Liver fibrosis is a pathological process of abnormal proliferation of fibrous connective tissue in the liver due to persistent liver damage, it is not an independent disease, but a common pathological basis of various chronic liver diseases, and is an inevitable pathological process of chronic liver diseases developing into cirrhosis.
First, the harm of liver fibrosis
When liver fibrosis, the formation of fibrous septum in the liver will destroy the normal intrahepatic microcirculation, reduce the intrahepatic vascular network, impede the direct contact between blood flow and liver cells, affect the exchange of substances between blood and liver cells, resulting in the hepatocytes damaged by inflammation is not easy to repair or even aggravate the damage, normal liver cells are hypoxic, degeneration, necrosis, so that liver fibrosis can further develop, forming a vicious circle. In addition, liver fibrosis can obstruct the flow of hepatic blood into the hepatic veins, which can encourage and aggravate the formation of portal hypertension. Chen Lan Yu, Department of Infection, Guang’anmen Hospital, Chinese Academy of Traditional Chinese Medicine, due to impaired hepatic blood circulation, hepatocyte degeneration and necrosis, new fiber intervals are continuously generated, and if timely treatment is not obtained, liver fibrosis will eventually develop into liver cirrhosis.
Second, the patient’s life and emotional regulation
Good rest, sufficient sleep, regular life: liver fibrosis patients should ensure sufficient sleep and avoid staying up late to enhance the immunity of the body and ensure the best function of the liver.
Avoid drug abuse: the liver is the largest metabolic organ of the body, all drugs are decomposed, transformed, detoxified and metabolized in the liver, so more attention should be paid to the protection of the liver; the use of drugs must be regulated under the guidance of a specialist, the principle of using drugs is: less and more precise, to be safe and effective.
Do not drink alcohol: the main component of alcohol is ethanol, ethanol can be converted into acetaldehyde in the liver, which has a direct damaging effect on the liver, causing degeneration and necrosis of liver cells. Therefore, it is unconditional and necessary for liver fibrosis patients to abstain from alcohol.
Stay away from radiation and prohibit exposure to toxic substances: Due to the “ionizing effect” and “biological effect” of X-rays, it can cause a series of adverse reactions in human body, especially in patients with liver diseases. Toxic substances can directly damage the liver, so patients with liver fibrosis should avoid exposure to toxic and harmful substances.
Avoid overworking: Overworking causes a large amount of nutrients and oxygen consumption, resulting in a significant reduction in the liver’s energy supply, weakening the liver’s resistance to disease and damaging liver function until irreversible lesions occur. Therefore, patients with liver fibrosis should avoid overworking, and can participate in some useful physical exercises, such as tai chi, etc. The activities should not feel fatigue.
Maintain a comprehensive and adequate nutrition, prohibit partial food, avoid over-eating: daily diet, should focus on supplying high and comprehensive nutrition, easy to digest and absorb eggs, fresh milk and its products, fresh vegetables, fruits and appropriate amount of meat, should not be partial food. But do not eat too much, especially too much sugar. Because sugar food is easily converted into fat and stored in various parts of the body, of which the liver is also the focus of storage, easy to form a fatty liver and aggravate fibrosis.
Keep your bowels open: It is especially important to keep your bowels open. The inability to pass stool or stool force can make the patient’s abdominal pressure increase abdominal muscle tension increases, which will aggravate the patient’s symptoms.
Three, liver fibrosis of Chinese medicine treatment
There is no name for liver fibrosis in Chinese medicine, but its clinical symptoms can be classified as “dysthymia, bulging and accumulation” in Chinese medicine. Chinese medicine has unique advantages in the prevention and treatment of liver fibrosis, and great progress has been made in the anti-liver fibrosis treatment for all aspects of liver fibrosis, and the research on the mechanism of anti-liver fibrosis effect of Chinese medicine has been carried out in multiple directions and levels.
(1) Chinese patent medicine Fuzheng Huayu capsule After more than 20 years of unremitting efforts, three generations of Chinese medicine experts from Shanghai University of Traditional Chinese Medicine (SUTCM) took the lead in proposing the hypothesis of “Zheng deficiency and blood stasis” as the Chinese medical mechanism of liver fibrosis, and “Fuzheng Huayu” as the Chinese medical treatment method. After repeated research of “clinical – experimental – clinical again”, he finally developed the national compound Chinese medicine for liver fibrosis and the first recommended drug in China’s liver fibrosis treatment guidelines – Fu Zheng Huayu Capsules.
In October 2009, it was awarded the Shanghai Patent New Product Certificate, and in July 2009, it was awarded the National Key New Product, and in February 2009, it was awarded the Second Prize of National Science and Technology Progress Award, and in January 2009, it was awarded the Chinese Medical Technology Award, the National Natural Science Foundation and the National New Drug Foundation, and in 1998, it was awarded the First Prize of Shanghai Science and Technology Progress twice. It has become the first-line recommended drug for the clinical treatment of liver fibrosis in China, and was formally patented by the U.S. Intellectual Property Office in 2006.
Shanghai University of Traditional Chinese Medicine has recently received approval from the ethics committee of the University of California, San Diego School of Medicine to enter clinical trials for the development of Fu Zheng Hua Yu Tablets.
The trial is also being conducted by the liver disease centers of the University of California, Stanford University, the University of Texas and the University of Chicago Medical School.
Ingredients】Danshen, fermented Cordyceps powder, peach kernel, pine pollen, gynostemma, schisandra (made)
Properties】This product is a capsule, the contents of brown granules, bitter and astringent taste.
Pharmacological action】The pharmacological test showed that this product can inhibit the degree of liver fibrosis caused by carbon tetrachloride plus high-fat feed in rats, and inhibit the elevation of serum alanine amino-converting enzyme caused by carbon tetrachloride and D-galactosamine in rats. Long-term toxicity test showed that 2.30 and 0.37g/kg of this product could reduce the reticulocyte count and increase the leukocyte count in rats administered by gavage for 6 months.
Functions: Promoting blood circulation and eliminating blood stasis, benefiting essence and nourishing liver. It is used for hepatitis B liver fibrosis which is caused by “blood stasis and blood obstruction, liver and kidney have foot”. The symptoms include pain in the ribs, dull complexion, red spots, soreness of the waist and knees, fatigue and weakness, dizziness and dullness of the eyes, dark red tongue or petechiae, thin or slightly yellow coating, thin pulse.
Dosage】Take orally, 5 capsules once, 3 times a day, 24 weeks as a course of treatment.
Adverse Reactions】Sometimes there is discomfort in the stomach after taking.
Contraindications】Not to be taken by pregnant women.
Precautions】Used with caution in cases of dampness and heat.
The results of the experimental treatment of animal liver fibrosis model showed that it had a significant blocking effect on the early stage of liver fibrosis, and inhibited the proliferation of lipid storage cells, reduced collagen synthesis, decreased excessive deposition of collagen in the Diss lumen, and dissolved and absorbed the formed liver fibrosis, and also effectively inhibited the expression of liver fibrosis a2(I) mRNA. The experiment also showed that the effect of improving the phagocytosis of mouse abdominal macrophages.
From May 1998 to July 1998, a phase II clinical trial on the clinical efficacy of this product in the treatment of chronic hepatitis B liver fibrosis as well as early cirrhosis was conducted in eight hospitals, including Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Beijing You’an Hospital, Beijing Ditan Hospital, Beijing Hospital of Traditional Chinese Medicine, Tianjin Infectious Disease Hospital and Hubei Hospital of Traditional Chinese Medicine Affiliated Hospital, using a multicenter randomized double-blind principle. The results showed that 300 cases in the treatment group, with 6 months as 1 course of treatment, had a significant efficiency of 55.67%, an effective rate of 26.00% and an overall effective rate of 81.67%, which was significantly better than the control group. After statistical treatment, there was a very significant difference (P < 0.01). Among the 92 cases of early cirrhosis, the apparent efficiency was 36.96%, the effective rate was 23.91%, and the total effective rate was 60.87%, which was significantly better than the control group (P < 0.01).
Functions】Softening hardness and dispersing nodules, resolving blood stasis and detoxification, benefiting Qi and nourishing blood.
Indications】Hidden pain in the ribs or masses under the dorsal surface, dull complexion, fullness in the epigastrium, poor appetite and loose stools, fatigue, dry and bitter mouth, red wisps, vermilion palm, dark tongue or petechiae, thin yellowish greasy tongue coating, thin string pulse. It can be used for chronic hepatitis and liver fibrosis or cirrhosis with blood blockage, deficiency of qi and yin, and heat toxicity.
Dosage】Orally, take 4 tablets once, three times a day (reduce by half for children), for a period of 6 months or as prescribed by the doctor.
Indications】Chronic hepatitis with fibrosis, early cirrhosis, alcoholic hepatitis, liver fibrosis caused by hepatic steatosis, and consolidation treatment of all stages of cirrhosis.
Adverse reactions] No adverse reactions have been found [Contraindications] Pregnant women are prohibited (because this preparation contains blood activators).
Da Huang Jing Worm PillThe formula of Da Huang Jing Worm Pill started from Zhang Zhong Jing’s Jin Kui Yao of Han Dynasty, which has the effect of activating blood circulation, breaking down blood stasis, softening hardness and dispersion, clearing blood stasis, draining damp heat and detoxifying.
It can clinically improve or repair liver injury, inhibit fibroplasia and prevent liver fibrosis. It can reduce aspartate aminotransferase (AST) and ALT in animals with acute injury, increase total serum protein (TP) in animals with chronic liver injury, reduce hydroxyproline content in liver tissues, and is especially suitable for the degradation of liver fibrous tissues; it also has a certain effect on reducing portal hypertension and can reduce hypersplenism; it has a dual role in regulating the human neurohumoral system and endocrine system, and can restore the compensatory function of liver cells It can restore the compensatory function of hepatocytes, increase the blood flow of the liver, make the hepatocytes obtain relatively sufficient energy and oxygen supply, and maintain their effective physiological functions.
Main ingredients: Rhubarb, turtle worm (fried), leech (made), gadfly (remove wing and foot, fried), grub (fried), dried lacquer (calcined), peach kernel, bitter almond (fried), scutellaria baicalensis, dioscorea, white peony, licorice [Functions: Invigorate blood circulation, break up blood stasis, pass through the meridians and eliminate gangrene.
Indications】Stasis of blood within the abdomen, abdominal masses, skin nail errors, dark eyes, hot flashes and thinness, menstrual failure. It is used clinically for uterine fibroids, cerebral thrombosis, dysmenorrhea and amenorrhea, chronic pelvic inflammatory disease, cirrhosis of the liver, etc., where blood stasis is present.
Dosage】Orally, take 3g (half cap) once, 1~2 times a day 【Adverse reactions】Unspecified.
This product is based on Liu Yu Zhen old Chinese medicine 50 years of treatment of liver disease experimental prescription “dredging formula”, and after nearly 20 years of prescription screening and clinical practice, Professor Liu Mo Lin and other experts, and developed into the ideal drug for the treatment of chronic liver disease – Anluo Hua Fibers pill because the efficacy of this product has, clear heat and cool the blood, remove blood stasis, dredge the liver blood flow, reduce portal vein pressure, prevent bleeding. It can lower portal vein pressure, prevent bleeding, and play the role of “Anluo”. It also has the effect of clearing inflammatory stagnation in the liver, resisting liver fibrosis and promoting fiber degradation and absorption, which plays the role of “fibrillation”. At the same time, in long-term clinical application, the pill form has better efficacy, so it is named “Anluo Huafu Wan”.
Advantages of Anluo Huafu Wan (1) Clinical formula researched by three generations for 50 years, with good efficacy.
(2) It is the only national new drug approved by SFDA for the treatment of liver fibrosis in the middle stage of liver cirrhosis.
(3) It is classified as a “confidential medicine” by the state.
(4) Obtained national technology patent, patent protection period (exclusive production) 20 years.
(5) In 2002, it was awarded the certificate of high-tech product achievement. (6) In 2003, it was awarded the national high-tech industrialization project. (7) In addition to anti-liver fibrosis, it significantly improves liver function, especially elevates albumin, increases albumin ratio, and quickly eliminates symptoms.
(9) It has been clinically proven by a large number of patients with advanced liver disease to significantly extend their life span and improve their quality of life [Ingredients] Dihuang, Panax notoginseng, leech and dirong, etc.
Properties]: Black-brown concentrated pills with slight breath and bitter taste.
Function】Strengthens the spleen and nourishes the liver, cools the blood, softens the blood and disperses the knots.
Indications】For use in: chronic hepatitis B, early and middle cirrhosis after hepatitis B. It is used for chronic hepatitis B, early and mid-stage cirrhosis of the liver after hepatitis B. Symptoms include deficiency of the liver and spleen, heat and stasis, and symptoms such as pain in the ribs, distension and fullness in the abdomen, fatigue, dry mouth and throat, reduced appetite, loose stools and yellow urine.
Dosage】Take 6g once orally, three times a day. Three months is a course of treatment.
Adverse Reactions】Sometimes abdominal pain, rash, nausea, vomiting, fever, etc.
Precautions] Avoid raw, cold, hard, spicy, alcoholic food, stop taking the medicine during menstruation.
Astragalus Curculio Granules is a clinical and experimental study on anti-liver fibrosis of Astragalus Curculio Granules in Guang’anmen Hospital after the national “Ninth Five-Year” TCM scientific and technological research project and the national “Tenth Five-Year” TCM After obtaining the clinical research approval, “Astragalus Curculio Granules” was transferred to Heilongjiang Baoyuan Pharmaceutical Co. Ltd., which is expected to create greater social and economic benefits.
(2) Single herbal medicine and monomer research.
In recent years, domestic and foreign scholars have conducted extensive research on the active ingredients of various herbs and their extracts, and found that many herbs or their monomers have better anti-liver fibrosis effects.
Peach kernel: Experimentally, it was found that peach kernel extract effectively inhibited the anabolism of collagen and other matrix components by increasing the activity of collagenase in liver tissue, inhibited the activation of liver lipid storage cells and promoted their catabolism, which led to the massive degradation of collagen and FN in the liver and significantly reduced the formation of fibrous intervals in the liver.
Salvia miltiorrhiza: In the experimental study of the anti-liver fibrosis effect of Salvia miltiorrhiza monomer IH764-3, it was found that IH764-3 significantly reduced the degree of CCL4 liver fibrosis in rats, significantly reduced the content of hepatic hydroxyproline and type II pre-collagen mRNA, reduced serum HA and LN levels, improved liver function, and histological examination also showed its anti-liver fibrosis effect.
Astragalus: It was found that Astragalus had a significant inhibitory effect on the proliferation of HSC cultured in vitro, and the degree of inhibition was dependent on the drug dose. Meanwhile, the ELISA test results showed that Astragalus could significantly inhibit the secretion of type II collagen in cell culture fluid.
Cordyceps sinensis: Cordyceps polysaccharide can reduce the degree of liver fibrosis, decrease the value of trans-proline (Hyp) content, reduce the production and secretion of collagen and TGF-β, and reduce the expression of TGF-β, suggesting that Cordyceps polysaccharide has good anti-LF effect, and its mechanism of action may lie in inhibiting the activation of liver stellate cells and their expression of TGF-β.
Radix Paeoniae: Serum HA, IV-C, PCIII and LN levels were lower than those of the model group after Radix Paeoniae treatment, and the difference was significant (P<0.05), suggesting that Radix Paeoniae has a good anti-liver fibrosis effect.
Panax notoginseng: The total glycoside of Panax notoginseng can significantly improve the liver function of CCL4 liver fibrosis rats, reduce the serum PCIII and HA levels and cause a significant decrease of hydroxyproline in liver tissue; significantly reduce the proliferation of lipid storage cells and the deposition of collagen.
Trigonella and Curcuma longa: It was found that Trigonella and Curcuma longa could reduce ALT, LN and HA in rats with liver fibrosis, promote the degradation of fibrous tissue, reduce the proliferation of fibrous tissue, restore the structure and function of hepatocytes, and improve the histopathological changes of liver.
Chuanxiong: It can significantly reduce alanine aminotransferase (ALT) and serum type III procollagen in serum of rats with experimental liver fibrosis, significantly reduce the degree of liver collagen fibrous proliferation, and has anti-lipid peroxidation and anti-liver fibrosis effects.
Fangqi: It significantly inhibited the expression of C-FOS and C-JUN mRNA in liver tissue of rats with carbon tetrachloride-induced liver fibrosis, and also inhibited the transcription of nuclear factor κB and the expression of intercellular adhesion molecule ICAM-1 mRNA, and suppressed TGF-β1-induced α-SMA secretion and collagen deposition.
Angelica sinensis: Angelica sinensis can significantly inhibit fibroblast proliferation, inhibit intrahepatic collagen synthesis and promote hepatocyte regeneration in CCL4 rat liver injury model, which has a protective effect on liver injury.
Bitter ginseng: It can inhibit the proliferation of liver fibroblasts and type III pre-collagen mRNA expression, and directly anti-liver fibrosis. Decrease serum hyaluronic acid, type IV collagen, tumor necrosis factor and liver tissue hydroxyproline content, reduce hepatocyte degeneration, necrosis and inflammatory activity in liver tissue, thus indirectly anti-fibrosis.
Although single-medicine has an anti-fibrotic effect, it is still recommended that patients go to a regular hospital and see a regular herbalist for treatment, who will treat each individual according to his or her condition.