The treatment of liver fibrosis and the h silymari

The treatment of liver fibrosis and treatment what is the harm caused by improper? Shanghai sea-air hospital liver treatment center for you to answer in detail!
One, the treatment of liver fibrosis:
antifibrotic drug treatment mainly include:
(1) removal of pathogenic factors for the primary disease, such as hepatitis B, hepatitis C virus therapy, anti-schistosomiasis treatment, alcohol, etc..
(2) for the treatment of liver fibrosis itself such as inflammation or by inhibiting lipid peroxidation, or inhibition of hepatic stellate cells by life, and promote collagen degradation. has been found with the anti-fibrosis drugs, many of which only verified in a variety of animal models the results and to explore the mechanism. Here,apple extract, we focus on is already in a variety of clinical applications of chronic liver disease had anti-fibrosis drugs, especially of the past 5 years to conduct clinical trials the efficacy of these drugs.
1
corticosteroids corticosteroids are often used as anti-inflammatory drugs of various liver diseases, but currently only two types of chronic liver disease proved to be effective. One is autoimmune hepatitis, 2004, Czaja et al reported 87 cases patients with autoimmune hepatitis, corticosteroid therapy 5-year average of the results on 325 samples of liver biopsy analysis showed that 53% of patients with fibrosis points to improve, 26% of patients with fibrosis progression free. and consistent with previously reported clinical efficacy . The other is severe alcoholic hepatitis with encephalopathy symptoms especially in patients with short-term steroid treatment to extend survival, but Phillips et al reported in 2006 that such increase of the 1 year survival rate is no longer significant after .
2, colchicine
is a plant bases, and the mechanism of collagen secretion by inhibiting microtubule polymerization in the process to achieve the purpose of inhibiting fibrosis. since 1986, reports of primary biliary Many biochemical parameters in patients with cirrhosis has improved, but did not reduce fibrosis. However, such reports of the 1988 Kershenobich Colchicine treatment of alcoholic hepatitis and liver fibrosis in patients with a variety of other randomized double-blind clinical trial of 100 patients followed for 14 years, results showed that colchicine can not only improve the fibrosis, but also can significantly improve the survival rate. but questioned the study methodology was a problem and not routine clinical application. followed by a number of meta-analysis and 2005 Morgan and so on alcoholic liver cirrhosis treated with colchicine randomized double-blind clinical trials, colchicine for the fibrosis and no significant improvement in survival rate.
3, silymarin
Silymarin Milk thistle is the activity of plant composition, can have anti-lipid peroxidation and fiber formation. all clinical studies confirm its use is safe, but the results are inconsistent against fibrosis. Ferenci et al reported in alcoholic cirrhosis, silymarin can reduce the mortality, early cirrhosis ease. But Pares et al reported 200 cases of confirmed liver biopsy or laparoscopic patients with alcoholic liver cirrhosis, a randomized double-blind placebo-controlled trial, the results did not support silymarin can improve survival in patients with alcoholic liver cirrhosis .2002 Lucena, and other small study also found that 6 months is only a short-term clinical effect of lipid peroxidation.
fibrosis 4. interferon (IFN a and interferon g)
Poynard et al reported 3010 cases of clinical trials of the four untreated patients with hepatitis C fibrosis, interferon a plus ribavirin for 24 weeks,Stevia Leaf Extract, in order to alleviate at least one METAVIR points as the standard treatment of most patients with fibrosis than the former has been reduced. into the group of patients with cirrhosis, 49% had cirrhosis reversed. fibrosis and began to reduce fibrosis, response rates of the virus, the virus level and age and weight are related. interferon g Although weaker than the effect of antiviral interferon a,milk thistle extract, but can stellate cells by inhibiting the synthesis of extracellular matrix production of anti-liver fibrosis effect mechanisms. Muir et al reported 20 cases of interferon a treatment fails or can not tolerate the hepatitis C hepatitis patients, 24 weeks of treatment with interferon g,trans resveratrol, liver biopsy done before and after treatment. The results suggest that interferon is safe g, 30% of patients had fibrosis improvement. Weng other 99 patients treated with interferon g hepatitis B fibrosis patients, treatment 9 months, by liver biopsy, the treatment group and 63%, 21% of the control group patients had improvement of liver fibrosis.
5, ursodeoxycholic acid
bear, oxygen acid can stabilize the cell membrane protective effect of reducing inflammation and fibrogenesis. Poupon other 367 patients with primary biliary cirrhosis with ursodeoxycholic acid treatment for 2 years, randomized controlled studies suggest that fibrosis can be reduced, particularly at the initial stage �� / �� patients with early stage can significantly improve the progress of fibrosis. In addition to other than primary biliary cirrhosis, ursodeoxycholic acid can reduce the child's familial intrahepatic cholestasis and cystic fibrosis of the fibrosis. Lindor et al reported 166 cases of non-alcoholic steatohepatitis patients randomized, placebo-controlled study, matching 2-year follow-up liver biopsy, suggesting that UDCA on liver fibrosis and even fat hepatic necrosis and inflammation are not improved. Dufour applications such as ursodeoxycholic acid and vitamin E combination therapy in patients with non-alcoholic steatohepatitis research, results suggest that 2 years of treatment only to improve laboratory biochemical indicators and degree of fatty liver.
6, polyunsaturated phosphatidylcholine on liver inflammation and fiber
the formation of oxidative stress in the process of effective anti-oxidation. Lieber et al reported on 789 patients with alcoholic liver disease a randomized, double-blind, placebo-controlled trial, observed for 2 years, due to selected patients did not expect the average daily alcohol consumption reduced from 224g to 35g of ethanol alcohol, the results show polyunsaturated phosphatidylcholine did not more significant improvement than the placebo fibrosis, but for some patient subgroups of polyunsaturated phosphatidylcholine reduces transaminase and bilirubin.
7, interleukin (IL) -10
IL-10 is anti-inflammatory and immune suppression cytokines, by reducing pro-inflammatory cytokines tumor necrosis factor-a and IL-1 and other inflammatory reactions, and to transformation of T cells to Th2. Nelson et al reported that IL-10 treatment of 30 cases of anti-virus ineffective in patients with hepatitis C liver fibrosis 1-year trial, IL-10 can reduce liver inflammation and fibrosis, but HCV-RNA increased from the start of treatment of 12.3mEq/ml 38mEq/ml. This makes long-term use in patients with viral IL-10 has been questioned .
8, losartan
renin - angiotensin - aldosterone system plays an important role in fibrosis formation. the main effect factor by angiotensin �� transforming growth factor b1 expression induced by stimulation of collagen deposition . angiotensin converting enzyme inhibitor losartan was observed to reduce the degree of liver fibrosis. Yokohama observed in 7 cases and other non-alcoholic steatohepatitis in patients with hypertension, after 48 weeks of oral losartan in 4 cases fibrosis and to improve liver histology, liver cirrhosis and hepatitis C patients after liver transplantation a retrospective pilot study similar to the results.
9, pirfenidone (Pirfenidone)
2005 �� Azuma, including 107 cases reported interstitial lung fibrosis patients randomized, double-blind, placebo-controlled clinical study, results suggest that the oxygen and the ability of patients significantly improved lung function was significantly reduced frequency of acute exacerbation, the treatment group significantly increased the survival rate. then in a variety of animal models of liver fibrosis confirmed the pirfenidone can block fibrosis, the pathological fibrosis score showed improvement, decreased collagen, a-smooth muscle actin-positive cells decreased and so, accompanied by decreased expression of transforming growth factor b1, and promote collagen degradation upregulation of matrix metalloproteinase such .2006 Armenda'riz-Borunda et al reported that application of pirfenidone (1200mg / d) treatment of 15 cases of hepatitis C patients with cirrhosis of the small sample clinical study, 12 weeks, living liver before and after treatment biopsy compared to 53% improvement in patients with inflammation of the liver index, 30% Ishak fibrosis stage decreased, 60% of patients with steatosis improvement.
10, bovine fetal liver extract compound
Cai Weimin, and so do the cattle tire compound liver extract tablets in the treatment of liver fibrosis in rats showed that: the treatment group deaths and semi-quantitative histological liver fibrosis score was significantly lower than the control group. Qian Li and other multi-center, self-control study to observe fetal bovine liver extract compound tablets in the treatment of 115 cases of patients with liver fibrosis effect of oral compound in patients with fetal bovine liver extract tablets 2 tablets / time, 3 times / d, 24 weeks of treatment, liver biopsy done before treatment were , of which 38 patients in the treatment of liver biopsy done again. The results showed: serum markers of liver fibrosis, hyaluronic acid,icariin, laminin,lutein, �� collagen, after treatment for 24 weeks and 36 weeks, compared with before treatment (0 weeks) significantly decreased compared, the difference was statistically significant. Liver biopsy studies showed, after treatment, liver fibrosis was significantly lower than before treatment improper treatment of liver fibrosis
What harm?
If not treated properly by the two major hazards mainly cirrhosis: First, because the structure of liver damage and the distortion of intrahepatic vascular pressure, blocking the arteries and veins or between the \increases, the formation of portal hypertension, resulting in splenomegaly, ascites formation and gastric varices, variceal upper gastrointestinal bleeding potential danger; Second,resveratrol, normal liver cells, blood circulation channel between the fibrous tissue components due to circulation disorder caused by deposition and affect the blood supply to liver cells, so that damage due to inflammation of the liver cell damage difficult to repair or even increased, until the function of normal liver cells is less and less, leading to liver failure. the two hazards are deadly The.
Shanghai hospital liver specialist sea and air is recommended that you must not blind drug treatment should be based on detailed analysis of the disease, syndrome differentiation, one side, drug treatment by professional medical advice, to ensure that you achieve better, faster treatment to avoid undesirable consequences.