-Chinese Journal of Internal Medicine, August 1999-

B-Mode Ultrasonogram Change of 276 Cases of Fatty Liver Patients Treated by Xuezhikang
Liu Ya
(Infectious Department of the Affiliated Hospital of Ningxia Medical College, Yinchuan City, 750004)
Zhao Jingchuan
(Liver and Gallbladder Surgery Department of No.1 People's Hospital)
Liu Hong
(B-Type Ultrasound Division of Ningxia Autonomous Region Hospital)
INTRODUCTION

Fatty liver is caused by lipid deposition in liver which exceeds 5% of the total liver weight, or over 40% liver lipidization in histology due to fat metabolism dysfunction as a result of many factors. [1] Clinical diagnosis of fatty liver mainly depends on B-Mode Ultrasonography at present, and clinical effect of medicines can be identified thereafter. There are lots of reports on the treatment of fatty liver with Traditional Chinese Medicine and western medicine. However, the curative effect is poor in repeatability. Here are the study results of B-type ultrasound of iconographical track, lipid and biochemical test results of 276 fatty liver patients treated with Xuezhikang.

PATIENTS AND METHODS

Patients
In 276 B-Mode ultrasonograph diagnosed fatty liver patients (among which 28 cases identified with liver biopsy puncture, 22 cases associated with cholecystolithiasis conducting cystectomy and morphological test of liver tissue taken in the operation verified the symptom of fatty liver), 192 cases were male (69.57%), 84 female (30.43%), aging from 23 to 64 years old with the average of 42. 136 patients (49.28%) had the symptoms such as weakness, dull pain in liver, and ventosity. And 104 patients (37.68%) were overweight [BMI ³ 26] with the average of BMI 28.6 ± 2.84. In addition, 78 (28.26%) of the 276 cases were alcohol addict, 48 patients (17.39%) suffered hepatitis, 24 (8.7%) got type II diabetes and 22 (7.97%) had cholelithiasis.

Treatment Method
Patients took Xuezhikang (provided by WBL Peking University Biotech Limited Company) twice a day, two capsules (0.3 g in each capsule) per time with three treatment each lasting for 8 weeks.

Tailored treatments were conducted for overweight, alcohol addict, hepatitis and diabetes patients respectively. That is, overweight patinets went on diet; alcohol addicts gave up alcohol; hepatitis patients received proper treatment and diabetic patients took medicine to control their GLU and blood sugar levels.

Observational Indexes
Blood samples were taken in the morning on fasting patients before and after the treatment. Then the concentration of serum TC, TG and HDL-C were tested. Biochemical tests were also made on ALT, AST, CHE, GLU, BUN, clotting time, and conventional blood and urine analysis. And side-effects were observed.

B-mode ultrasonograpgy: the diagnose criteria: (1) liver enlargement, enhanced echo, light points were fine and fully intense showing a brightliver; (2) distinct enhancement of liver and kidney echoes; (3) declined echo from the very deep; (4) obscure or disappearance of liver vessel [2]. The above examinations were repeated every 8 weeks.

Statistical Method
All data were input into computer with metrical information by t-test and enumeration data by c2 test.


RESULTS

Lipid Change before and after the Treatment
The findings indicated that 6-month Xuezhikang treatment led to the reduction of TC and TG levels and HDL-C increase (P < 0.01) compared with that of before treatment.
(Table I)

Table I. Lipid Change before and after Xuezhikang Treatment (x ± s)
Lipid Index
No. of Cases
Before treatment
After treatment
Percentage(%)
TC (mmol/L)
105
6.90 ± 1.30
5.12 ±1.31
<25.8*
TG (mmol/L)
114
2.78 ± 0.31
1.37 ± 0.25
<50.7*
HDL-C (mmol/L)
98
0.97 ± 0.09
1.35 ± 0.10
<39.17*
Compared with the level before treatment, * P < 0.01

Biochemical Index Change after Xuezhikang Treatment
At the end of the treatment, most patients got rid of malaise or improved their symptoms after liver health caring measures and Xuezhikang treatment with a dramatic improvement in biochemical index (matching t-test, P < 0.001). Table II.

Table II. Biochemical Index Change before and after Xuezhikang Treatment(x ± s)
Biochemical Index
Before treatment
After treatment
Different average
tValue
ALT(IU/L)
153.32±87.15
40.16±22.24
112.84±64.91
28.88*
AST(IU/L)
81.28± 24.39
35.25±11.84
46.03±12.55
60.93*
CHE(U/L)
2390.48±671.30
1360.27±374.91
1030.21±296.39
57.74*
Compared with the level before treatment, * P < 0.01

B-Mode Ultrosonogram Change after Xuezhikang Treatment
Most B-mode ultrosonogram changes of the target patients occurred after 4-month treatment. At the end of the treatment, every observational index had a dramatic improvement compared with that of before treatment (after tetraform x2 test, P < 0.001), Table III.

Table III. B-type Ultrosonogram Change before and after Xuezhikang Treatment
Swell liver, showing brightliver
Actual echo far, field sound decline
Vague texture of vessel
Disappearance of vessel texture
Before treatment
242
276
228
138
After treatment
51
58
42
22
x2 value
265.36*
360.29*
250.81*
118.43*
Compared with that of before treatment, *P < 0.001

After 6-month treatment, B-mode ultrosonogram of 129 patients (47%) basically restored to normal pattern, among which 13 had been verified through liver biopsy puncture.

Side-effects
During Xuezhikang treatment, only three cases had slight malaise on upper stomach and it alleviated 1 week later. The remaining cases had no report of any toxic and side-effects.

DISCUSSION

With the increase of living standard and the alteration of life style, together with more and more alcohol consumption and the on-going increase of overweight people, there are increasing number of fatty liver incidence. Therefore, the diagnosis and treatment of fatty liver are getting more and more concern. However, as the hidden nature and lack of specificity in terms of clinical observation and laboratory test, it is difficult to identify fatty liver. Though liver biopsy puncture diagnosis can be reliable, obtaining patients acceptance is not an easy task. But B-mode ultrasonography enjoys high accuracy without any damage. Ni Yanjun [3] reported liver biopsy at the time of cystectomy for B-Mode ultrasonography diagnosed fatty liver patients associated with cholecystolithiasis had illustrated 89.9% of steatosis. The findings of this study showed that the ultrasonogram change was in conformity with the improvement of lipid reduction, biochemical index and clinical observation after Xuezhikang treatment. This implied the potential of utilizing B-mode ultrasonograpgy as a way to evaluate curative effect.

The remarkable effects of integrated lipid regulation by Xuezhikang opens a wide channel to treat fatty liver patients. In this study, when disease-tailored treatment went hand in hand with Xuezhikang administration, serum TC and TG dropped remarkably and there was significant change in B-Mode ultrasonogram of the target patients. And liver functions of those patients restored and clinical symptoms improved. All these suggested Xuezhikang could be applied widely to treat fatty liver patients.


REFERENCES

1.
 Ye Weifa, Clinical Science of Liver and Gallbladder, Tianjin Science & Technology Publishing House, 1987, 927 ~ 934.
2.
 Chen Renbin, Practical Ultrasonic Diagnosis, Beijing: China Medical Science and Technology Press, 1997, 209 ~ 213.
3.
 Ni Yanjun, Advances of Pathological Mechanism, Diagnosis and Treatment of Fatty Liver, Digestion System Disease Book of Foreign Medicine Series, 1997, 17:158 ~ 161.
 
 
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