one
can lose weight if fatty liver diseases are not cured. Syndromes of fatty liver could be typed into 4 TCM
types of the asthenia Pi-Shen with Gan-stagnation type, the asthenia
Pi-Shen type, the asthenia Pi with phlegm-heat type and the unclassified
type. Among them the asthenia Pi-Shen with Gan-stagnation type was the
commonest one, which accounted to 62.32%(77).
Dr. Liu T, and the research team at the Shanghai University of
Traditional Chinese Medicine, in the study to explore the pathogenesis
of nonalcoholic fatty liver (NAFL) in traditional Chinese medicine (TCM)
by comparing the therapeutic efficacy of methods for fortifying the
spleen and replenishing qi, warming yang and fortifying the spleen and
warming yang to move water, showed that body weight, liver and epididymal fat indexes and liver TAG level of rats all significantly increased in the model group as compared with the normal group (P<0.05). Hepatic fatty
infiltration, TAG concentration and the levels of serum TAG and ALT
were significantly decreased in the LGZG and SZ groups when compared to
those in the model group (P<0.05). Method of warming yang or moving water can promote the lipid metabolism.
It may be an effective strategy in preventing and treating NAFL by
treating with warming yang and moving water together(978
Other studies showed that Zhi Zi has a very strong inhibitory action on lipidosis and inflammatory
injury in the rat model of NAFLD. This mechanism may possibly be
related to the inhibition of the free fatty acid metabolism pathway(79).
In the study to investigate the effect of Cigu Xiaozhi pills on expression of tumor
necrosis factor alpha (TNF-alpha) in rat with nonalcoholic
steatoheptatitis (NASH), found that Cigu Xiaozhi pills can effectively treat experimental nonalcoholic
steatohepatitis in rats, and its mechanism may be associated with
ameliorating hepatocellular steatosis, removing the free radicals and
enhancing the capability of anti-oxidation and anti-inflammatory(80).
Most people with fatty liver disease are experience no symptoms at all,
but Fatty liver disease is associated with high blood pressure, heart
disease
and diabetes can, in time, cause life threatening cirrhosis of the
liver. According to the article By Donald Norfolk, "Today, as a direct
effect of the obesity plague, it's reckoned that one
in five British adults is now suffering from fatty liver disease,
unconnected with virus infections or heavy drinking. This malady, known
medically as steatosis, is believed to affect 90 per cent of morbidly
obese patients, in whom it may remain totally symptomless for many
years"(81).
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Sources
(a) http://www.cdc.gov/nchs/fastats/liverdis.htm
(73a) http://www.ncbi.nlm.nih.gov/pubmed/23284829
(73b) http://www.ncbi.nlm.nih.gov/pubmed/23282121
(73c) http://www.ncbi.nlm.nih.gov/pubmed/23279260
(73) http://www.ncbi.nlm.nih.gov/pubmed/23278163
(74) http://www.ncbi.nlm.nih.gov/pubmed/16245220
(75) http://www.ncbi.nlm.nih.gov/pubmed/21521847
(76) http://www.ncbi.nlm.nih.gov/pubmed/15768875
(77) http://live.shanghaidaily.com/column_detail.asp?type=column&id=718
(78) http://www.ncbi.nlm.nih.gov/pubmed/23073195
(79) http://www.ncbi.nlm.nih.gov/pubmed/22594108
(80) http://www.ncbi.nlm.nih.gov/pubmed/20707200
(81) http://ezinearticles.com/?Fatty-Livers:-A-Silent-Cause-of-Premature-Death&id=7065449
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