Fan Jian-Gao
Department of Gastroenterology, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai 200080, China.
Hepatobiliary Pancreat Dis Int. 2004 Aug;3(3):375-80.
Currently, the management of non-alcoholic fatty liver disease (NAFLD) is less than certain. Some choleretic might be of potential benefit and deserve further evaluation. This multicenter clinical trial was designed to evaluate the efficacy and safety of Chinese herbal medicine Danning Pian (composed of rhubarb, grant knotweed, dried green orange peel and dried old orange peel) in the short-term treatment of patients with NAFLD.
The efficacy and safety of Danning Pian in the short-term treatment of NAFLD were investigated in 232 patients by a multicenter clinical trial during the period of July 1999 to February 2000. The patients consisting of 189 males and 43 females with an average age of 46.1+/-8.7 years were given 3-5 tablets of Danning Pian orally thrice daily for 3 months in addition to the other comprehensive therapy. The effects of Danning Pian on NAFLD were evaluated by the improvement of clinical symptoms, blood lipids, hepatic enzymes and liver ultrasonographic features. The drug safety was monitored by physical examinations, vital signs, and laboratory tests in addition to the assessment of the adverse events.
All the enrolled patients completed the study except one whose serum ALT level was moderately increased during the therapy with Danning Pian. The effective rate of Danning Pian for the improvement of clinical symptoms, serum ALT levels, blood lipid and fatty liver was 85.8%, 78.2%, 39.6% and 34.0% respectively after the therapy for 3 months. However, the reduction of excessive body weight and waistline did not reach the significant level on the whole after the therapy. The general mild adverse events included diarrhea, skin rash and mild to moderate elevation of serum ALT level. The incidence of adverse reaction was 15.1%.
The data of this trial indicate that Danning Pian is effective and safe, generally well-tolerated without severe adverse events, in the treatment of patients with NAFLD over a 3-month period.
目前,非酒精性脂肪性肝病(NAFLD)的治疗方法尚不确定。一些利胆剂可能具有潜在益处,值得进一步评估。本多中心临床试验旨在评估中药胆宁片(由大黄、虎杖、青皮和陈皮组成)短期治疗NAFLD患者的疗效和安全性。
1999年7月至2000年2月期间,通过多中心临床试验对232例患者进行了胆宁片短期治疗NAFLD的疗效和安全性研究。患者包括189例男性和43例女性,平均年龄46.1±8.7岁,除接受其他综合治疗外,口服胆宁片,每次3 - 5片,每日3次,共3个月。通过临床症状、血脂、肝酶和肝脏超声特征的改善来评估胆宁片对NAFLD的疗效。除评估不良事件外,还通过体格检查、生命体征和实验室检查监测药物安全性。
除1例患者在服用胆宁片治疗期间血清ALT水平中度升高外,所有入选患者均完成了研究。治疗3个月后,胆宁片改善临床症状、血清ALT水平、血脂和脂肪肝的有效率分别为85.8%、78.2%、39.6%和34.0%。然而,治疗后总体上体重和腰围的减轻未达到显著水平。一般轻度不良事件包括腹泻、皮疹和血清ALT水平轻度至中度升高。不良反应发生率为15.1%。
本试验数据表明,胆宁片在治疗NAFLD患者3个月期间有效且安全,总体耐受性良好,无严重不良事件。