Insights & Discussion
Chinese medicine formulas for nonalcoholic fatty liver disease were superior to antioxidants in alanine aminotransferase normalization.
Seven systematic reviews were ultimately included. All systematic reviews were conducted based on randomized controlled trials and published in the last decade. According to the AMSTAR 2 tool, one systematic review was judged as having a moderate confidence level, whereas the other studies were rated as having a low or extremely low level of confidence. The ROBIS tool showed that the included systematic reviews all had a high risk of bias due to insufficient consideration of identified concerns. According to the GRADE system, only two outcomes were determined as high quality; namely, TCM formulas with the HuoXueHuaYu principle were better than conventional medications in ultrasound improvement, and TCM formulas were superior to antioxidants in alanine aminotransferase normalization. Other outcomes were downgraded to lower levels, mainly because of heterogeneity among studies, not meeting optimal information sample size, and inclusion of excessive numbers of small sample studies. Nevertheless, the evidence quality of extracted outcomes should be further downgraded when applying to clinical practice due to indirectness.
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Cooked adzuki beans contribute notably to preventing obesity and regulating gut microbiota composition, while also alleviating systemic inflammation and metabolic disorders.
2022 Frontiers in Nutrition Cooked Adzuki Bean Reduces High-Fat Diet-Induced Body Weight Gain, Ameliorates Inflammation, and Modulates Intestinal Homeostasis in Mice Zhao Q, Liu Z, Zhu Y, Wang H, Dai Z, Yang X, et al.
Animal Study Adzuki Bean Anti-Inflammatory Fatty Liver Disease
The methodology involved a controlled experiment where mice were fed diets of varying lipid content: a low-fat diet or a high-fat diet. The specific twist in this experiment was the inclusion or exclusion of cooked adzuki beans to their diet, ensuring 15% of the diet comprised of this. The duration of this dietary regimen was 12 weeks.
In the discussion of results, it was discovered that cooked adzuki beans provided key beneficial effects. This included a significant inhibition of weight gain and hepatic steatosis, a reduction in high levels of specific markers such as serum triacylglycerol, alanine aminotransferase, and aspartate aminotransferase, providing a counter to systemic inflammation and metabolism-related endotoxemia commonly found in those consuming a high-fat diet. Moreover, the inclusion of adzuki beans positively affected the gut microbiota composition, reducing fat-inducing bacteria and enriching the gut with beneficial bacteria to help alleviate inflammation and metabolic disorders associated with high-fat diets.
Traditional Chinese medicines such as Shenge formula, Shugan Jianpi Huatan decoction and Heze lipid lowing oral liquid decoction might have positive effects on NAFLD by improving TCM syndrome scores, liver function, and body lipid profile.
2021 Chinese Medicine Efficacy and safety of traditional Chinese medicines for non-alcoholic fatty liver disease: a systematic literature review of randomized controlled trials Liang, Z., Chen, X., Shi, J. et al.
Systematic Review Fatty Liver Disease NAFLD
A total of 53 RCTs involving 5997 participants with NAFLD were included in this review. Each included RCT tested a different TCMs giving a total of 53 TCMs identified in this study. Based on the evaluation of the RCT results, TCMs might have various beneficial effects such as improving TCM syndrome score, liver function, and body lipid profile. A range of non-serious, reversible adverse effects associated with the use of TCMs were also reported. However, no conclusion about the efficacy and safety of TCMs in NAFLD can be made. The quality of reporting was generally poor and the risks of bias was mostly uncertain in all trials.
Traditional Chinese medicines might have various beneficial effects for non-alcoholic fatty liver disease such as improving TCM syndrome score, liver function, and body lipid profile.
2021 Chinese Medicine Efficacy and safety of traditional Chinese medicines for non-alcoholic fatty liver disease: a systematic literature review of randomized controlled trials Liang Z, Chen X, Shi J, Hu H, Xue Y, Ung COL
Systematic Review Fatty Liver Disease NAFLD
A total of 53 RCTs involving 5997 participants with NAFLD were included in this review. Each included RCT tested a different TCMs giving a total of 53 TCMs identified in this study. Based on the evaluation of the RCT results, TCMs might have various beneficial effects such as improving TCM syndrome score, liver function, and body lipid profile. A range of non-serious, reversible adverse effects associated with the use of TCMs were also reported. However, no conclusion about the efficacy and safety of TCMs in NAFLD can be made. The quality of reporting was generally poor and the risks of bias was mostly uncertain in all trials.
There is some evidence from RCTs that supported the effectiveness and safety of TCMs for NAFLD. However, no conclusive recommendations can be made due to the questionable quality of the RCTs. Improvement in the RCT protocol, the use of a larger sample size, a setting of multicenter, and a more focused approach in selecting TCMs are recommended for developing high quality evidence about the use of TCMs in managing NAFLD.
Many clinical and experimental studies suggest that Chinese herbal formula are effective in reducing fatty liver disease, and revolving inflammation via many mechanistic pathways.
2020 Frontiers in Endocrinology Chinese Medicinal Herbs Targeting the Gut–Liver Axis and Adipose Tissue–Liver Axis for Non-Alcoholic Fatty Liver Disease Treatments: The Ancient Wisdom and Modern Science Zhang Shuwei, Wong Yui-Tung, Tang Ka-Yu, Kwan Hiu-Yee, Su Tao
Review Article Fatty Liver Disease NAFLD
The NAFLD pandemic implies an increase number of patients diagnosed with NAFL, NASH, liver fibrosis and HCC in the near future. Although the interpretation and diagnosis of NAFLD in Chinese medicine are different from those in western medicine, many clinical and experimental studies suggest that Chinese herbal formula are effective in reducing hepatic steatosis, and revolving inflammation via many mechanistic pathways. Some Chines herbal formulae also target at the gut–liver axis in NAFLD, while the adipose tissue–liver axis emerges to be a therapeutic approach for the treatment of NAFLD. More clinical and in-depth mechanistic investigations may help to validate the roles of these Chinese herbal formulae for the treatment of NAFLD. Application of the modern technology can also help to discover novel herbal-based therapeutics for the treatment.
Acupuncture relieved hepatic steatosis and reduced total cholesterol and triglyceride in non-alcoholic fatty liver disease patients.
2018 The Journal of Internal Korean Medicine Clinical Effectiveness of Acupuncture in the Treatment of Non-Alcoholic Fatty Liver Disease: A Systematic Review Joon Hyun, Joo-bok Lee, So-yeon Kim, Chang-woo Han
Systematic Review Fatty Liver Disease NAFLD
From the 8 included trials, the values of the following examinations were extracted: liver ultrasonography, liver CT, body fat CT, aspartate transaminase (AST), alanine transaminase (ALT), gamma-glutamyltransferase (GGT), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, fasting blood sugar (FBS), hosmeostatic model assessment for insulin resistance (HOMA-IR), weight, body mass index (BMI), waist hip ratio (WHR), obesity degree, body fat mass, body fat rate, leptin, malondialdehyde (MDA), and super oxide dismutase (SOD). In the 4 outcomes, cure rate in liver ultrasonography (RR=1.56; 95%CI=1.05~2.31; P=0.03), cure rate in liver CT (RR=2.23; 95%CI=1.33~3.72; P=0.002), TC (MD=-0.78; 95%CI=-1.41~-0.15; P=0.02), and TG (MD=-2.05; 95%CI= -3.88~-0.21; P=0.03), acupuncture was more effective than the control intervention.
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