Cirrhosis is associated with debilitating complications that significantly impact on a patient’s physical function and reduce quality of life.Owing to highly prevalent sarcopenia,malnutrition and hepatic encephalopat...Cirrhosis is associated with debilitating complications that significantly impact on a patient’s physical function and reduce quality of life.Owing to highly prevalent sarcopenia,malnutrition and hepatic encephalopathy,functional impairment or frailty is a common complication of cirrhosis.Frailty in turn increases the patient’s risk of hospitalization,accidental falls and fractures,and death.The management of frailty and its associated adverse effects is imperative in improving the overall prognosis of patients with advanced liver disease.The cornerstone of therapy revolves around optimizing physical function with appropriate nutrition and exercise.Nutritional therapy with protein supplementation has shown significant benefit,while studies on exercise have been controversial.However,newly emerging studies trend towards a beneficial effect of physical exercise with improvement in quality of life.The implementation of technology in liver disease management shows future promise.Fitbits and other wearable devices can be used to help monitor a patient’s personal progress in physical exercise and nutritional optimization.Additionally,the progressive development of new smartphone applications to help aid in the diagnosis and monitoring of complications of cirrhosis provides a sophisticated avenue for improving care of patients with cirrhosis.展开更多
Objective： To observe the clinical effects of acupoint thread-embedding method for non-alcoholic fatty liver disease （NAFLD） in pattern of liver qi stagnation and spleen deficiency. Methods： A total of 180 cases i...Objective： To observe the clinical effects of acupoint thread-embedding method for non-alcoholic fatty liver disease （NAFLD） in pattern of liver qi stagnation and spleen deficiency. Methods： A total of 180 cases in conformity with the diagnostic criteria of NAFLD in pattern of liver qi stagnation and spleen deficiency were randomly divided into a treatment group and a control group, 90 cases in each group, and finally 88 cases in the treatment group and 90 cases in the control group were recruited for statistics. The treatment group was managed by acupoint thread-embedding method, and the control group was treated by oral administration of Polyene Phosphatidylcholine capsules. Both groups were treated for 6 months. Before and after the treatment, liver enzymology, blood fat test, abdominal B ultrasonic examination, and assessment of clinical effects were respectively processed. Results： After treatment, alanine transaminase （ALT）, aspartate transaminase （AST）, total cholesterol （TC）, and triglyceride （TG） decreased in the treatment group, and were significantly different from those in the control group after treatment （all P〈0.05）. There was no statistically significant inter-group difference in the degree of fatty liver （by B ultrasound examination） before treatment （P〉0.05）. After treatment, the improvement degree of fatty liver in the treatment group was more significant than that in the control group （P〈0.05）. The total effective rates were 89.8% in the treatment group and 76.7% in the control group, with a statistically significant difference between the two groups （P〈0.05）. Conclusion： The acupoint thread-embedding method can reduce the levels of ALT, AST, TC and TG in NAFLD patients, and can improve the pathologic degree of fatty liver and its clinical effects are remarkably better than that of oral medications.展开更多
基金funding from the National Institutes of Health through an institutional Harvard Trauma Inflammation T32 educational training grant(4T32GM103702–04)Elliot B.Tapper receives funding from the National Institutes of Health through the Michigan Institute for Clinical and Health Research(KL2TR002241).
文摘Cirrhosis is associated with debilitating complications that significantly impact on a patient’s physical function and reduce quality of life.Owing to highly prevalent sarcopenia,malnutrition and hepatic encephalopathy,functional impairment or frailty is a common complication of cirrhosis.Frailty in turn increases the patient’s risk of hospitalization,accidental falls and fractures,and death.The management of frailty and its associated adverse effects is imperative in improving the overall prognosis of patients with advanced liver disease.The cornerstone of therapy revolves around optimizing physical function with appropriate nutrition and exercise.Nutritional therapy with protein supplementation has shown significant benefit,while studies on exercise have been controversial.However,newly emerging studies trend towards a beneficial effect of physical exercise with improvement in quality of life.The implementation of technology in liver disease management shows future promise.Fitbits and other wearable devices can be used to help monitor a patient’s personal progress in physical exercise and nutritional optimization.Additionally,the progressive development of new smartphone applications to help aid in the diagnosis and monitoring of complications of cirrhosis provides a sophisticated avenue for improving care of patients with cirrhosis.
基金supported by Zhejiang Provincial Science and Technology Plan Project of Traditional Chinese Medicine(No.2012ZB126)~~
文摘Objective： To observe the clinical effects of acupoint thread-embedding method for non-alcoholic fatty liver disease （NAFLD） in pattern of liver qi stagnation and spleen deficiency. Methods： A total of 180 cases in conformity with the diagnostic criteria of NAFLD in pattern of liver qi stagnation and spleen deficiency were randomly divided into a treatment group and a control group, 90 cases in each group, and finally 88 cases in the treatment group and 90 cases in the control group were recruited for statistics. The treatment group was managed by acupoint thread-embedding method, and the control group was treated by oral administration of Polyene Phosphatidylcholine capsules. Both groups were treated for 6 months. Before and after the treatment, liver enzymology, blood fat test, abdominal B ultrasonic examination, and assessment of clinical effects were respectively processed. Results： After treatment, alanine transaminase （ALT）, aspartate transaminase （AST）, total cholesterol （TC）, and triglyceride （TG） decreased in the treatment group, and were significantly different from those in the control group after treatment （all P〈0.05）. There was no statistically significant inter-group difference in the degree of fatty liver （by B ultrasound examination） before treatment （P〉0.05）. After treatment, the improvement degree of fatty liver in the treatment group was more significant than that in the control group （P〈0.05）. The total effective rates were 89.8% in the treatment group and 76.7% in the control group, with a statistically significant difference between the two groups （P〈0.05）. Conclusion： The acupoint thread-embedding method can reduce the levels of ALT, AST, TC and TG in NAFLD patients, and can improve the pathologic degree of fatty liver and its clinical effects are remarkably better than that of oral medications.
