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ObjectiveTo observe the clinical effect of Mongolian medicine Qinggan Jiuwei powder in the treatment of alcoholic liver fibrosis by observing the improvement in imaging indices. MethodsA total of 104 patients with alcoholic liver fibrosis who visited Department of Gastroenterology in Horqin District First People′s Hospital in Tongliao from October 2015 to January 2017 were enrolled and randomly divided into experimental group and control group, with 52 patients in each group. The patients in the experimental group were given Mongolian medicine Qinggan Jiuwei powder, while those in the control group were given reduced glutathione tablets. Liver function parameters, liver-spleen ultrasound findings, and liver stiffness measurement (LSM) determined by FibroScan were observed before and after treatment. The independent samples t-test was used for comparison of normally distributed continuous data between groups, and the paired samples t-test was used for comparison within each group; the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between groups. ResultsBoth groups had varying degrees of improvements in clinical symptoms and signs. Both groups had significant changes in alanine aminotransferase, aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), and LSM after treatment (experimental group: Z=-3.09, -7.19, and -8.27, t=7.13, P=0.002, ＜0.001, ＜0.001, and ＜0.001; control group: Z=-3.28, -4.60, and -5.06, t=8.54. P=0.001, ＜0.001, ＜0.001, and ＜0.001). There were significant differences in AST and GGT after treatment between the two groups (Z=-2.02 and -2.15, P=0.04 and 0.03). Both groups had significant changes in oblique diameter of the right liver lobe, diameter of the portal vein, blood flow rate of the portal vein, spleen thickness, and diameter of the splenic vein after treatment (experimental group: t=6.48，11.02,2.20，3.30 and 5.30, P＜0.001, ＜0.001, =0.030, ＜0.001, and ＜0.001; control group: t=3.51、6 31、2.68、3.06、4.71, P=0.01, ＜0.001, =0.01, ＜0.001, and ＜0.001). There were significant differences in oblique diameter of the right liver lobe and diameter of the portal vein after treatment between the two groups (t=3.96 and 3.53, P=0.02 and 0.01). ConclusionMongolian medicine Qinggan Jiuwei powder has a good clinical effect in the treatment of alcoholic liver fibrosis and can effectively reduce the imaging index LSM and values measured by abdominal color Doppler ultrasound in patients with alcoholic liver fibrosis.

Liver injury caused by various reasons can lead to the occurrence of liver fibrosis, which is the pathological process from chronic liver disease to liver cirrhosis. Liver fibrosis is caused by the increased synthesis and reduced degradation of extracellular matrix (ECM). ECM is mainly degraded by matrix metalloproteinases (MMP), and therefore, MMP play an important role in the progression and diagnosis/treatment of liver fibrosis. This article reviews the research advances in the association between MMP and liver fibrosis.

Objective To investigate the clinical effect of Mongolian drug Qinggan Jiuwei powder in the treatment of patients with alcoholic hepatitis. Methods A total of 63 patients with alcoholic hepatitis who were admitted to Affiliated Hospital of Inner Mongolia University for The Nationalities from May 2014 to April 2016 were enrolled. The 32 patients in the trial group were given Mongolian drug Qinggan Jiuwei powder, and the 31 patients in the control group were given reduced glutathione tablets. The course of treatment was 4 weeks for both groups, and the patients were asked to quit drinking, stay in bed, and have a rest. The t-test was used for the comparison of continuous data between groups. Results After treatment, the control group showed significant improvements in the liver function parameters alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase (GGT) (ALT: 38.7±13.3 U/L vs 77.5±16.7 U/L, t=10.21, P＜0.01; AST: 43.8±21.8 U/L vs 176.6±40.1 U/L, t=16.90, P＜0.01; GGT: 63.8±21.7 U/L vs 302.9±73.3 U/L, t=17.40, P＜0.01); the trial group also showed significant improvements in these parameters (ALT: 37.6±14.6 U/L vs 78.1±17.5 U/L, t=10.10, P＜0.01; AST: 39.6±15.3 U/L vs 180.3±44.3 U/L, t=16.40, P＜0.01; GGT: 59.9±23.8 U/L vs 304.7±66.5 U/L, t=19.60, P＜0.01). After treatment, the control group showed significant improvements in the serum liver fibrosis parameters hyaluronic acid, precollagen type Ⅲ, laminin, and collagen type Ⅳ(hyaluronic acid: 122.1±36.2 ng/ml vs 369.2±139.8 ng/ml, t=9.52, P＜0.05; precollagen type Ⅲ: 118.6±43.8 ng/ml vs 185.9±92.7 ng/ml, t=3.66, P＜0.05; laminin: 137.2±49.9 ng/ml vs 166.1±50.4 ng/ml, t=2.24, P＜0.05; collagen type Ⅳ: 128.7±48.3 ng/ml vs 155.1±44.5 ng/ml, t=2.27, P＜0.05); the trial group also showed significant improvements in these parameters (hyaluronic acid: 101.1±27.9 ng/ml vs 367.4±149.7 ng/ml, t=9.88, P＜0.01; precollagen type Ⅲ: 91.6±48.4 ng/ml vs 188.3±100.5 ng/ml, t=4.95, P＜0.01; laminin: 94.8±34.6 ng/ml vs 167.6±48.7 ng/ml, t=5.61, P＜0.01; collagen type Ⅳ: 92.7±30.3 ng/ml vs 161.3±62.2 ng/ml, t=6.87, P＜0.01). There were significant differences in the liver function parameters after treatment between the two groups (t=2.53, 2.31, 3.56, and 3.90, all P＜0.05). Conclusion The Mongolian drug Qinggan Jiuwei powder can improve liver function and reduce liver fibrosis parameters in patients with alcoholic hepatitis.

ObjectiveTo analyze the clinical efficacy of glucocorticoid therapy in addition to conventional treatment for patients with drug-induced cholestatic liver disease. MethodsA total of 115 patients with drug-induced cholestatic liver disease who were admitted to Affiliated Hospital of Inner Mongolia University for the Nationalities from January 2010 to December 2014 were collected and divided into glucocorticoid treatment group and non-glucocorticoid treatment group. The glucocorticoid treatment group was given methylprednisolone sodium succinate 120 mg once daily by intravenous injection in addition to conventional treatment. The indicator for glucocorticoid response was defined as 10% decrease of total bilirubin (TBil) on the third day or 30% decrease on the seventh day. Then the patients were orally given prednisone tablets 10 mg three times daily based on the level of TBil, and the administration of prednisone tablets was adjusted to twice daily a week later. The course of treatment was less than three weeks. Comparison of continuous data in normal distribution between the two groups was made by t test, and comparison of continuous data not in normal distribution between the two groups was made by rank sum test. ResultsThe levels of gamma-glutamyl transpeptidase (GGT), alanine aminotransferase (ALT), and TBil in the glucocorticoid treatment group decreased significantly on days 3, 7, and 14 of treatment compared with those before treatment (tGGT=3.64, 13.08, 16.22; tALT=2.39, 4.73, 8.36; tTBil=3.46, 7.41, 13.17; all P＜0.05). Compared with the non-glucocorticoid treatment group, the glucocorticoid treatment group had significantly lower AST and ALT levels before treatment and on days 3 and 7 of treatment (all P＞0.05). The GGT, AST, and TBil levels in the glucocorticoid treatment group were significantly lower than those in the non-glucocorticoid treatment group on day 14 of treatment (t=7.074, 2.929, 2.018; all P＜0.05). The average decreasing speed of bilirubin in the glucocorticoid treatment group was 12.21%±2.91% per day, significantly faster than 6.27%±0.92% per day in the non-glucocorticoid treatment group (t=15.11, P＜0.001). ConclusionGlucocorticoid therapy in addition to conventional treatment for patients with drug-induced cholestatic liver disease is superior to conventional treatment alone in lowering TBil, GGT, and ALT levels.