Treatment and prevention of diabetes complicated with non-alcoholic fatty liver disease by integrated traditional Chinese and Western medicine

Today’s social economy and science and technology levels are developing rapidly.Type 2 diabetes mellitus(T2DM)is increasing in incidence,and T2DM promotes non-alcoholic fatty liver disease(NAFLD)through some mechanisms.The pathogenesis of T2DM and NAFLD is interconnected,interacted with,and promoted.While increasing the economic burden on patients,it also affects the quality and life of patients themselves.In the world,the current treatment methods include exercise and diet control,drugs(including sugar reduction,lipid-lowering drugs,etc.),weight loss surgery,etc.,but currently,researching drugs can only control the progress of the disease.At present,there is no drug for T2DM combined with NAFLD treatment.Therefore,it is necessary to find and study effective drugs for NAFLD.Based on the principle of“syndrome differentiation,”traditional Chinese medicine(TCM)played an important role in treating this disease.The theory of TCM believes that the cause of NAFLD is mostly diet disorders and imbalances in daily life,leading to liver Qi stagnation,spleen dysfunction,and liver and kidney deficiency,producing phlegm and stasis.During the treatment process,we must pay attention to the goal of phlegm turbidity,but also pay attention to the source of phlegm turbidity,strengthen the spleen and stomach,nourish the liver and kidney,and restore the physiological function of the body.The ingredients of Chinese medicine extracts have the effects of antagonist oxidation stress,protecting liver cells,improving fibrous soluble systems,and promoting lipid metabolism,thereby reducing inflammatory factors to release damage to liver cells.By combining the diagnosis of TCM syndromes with Western medical disease diagnosis,the model of disease diagnosis combined with syndrome differentiation can compensate for some of the limitations of TCM’s sole reliance on syndrome differentiation,allowing for a better grasp of the disease.In treatment,a dual approach using traditional Chinese and Western medicine can enhance efficacy and reduce toxicity,leveraging both complementary strengths.Chinese medicine explains its treatment of NAFLD from a macro and micro level,providing a safer and more effective method for treating the disease.

Research progress of external therapies of traditional Chinese medicine in the treatment of non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease(NAFLD)is a common chronic liver disease characterized by diffuse hepatic steatosis.With the improvement of people's living standard,the incidence rate of NAFLD has been increasing,which has become one of the global health problems in 21st Century.However,there is no specific drug or standard treatment for NAFLD,which brings challenges to treatment.Acupuncture,moxibustion,massage and other external therapies based on the characteristics of traditional Chinese medicine have obvious curative effect in the clinical treatment of NAFLD,but the mechanism has not been systematically explained,which makes the clinical promotion evidence insufficient.This paper aims to summarize the researches on the treatment of NAFLD by external therapies of traditional Chinese medicine in recent years,and analyze its possible mechanism,so as to provide a scientific theoretical basis for future basic experiments and clinical research,and form a set of standardized clinical diagnosis and treatment scheme with the characteristics of traditional Chinese medicine.

Reversal of non-alcoholic fatty liver disease complicated with cirrhosis by traditional Chinese medicine:a case report and experience

Non-alcoholic fatty liver disease(NAFLD)has become the world’s most common chronic liver disease and is considered one of the main causes of occult liver cirrhosis.To date,major guidelines in China and abroad have not recommended any drugs with precise efficacy and safety for NAFLD,especially for NAFLD-related liver fibrosis or cirrhosis,which lack effective drugs.Traditional Chinese medicine has significant curative effects and advantages in preventing and treating NAFLD.We retrospectively analyzed a case of liver cirrhosis due to NAFLD that was treated solely with traditional Chinese medicine for nearly one year at the Diagnosis and Treatment Center of Advantage Specific Diseases for Fatty Liver in our hospital to provide a reference for the prevention and treatment of non-alcoholic liver fibrosis and liver cirrhosis by traditional Chinese medicine.

Treatment for non-alcoholic steatohepatitis with type 2 diabetes by traditional Chinese medicine:a case report and experience

Non-alcoholic fatty liver disease and type 2 diabetes are common comorbidities or target organ damage,which can lead to adverse metabolism and increased risk of cardiovascular and cerebrovascular diseases.In the management plan of non-alcoholic fatty liver disease and type 2 diabetes,there is no drug with significant efficacy or both.The dialectical idea of traditional Chinese medicine has a good curative effect and significant advantages in treating metabolic disorders.The author now reviewed a case of non-alcoholic steatohepatitis combined with type 2 diabetes.In this case,the method of invigorating the spleen and eliminating turbidity was effective,which effectively prevented the progression of liver disease in the patient,and T2DM was alleviated by maintaining within the standard range after the use of insulin was stopped.It can be said that“killing two birds with one stone”,more fully reflects the advantages of traditional Chinese medicine in the integrated treatment of metabolic-related diseases.

Advances in traditional Chinese medicine for liver disease therapy in 2020

Liver diseases are gradually becoming a serious threat to human health worldwide.Although a number of medications have been introduced for the prophylaxis,diagnosis,and treatment of liver diseases,several limitations and challenges remain.Traditional Chinese medicine is frequently used to treat liver diseases and well known to protect hepatocytes and inhibit inflammation,oxidative stress,and fibrosis.However,given the complex composition of traditional Chinese medicine,clarifying the mechanisms behind its curative and protective effects is difficult.In this review,research progress on traditional Chinese medicine for the treatment of liver diseases in 2020 is summarized on the basis of the literature available in the PubMed database.Herbal extracts derived from traditional Chinese medicine,including flavonoids,polysaccharides,saponins,and alkaloids,and Chinese medicinal formulas,such as the classic decoctions Chaihu Shugan powder,Linggui Zhugan decoction,and Huanglian Jiedu decoction,have shown promising therapeutic efficacy in liver disease treatment.We summarized the findings of several studies on the active ingredients of traditional Chinese herbs used for liver disease treatment in 2020,focusing mainly on their ability to confer antiviral effects to treat hepatitis,regulate antioxidant levels and apoptosis to treat liver injury,inhibit inflammation and improve dysfunctions in amino acids and energy metabolism to treat alcoholic liver disease,reduce hepatic lipid deposition to treat nonalcoholic fatty liver disease,promote activated hepatic stellate cells to treat liver fibrosis,inhibit the proliferation or promote the apoptosis of liver cancer cells to treat hepatocellular carcinoma,and improve bile acid metabolism to treat cholestasis.

Regulatory effect of a Chinese herbal medicine formula on nonalcoholic fatty liver disease

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)has become a major cause of chronic liver disease.The Chinese herbal medicine(CHM)Dachaihu decoction(DCHD)has been proved to treat NAFLD with good efficacy in previous studies.Based on the TCM principle of formula formation,we divided DCHD into soothing liver part,invigorating spleen part,and dredging intestine part.Marshall officially proposed the concept of“intestinal-hepatic axis”,which systematically explains the interactions between the intestine and liver.We hypothesized that the effect of CHM on NAFLD is achieved by regulating the liver and intestine.Thus,we aimed to investigate the possible effect of a CHM formula on NAFLD in a rat model.AIM To investigate the effects of a CHM formula(a decoction of Chinese thorowax root,scutellaria root,and white peony root)on NAFLD and its regulatory effect on the“intestinal-liver”axis.METHODS Sixty rats were randomly divided into control,model,pioglitazone hydrochloride(PH),and CHM(a decoction of Chinese thorowax root,scutellaria root,and white peony root)groups.An NAFLD rat model was established using a high-fat highfructose diet for 16 wk.From the 13th week,rats were administered with PH or a decoction of Chinese thorowax,scutellaria,and white peony root(CHM group)for 4 wk.Rats in the control group and model group were administered with an equal volume of distilled water.At the end of the study,blood was collected via the abdominal aorta.Liver tissues were harvested and any morphological changes were observed by hematoxylin-eosin(HE)staining,Oil red O staining,and Masson staining.In addition,blood lipids,liver function markers,and triglyceride(TG)in liver tissues were analyzed.The levels of transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),Toll-like receptor-4(TLR4),and nuclear factor-kappa B(NF-кB)in liver tissues and secreted immunoglobulin A(sIgA)in intestinal tissues were analyzed by ELISA,and protein and mRNA expression of occludin and zonula occludens-1(ZO-1)in the intestine were measured using Western blot and reverse transcriptionquantitative polymerase chain reaction,respectively.The endotoxin level in plasma was detected by endpoint chromogenic assay.RESULTS Compared to the normal control group,the liver coefficient,serum TG,total cholesterol(TC),low density lipoprotein(LDL),aspartate aminotransferase(AST),and alanine aminotransferase(ALT),blood glucose,plasma endotoxin,and the levels of TG,TNF-α,TGF-β,NF-kB,and TLR4 in liver tissues increased significantly in the model group,while serum high density lipoprotein(HDL),intestinal sIgA,and protein and mRNA expression of occludin and ZO-1 decreased significantly in the model group(P<0.01).PH and CHM attenuated the elevated liver coefficient,serum TG,TC,LDL,AST,and ALT,blood glucose,plasma endotoxin,and the levels of TG,TNF-α,TGF-β,NF-kB,and TLR4 in liver tissues and increased serum HDL levels compared to the model group(P<0.01).Intestinal sIgA and the protein and mRNA expression of intestinal occludin and ZO-1 were significantly increased in the PH group compared to the model and CHM groups(P<0.01).CONCLUSION The decoction of Chinese thorowax root,scutellaria root,and white peony root is beneficial in regulating lipid metabolism and liver function,which indicates that it has a good effect on the liver.To a certain extent,this CHM formula can affect both the liver and intestine,while its effect on the liver is superior to that on the intestine.

Chinese medicine formulas for nonalcoholic fatty liver disease: Overview of systematic reviews

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)affects more than one-quarter of the global population.Due to the lack of approved chemical agents,many patients seek treatment from traditional Chinese medicine(TCM)formulas.A variety of systematic reviews have been published regarding the effectiveness and safety of TCM formulas for NAFLD.AIM To critically appraise available systematic reviews and sort out the high-quality evidence on TCM formulas for the management of NAFLD.METHODS Seven databases were systematically searched from their inception to 28 February 2020.The search terms included“non-alcoholic fatty liver disease,”“Chinese medicines,”“systematic review,”and their synonyms.Systematic reviews involving TCM formulas alone or in combination with conventional medications were included.The methodological quality and risk of bias of eligible systematic reviews were evaluated by using A Measure Tool to Assess Systematic Reviews 2(AMSTAR 2)and Risk of Bias in Systematic Review(ROBIS).The quality of outcomes was assessed by the Grading of Recommendations Assessment,Development and Evaluation(GRADE)system.RESULTS Seven systematic reviews were ultimately included.All systematic reviews were conducted based on randomized controlled trials and published in the last decade.According to the AMSTAR 2 tool,one systematic review was judged as having a moderate confidence level,whereas the other studies were rated as having a low or extremely low level of confidence.The ROBIS tool showed that the included systematic reviews all had a high risk of bias due to insufficient consideration of identified concerns.According to the GRADE system,only two outcomes were determined as high quality;namely,TCM formulas with the HuoXueHuaYu principle were better than conventional medications in ultrasound improvement,and TCM formulas were superior to antioxidants in alanine aminotransferase normalization.Other outcomes were downgraded to lower levels,mainly because of heterogeneity among studies,not meeting optimal information sample size,and inclusion of excessive numbers of small sample studies.Nevertheless,the evidence quality of extracted outcomes should be further downgraded when applying to clinical practice due to indirectness.CONCLUSION The quality of available systematic reviews was not satisfactory.Researchers should avoid repeatedly conducting systematic reviews in this area and focus on designing rigorous randomized controlled trials to support TCM formula applications.

Herbal medicines and nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease(NAFLD), which is characterized by excessive fat accumulation in the liver of patients who consume little or no alcohol, becomes increasingly common with rapid economic development. Long-term excess fat accumulation leads to NAFLD and represents a global health problem with no effective therapeutic approach. NAFLD is considered to be a series of complex, multifaceted pathological processes involving oxidative stress, inflammation, apoptosis, and metabolism. Over the past decades, herbal medicines have garnered growing attention as potential therapeutic agents to prevent and treat NAFLD, due to their high efficacy and low risk of side effects. In this review, we evaluate the use of herbal medicines(including traditional Chinese herbal formulas, crude extracts from medicinal plants, and pure natural products) to treat NAFLD. These herbal medicines are natural resources that can inform innovative drug research and the development of treatments for NAFLD in the future.

Enhancing Clinical Efficacy through the Gut Microbiota: A New Field of Traditional Chinese Medicine

Traditional Chinese medicines (TCMs) have a long history of playing a vital role in disease prevention, symptom alleviation, and health improvement. However, their complex ingredients and as-yetunknown mechanisms restrict their application. With increasing evidence indicating that the gut microbiota is important in host health and may be associated with the therapeutic activity of TCM components, it may now be possible to assess the effects of TCMs from the perspective of the gut microbiota. The gut microbiota functions within four major physiological pathways as follows: It participates in host metabolism, forms global immunity, maintains homeostasis of the gastrointestinal tract, and affects brain function and host behavior. This article reviews the reported correlations between TCMs and certain diseases, such as chronic liver disease, ulcerative colitis, obesity, and type 2 diabetes, and elucidates the underlying mechanisms, with a focus on changes in the gut microbiota. In future, further studies are required with more advanced experimental design in order to reveal the interactions between TCMs and the gut microbiota, and provide new insight into and guidance for TCM-based drug discovery.

Effects of Qushi Kaiyu decoction on lipid metabolism and inflammatory factors in non-alcoholic fatty liver disease rats

Objective:To examine the therapeutic effects of the Traditional Chinese Medicine Qushi Kaiyu decoction on Non-alcoholic fatty liver disease(NAFLD)rats and relevant mechanisms.Methods:A NAFLD rat model was constructed in this study using a high-fat diet,and different Qushi Kaiyu decoction doses were administered by gavage.The body weight,liver index,and blood lipid biochemical markers(TG,Total cholesterol(TC),LDL,and HDL)in different groups were examined.Simultaneously,HE staining and oil red O staining were carried out on liver tissues to study histopathological changes in liver tissues of NAFLD rats after Qushi Kaiyu decoction intervention.ELISA was used to measure serum levels of inflammatory factors(IL-1β,IL-6,TNF-α)in various groups and to preliminarily study the effector mechanisms of how Qushi Kaiyu decoction alleviates NAFLD.Results:Qushi Kaiyu decoction can significantly decrease the body weight and liver index of NAFLD rats,decreases serum TG,TC,and LDL levels,and increases HDL levels.HE staining and oil red O staining showed that Qushi Kaiyu decoction could improve steatosis in NAFLD rat liver tissues and decrease lipid content.Additionally,ELISA results showed that the Qushi Kaiyu decoction could significantly reduce the serum levels of inflammatory factors(IL-1β,IL-6,TNF-α)in NAFLD rats.Conclusion:The Qushi Kaiyu decoction shows significant therapeutic efficacy in NAFLD,and its effector mechanism may be related to the alleviation of inflammatory responses.

Colon hydrotherapy plus Traditional Chinese Medicine to treat non-alcoholic fatty liver disease:a pilot study

OBJECTIVE: To demonstrate the potential to treat non-alcoholic fatty liver disease(NAFLD) with colon hydrotherapy(CHT) plus Traditional Chinese Medicine(TCM).METHODS: A total of 20 patients were enrolled into the study and received CHT with TCM for 2 weeks.Body mass index(BMI) and levels of serum triglycerides(TG) and total cholesterol(TC) were compared between pre-treatment and post-treatment.RESULTS: Two-week treatment with CHT plus TCM significantly lowered BMI and reduced blood lipids.BMI decreased from 29.5 ± 4.3 to 25.4 ± 1.0, while mean TG levels decreased by 0.70 mmol/L on average from baseline and mean TC levels decreased by0.37 mmol/L. Forty-five percent of patients exhibited TC decreasing by more than 10% from baseline and25%ofpatientsexhibited TCdecreasingbymore than 20%. Sixty percent of patients exhibited TG decreasing by more than 20% and 20% of patients exhibited TG decreasing by more than 40%. However,high-density and low-density lipoprotein cholester-ol levels did not change significantly after intervention. No serious adverse events were reported.CONCLUSION: Our findings suggest that CHT plus TCM to treat NAFLD is promising and it might be a new treatment strategy for management of NAFLD.

Efficacy of Sea Buckthorn Therapy in Patients with Nonalcoholic Fatty Liver Disease

Aim: To evaluate the clinical efficacy of the traditional Chinese medicine sea buckthorn (SBT) in the treatment of patients with nonalcoholic fatty liver disease (NAFLD). Method: 94 patients with NAFLD were randomly divided into two groups: 48 cases of patients received oral sea buckthorn 1.5 g (3 times a day) for three months as the treated group, and 46 cases received only the vehicle for three months as the control group. Serum lipids, transaminase and serum liver fibrosis indices were assessed at baseline and after SBT treatment. All patients underwent liver CT and Fibroscan examination at baseline and after treatment. Results: SBT treatment resulted in a significant decrease in the serum levels of alanine aminotransferase (ALT), LDL-C, hyaluronic acid and collagen type IV. The liver stiffness measurement (LSM) of the treated patients was significantly lower than that in the control or baseline. The CT liver/spleen ratio of the treated patients was also significantly increased. Conclusion: The results of our study demonstrated the beneficial effects of SBT on serum lipids, transaminase, and liver/spleen ratio and liver stiffness in patients with NAFLD, which may be further developed as a promising therapy for the treatment of NAFLD.

Intestinal Microecology:An Important Target for Chinese Medicine Treatment of Non-alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease(NAFLD)has become one of the most common chronic liver diseases worldwide,causing serious economic and medical burdens.Currently,Chinese medicine(CM)has become an important means in treating NAFLD in China.Intestinal microecology(IM)is an important part of the internal environment in the human body and is involved in the occurrence and development of NAFLD.In this paper,the authors systematically discuss the significance of IM in the pathogenesis of NAFLD and the current status of research on the CM treatment of NAFLD via IM regulation.In combination with our own research practice,we propose that IM is an important target for the treatment of NAFLD with CM and formulate plans for future research to target limitations existing in current studies.

Exploring the effect of Radix Bupleuri(Bupleurum chinense DC)on nonalcoholic fatty liver disease based on network pharmacology

Objective:To investigate the main effects of Radix Bupleuri(Chinese name called Chai Hu)in the prevention and improvement of nonalcoholic fatty liver disease using network pharmacology techniques.Methods:We used theTraditional Chinese Medicine Systematic Pharmacologydatabase to query the main active ingredients of Radix Bupleuri;used theDisGenet database,Treatment Target Database,and DrugBank Database to screen the targets of nonalcoholic fatty liver disease;used the matchingtraditional Chinese medicine-disease targets to build the traditional Chinese medicine-component-target network system using Cytoscape software;used STRING software to build the protein protein interactionsystem and visualized the data;DAVID database was used forgene ontologyfunctional enrichment study andKyoto Encyclopedia of Genes and Genomespathway study.Results:Twelve major functional components and 175 targets have been obtained for the prevention and alleviation of nonalcoholic fatty liver disease in Radix Bupleuri;network pharmacology also confirmed the maximum degree value of kaempferol,the main active component of Radix Bupleuri;geneontologyfunctional enrichment analysis obtained the top 10 entries ofbiological process,cellular component,molecular functionand Kyoto Encyclopedia of Genes and Genomespathway analysis obtained the top 30 entries of the signalling pathway.Conclusion:Radix Bupleuri may use Fluid shear stress and atherosclerosis,Cancer,Advanced glycation end-(receptor of advanced glycation,interleukin 17,Hepatitis B,Toxoplasmosis,Relaxin,andtumor necrosis factorsignalling pathway to regulate the inflammatory response of interleukin6,tumor necrosis factor,and prostaglandin endoperoxide synthase2targets and reduce extracellular matrix deposition to improve the therapeutic effect of Nonalcoholic fatty liver disease.And the active ingredient of traditional Chinese medicine Radix Bupleuri,kaempferol,may also play a significant role in this.

Lingguizhugan Decoction, a Chinese herbal formula, improves insulin resistance in overweight/obese subjects with non-alcoholic fatty liver disease: a translational approach

Lingguizhugan Decoction(LGZG)has been investigated in basic studies,with satisfactory effects on insulin resistance in non-alcoholic fatty liver disease(NAFLD).This translational approach aimed to explore the effect and underlying mechanism of LGZG in clinical setting.A randomized,double-blinded,placebo-controlled trial was performed.A total of 243 eligible participants with NAFLD were equally allocated to receive LGZG(two groups:standard dose and low dose)or placebo for 12 weeks on the basis of lifestyle modifications.The primary efficacy variable was homeostasis model assessment of insulin resistance(HOMA-IR).Analyses were performed in two populations in accordance with body mass index(BMI;overweight/obese,BMI 24 kg/m^(2);lean,BMI<24 kg/m^(2)).For overweight/obese participants,low-dose LGZG significantly decreased their HOMA-IR level compared with placebo(0.19(1.47)versus 0.08(1.99),P=0.038).For lean subjects,neither dose of LGZG showed a superior effect compared with placebo.Methylated DNA immunoprecipitation sequencing and real-time qPCR found that the DNA N6-methyladenine modification levels of protein phosphatase 1 regulatory subunit 3A(PPP1R3A)and autophagy related 3(ATG3)significantly increased after LGZG intervention in overweight/obese population.Low-dose LGZG effectively improved insulin resistance in overweight/obese subjects with NAFLD.The underlying mechanism may be related to the regulation of DNA N6-methyladenine modification of PPP1R3A and ATG3.Lean subjects may not be a targeted population for LGZG.

Yunpi Qushi Jiangzhuo Recipe Alleviates Lipid Deposition and Reduces Liver Damage in Mice with Non-alcoholic Fatty Liver Disease

Background:Non-alcoholic fatty liver disease(NAFLD)is a multifactorial liver metabolic disease,which af-fects nearly a quarter of the world’s population.Yunpi Qushi Jiangzhuo Recipe(QSJZR)is a traditional Chi-nese medicine compound,which is composed of Amomum kravanh Pierre ex Gagnep,Coix lacryma-jobi L.var.ma-yuen(Roman.)Stapf,Prunus armeniac a L.var.ansu Maxim,Salvia miltiorrhiza Bge,Nelumbo nucifera Gaertn,Alisma plantago-aquatica Linn,Polyporus umbellatus(Pers.)Fries,Poria cocos(Schw.)Wolf,and Artemisia capillaris Thunb.QSJZR has a certain therapeutic effect on NAFLD patients,but its specific mechanism is not clear.Objective:To investigate the effect of QSJZR on high-fat diet(HFD)-fed NAFLD mice and its mechanism.Methods:Twenty-four SPF female C57BL/6 J mice(21.0±0.5 g)were randomly divided into normal diet(ND)group,HFD group and QSJZR group.ND group was given basal diet,while the other two groups were given HFD.Meanwhile,each mouse in QSJZR group was given 0.2 mL/day(containing 2.27 g crude drug per mL)QSJZR,ND group and HFD group were given the same amount of normal saline for 13 consecutive weeks.Then,the serum was collected for biochemical assay,and the liver was removed for pathological examination and biochemical analysis.Results:Body weight and white fat weight of the HFD-induced NAFLD mice significantly decreased after min-istration with QSJZR,while liver weight had no significant change.QSJZR also significantly reduced liver and serum triglyceride levels,and alleviated hepatocyte lipid deposition by regulating genes and proteins expression related to lipid metabolism,including AMPK,SREBP1C,CPT1A and ACC.In addition,compared with HFD group,liver malondialdehyde(MDA)content was lower in QSJZR group,while glutathione peroxidase(GPx)content was higher.Serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels were lower in QSJZR group than those in HFD group.Treatment with QSJZR significantly alleviated liver injury by increasing BCL2/BAX protein ratio and down-regulating ASK1/JNK pathway.Conclusion:Administration of QSJZR to NAFLD mice once daily for 13 weeks can decrease lipid levels,and alleviate liver damage.These results suggest that QSJZR might be used to treat NAFLD,although more studies need to be conducted for further verification.

Mesenchymal stem cells: A promising therapeutic avenue for nonalcoholic fatty liver disease

Non-alcoholic fatty liver disease(NAFLD)is a pressing global health concern that is associated with metabolic syndrome and obesity.On the basis of the insights provided by Jiang et al,this editorial presents an exploration of the potential of mesenchymal stem cells(MSCs)for NAFLD treatment.MSCs have numerous desirable characteristics,including immunomodulation,anti-inflammatory pro-perties,and tissue regeneration promotion,rendering them attractive candidates for NAFLD treatment.Recent preclinical and early clinical studies have high-lighted the efficacy of MSCs in improving liver function and reducing disease severity in NAFLD models.However,MSC heterogeneity,long-term safety concerns,and unoptimized therapeutic protocols remain substantial challenges.Addressing these challenges through standardized protocols and rigorous clinical trials is essential to the safe and successful application of MSCs in NAFLD mana-gement.Continued research into MSC mechanisms and therapeutic optimization is required to improve treatments for NAFLD and related liver diseases.

Treatment of Non-alcoholic Fatty Liver Disease by Qianggan Capsule(强肝胶囊)

Objective： To observe the therapeutic effect and safety of Qianggan Capsule （强肝胶囊, QGC） in treating non-alcoholic fatty liver disease （NAFLD）, using potyene phosphatidylcholine capsule （PPC） as a reference. Metheds： Eighty-eight patients with NAFLD were randomly assigned to two groups, 45 in the treatment group treated with QGC and 43 in the control group treated with PPC. The course of treatment tasted for 6 months. Changes in liver function, blood lipids, and iconographic indexes before and after treatment were observed, and clinical efficacy was evaluated. Results： In the treatment group, alanine aminotransferase （ALT） was towered significantly from 56.02 ± 32.59 lUlL before treatment to 38.27 ± 22.68 IU/L after treatment, and CT liver/spleen ratio significantly increased from 0.69± 0.18 to 0.91 ± 0.25, showing statistical significance （P〈0.05）; in contrast, the corresponding changes of the two indexes in the control group were 56.56 ±26.33 IU/L to 49.67 ± 26.22 IU/L, and 0.66± 0.20 to 0.75 ± 0.24, respectively, the pre-post treatment difference showing insignificant difference （P〉0.05）. No severe adverse reactions occurred during the whole treatment course. Conclusion： QGC is an effective and safe remedy for the treatment of NAFLD.

Effect of Sinai San decoction on the development of non-alcoholic steatohepatitis in rats

AIM: To explore the effect of Sinai san decoction on the development of non-alcoholic steatohepatitis induced by CCL4 combined with a fat-rich diet in rats.METHODS: Twenty-seven Sprague-Dawley rats were divided into three groups randomly: control group (n = 9),model group (n = 9) and treatment group (n = 9). The rats of model group and treatment group were given small dosage of CCL4 combined with a fat-rich diet, andthose of control group were given normal diet. After four weeks of fat-rich diet feeding, the rats of treatment group were given Sinai san decoction. The serum levels of aminotransferase and lipid were measured, and the pathology of livers was observed by HE staining after the rats were sacrificed at eight weeks.RESULTS: The rats' livers presented the pathology of steatosis and inflammation with higher serum levels of ALT and AST in the model group. In the treatment group the serum ALT and AST levels decreased significantly and were close to the control group. The hepatic inflammation scores also decreased markedly, but were still higher than those of control group. And the degree of hepatocyte steatosis was similar to that of model group.CONCLUSION: Sinai san decoction may ameliorate the hepatic inflammation of rats with steatohepatitis induced by small dosage of CCL4 combined with a fat-rich diet,but does not prevent the development of hepatocyte steatosis.