Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
J Gastroenterol Hepatol. 2013 Dec;28 Suppl 4:79-80. doi: 10.1111/jgh.12242.
Treatment of non-alcoholic fatty liver disease involves not only the management of the liver disease itself but the associated metabolic risk factors as well. However, no single treatment has been shown to be universally efficacious. Effective treatment regimens directed at both decreasing insulin resistance as well as the processes of necroinflammation have been investigated and include lifestyle intervention, surgical treatment, and pharmacotherapy. Lifestyle modification, weight loss, and physical activity represent the cornerstone of treatment. Given the important role of insulin resistance in the pathophysiology of non-alcoholic steatohepatitis, thiazolidinediones are used to improve insulin resistance. Ongoing large multicenter studies will provide information about long-term efficacy and safety of pioglitazone in patients with non-alcoholic steatohepatitis. Many other medications have shown promising results in the investigations using animal models and in preliminary pilot studies. Because the sample sizes of these studies were relatively small and the durations were short, further validation is required.
非酒精性脂肪性肝病的治疗不仅涉及肝脏疾病本身的管理，还涉及相关的代谢危险因素。然而，没有一种单一的治疗方法被证明是普遍有效的。已经研究了针对降低胰岛素抵抗和坏死性炎症过程的有效治疗方案，包括生活方式干预、手术治疗和药物治疗。生活方式的改变、体重的减轻和体力活动是治疗的基石。鉴于胰岛素抵抗在非酒精性脂肪性肝炎的病理生理学中的重要作用，噻唑烷二酮类药物被用于改善胰岛素抵抗。正在进行的大型多中心研究将提供关于吡格列酮治疗非酒精性脂肪性肝炎患者的长期疗效和安全性的信息。许多其他药物在动物模型研究和初步的初步研究中显示出了有希望的结果。由于这些研究的样本量相对较小，持续时间较短，因此需要进一步验证。
