Treatment of fatty liver

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 Simple fatty liver is an early manifestation of a variety of liver toxicity, such as early detection, timely treatment, it can be comp

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Simple fatty liver is an early manifestation of a variety of liver toxicity, such as early detection, timely treatment, it can be completely restored to normal. In addition, the fatty liver has been developed into fatty hepatitis and liver fibrosis, and the liver disease can be reversed after the removal of the cause and control of the primary disease. But if left unchecked, it can further develop liver cirrhosis, at this time if the active treatment is also difficult to make the liver pathological changes returned to normal. Therefore, it can improve the prognosis and quality of life of the patients with fatty liver by early treatment to promote the regression of liver fat and the prevention and treatment of complications.

Principles of treatment of fatty liver

Clinically, fatty liver may be an independent disease, but more often it is a pathological manifestation of systemic disease in the liver. Therefore, according to the patient's specific condition, reasonable application of diet therapy, exercise therapy, behavior therapy and a variety of Chinese and Western medicine comprehensive treatment, to give attention to the prevention and treatment of fatty liver and its underlying diseases, so as to achieve the best effect.

The principle of treatment of fatty liver can be summarized as follows: (1) the removal of the cause and predisposing factors, positive control of primary disease; (2) to adjust the diet, correct nutritional imbalance; (3) adhere to the necessary training to maintain ideal body weight; (4) to maintain a relatively normal blood lipid levels and blood glucose levels; (5) self care the consciousness of education to correct bad behavior; (6) when necessary, appropriate liver, fat, anti fibrosis drugs, promote liver lipid excretion, prevent liver cell necrosis, inflammation and fibrosis.

First, the cause of treatment

Fatty liver is a kind of acquired disease caused by multiple etiological factors. It is very important for the prevention and treatment of fatty liver. For most patients with fatty liver should first clear pathogeny and inducement of fatty liver may be, you must pay attention to factors easily overlooked, such as side effects of drugs, pharmaceutical and industrial poisoning, L- carnitine deficiency, protein calorie malnutrition, parenteral nutrition, thyroid function of hyperthyroidism or hypothyroidism, Wilson's disease, pregnancy vomiting and toxemia of pregnancy, severe anemia and cardiopulmonary dysfunction in chronic hypoxia state. And a comprehensive assessment of the patient's general condition, such as whether the coexistence of diabetes, hyperlipidemia, hypertension, coronary heart disease, cerebral atherosclerosis and alcohol dependence and abstinence syndrome, cardiovascular and cerebrovascular diseases for chronic nonalcoholic fatty liver patients as the main contradictions coexist, priority should be given to treatment; and pay attention to distinguish between the different causes and the fatty liver of different onset forms of treatment, such as the principle of treatment of acute and chronic fatty liver, alcoholic and nonalcoholic fatty liver disease, malnutrition and overnutrition of fatty liver is totally different, for example, acute fatty liver sometimes need to immediately by ICU rescue, and focuses on finding the cause of chronic fatty liver health and health education and intervention. The doctor can not accurately judge the condition of the patients, treated differently, it is difficult to improve the therapeutic effect of fatty liver.

Mild or moderate fatty liver in the removal of the cause and control of the original disease, liver histological changes can be improved, or even completely restored to normal. Abstinence is absolutely effective for simple alcoholic fatty liver, and liver fat deposition usually subsides within weeks or months. The majority of drug induced fatty liver can be completely recovered within 2-3 months after stopping the drug in time. Fatty liver caused by starvation and protein - calorie deficiency can be reversed rapidly by supplementing protein or amino acids in the diet and sufficient heat. The key to the treatment of obesity and diabetic fatty liver. Parenteral nutrition should be used to avoid excessive heat and excessive fat emulsion infusion in fatty liver. Chronic hepatitis patients regardless of whether the need for long-term high calorie intake and excessive emphasis on rest, weight gain may be induced by fatty liver, it should be possible to avoid these factors. The fatty liver caused by small bowel bypass surgery should be re operated to restore the situation before the diversion and supplement the essential amino acids. The liver injury caused by vomiting of fatty liver after pregnancy was lost, while in the acute fatty liver of pregnancy, the fat deposition in the liver could be completely dissipated after the termination of pregnancy and complications. Thus, the removal of the cause and control of the primary disease is the basic method for the treatment of fatty liver.

  two, diet therapy

Epidemiological studies have shown that the incidence of fatty liver is closely related to the unreasonable diet and nutritional imbalance. The scientific and reasonable diet plays an important role in the effective prevention and treatment of obesity fatty liver, diabetic fatty liver, dystrophic fatty liver, hepatitis and fatty liver of hyperlipidemic fatty liver and alcoholic liver disease in. Therefore, dietary adjustment is considered to be the basic method for the treatment of most chronic fatty liver, and it is also an important measure to prevent and control the progress of fatty liver. The principle of diet therapy should be based on the patient's ideal target weight, the correct adjustment of the daily energy intake and scientific distribution of various nutritional factors, and adhere to a reasonable diet. Lean meat, fish, egg white and fresh vegetables are rich in dietary lipophilic substances, contribute totheextinction of fatty liver, drug highfiber help to increase satiety and control blood glucose and blood lipid, the nutrition of fatty liver is particularly important. It should be noted that the fatty liver patients in the diet must contain the right amount of fat, and pay attention to the appropriate control of carbohydrate intake. Because the amount of fat intake required for human health, even if the intake of fat free food, the body can utilize carbohydrate and amino acids precursor synthesis of fat; and excessive intake of carbohydrates, especially rich in monosaccharide or disaccharide sweets, can increase insulin secretion, to promote sugar into fat. For alcoholic liver disease, malignant malnutrition and protein - calorie malnutrition caused by fatty liver and fatty liver cirrhosis, in particular, should emphasize the addition of adequate quality protein and calorie nutritional support therapy. In short, should be based on the different causes of the disease and the patient to develop a specific diet treatment program, and timely adjustments in the event of changes in the disease.

Three, exercise therapy

Lack of exercise can lead to disuse atrophy and low respiratory and circulatory function, and reduce energy consumption, induce obesity and its related complications. The exercise is the best method of heat consumption, lipid-lowering diet, improve insulin resistance and prevent bad illnesses. Patients with chronic excess fatty liver should adhere to participate in moderate exercise amount of aerobic exercise, in order to maintain ideal weight and relatively normal blood lipid and blood glucose levels, and maintain normal insulin sensitivity. A large number of facts show that, for the promotion of exercise therapy caused by obesity, diabetes, hyperlipidemia and other nutritional excess fatty liver regression is especially important, and can prevent the coexistence of insulin resistance and hypertension, reduce the incidence of atherosclerosis and cardiovascular and stroke.

Before the start of the exercise therapy for patients with a comprehensive medical examination, physical examination and lifestyle checks. The specific movement as much as possible to mobilize the body muscles in equal aerobic projects, namely the maximum intensity of 50% before and after the heart rate reaches a certain level (age 170- / min), and according to the motion intensity determines each exercise duration (15-60 minutes) and frequency (3-5 times per week). At the same time, pay attention to exercise calorie consumption should be limited, and diet therapy and other use, and to prepare and organize activities to prevent sports injury, exercise should be from small to large, slowly increasing, at the same time to explain patients with complication and treatment may appear in motion. Many studies show that the obesity exercise is more important than dieting to lose weight, the reason for the removal of the exercise to lose weight is mainly abdominal visceral fat, visceral obesity and abdominal obesity than subcutaneous fat more easily with diabetes, hyperlipidemia, hypertension and fatty hepatitis and other malignant diseases. Dystrophic fatty liver, alcoholic fatty liver, fatty liver, drugs of parenteral nutrition associated with fatty liver, and serious heart, brain, kidney and liver dysfunction in all patients with fatty liver should be appropriate to limit the amount of activity, and in patients with acute fatty liver needs to emphasize the importance of bed rest.

Four, psychological and behavioral modification therapy

Today's medical model has changed from the original biomedical model to biological, psychological and social medicine. The concept of health is no longer limited to disease, but a state of physical, mental, and social well-being. The biological factors are closely related to the occurrence of the disease, but the social factors such as psychological factors and bad behavior also play an important role in the development of the disease. Therefore, for the development of many diseases should be considered psychogenic factors involved, and proper psychological treatment is very important for the rehabilitation of chronic liver disease in patients with fatty liver. For most of the treatment of focal fatty liver may be only through psychological comfort, relieve the patient's psychological fear of cancer.

Obesity, type 2 diabetes, hypertension and fatty liver disease or even a large class can be regarded as the new "city of modern life or fashionable disease disease, its occurrence mainly sedentary lifestyle and diet of high fat and high calorie and increasingly fierce competition environment is closed. In addition, excessive and excessive feeding, snacks and night eating, do not eat breakfast and dinner, the quality is too high and too late, irregular diet can disrupt metabolism dynamics, provide the conditions for the onset of obesity and fatty liver. Therefore, it is necessary to correct their unhealthy diet and lifestyle. The behavior modification therapy of fatty liver aims to prevent and treat diseases by changing the bad habits and habits of patients with fatty liver and their high risk groups. It is mainly suitable for obesity, type 2 diabetes, hyperlipidemia and fatty liver and alcoholic liver disease, adjuvant therapy, the available charts of the diet, weight diary, chewing therapy and reasonable distribution of meals and other methods, and to encourage them to participate in sports, to understand "what to do than sit a real strong" this truth; the latter should abstain from all alcoholic beverages, including beer, low Yellow Wine, and pay attention to prevention and treatment of alcohol dependence and abstinence syndrome.

Five, drug therapy

On the part of patients with fatty liver, especially fatty hepatitis patients complicated with liver injury in the liver, reducing enzyme, can choose appropriate drugs to promote fat, liver fat and inflammation subsided, preventing liver cell necrosis and hepatic fibrosis. Due to the complex etiology and pathogenesis of fatty liver, many problems are still under study. Therefore, so far has not found specific drugs for treatment of fatty liver, although it has been reported that in the removal of etiology and control of primary disease cases, relying solely on drugs can cure fatty liver, but in general, the drug only play an auxiliary role in the treatment of fatty liver, according to etiology, the fatty liver type, stage and complication of appropriate selection of 2 to 3 kinds of drugs.

At present, most drugs used to treat fatty liver, are almost always in physiological and biochemical processes of the liver as the foundation, and the choice of the results of animal experiments, the purpose is to promote and accelerate the transfer of fatty liver lipid metabolism in the liver, which is called "fat drugs". We found that some fat drugs including vitamin B, choline and methionine, after clinical practice has proved that the effect is not certain; silymarin, polyunsaturated lecithin (Yi Shanfu) and ursodeoxycholic acid and cell protective agent for some patients with fatty liver, but not for other patients with fatty liver; propylthiouracil and corticosteroids may be effective only for patients with alcoholic hepatitis; anti fibrosis drugs including interferon, colchicine, advantages and disadvantages of the treatment of liver fibrosis is still controversial; some drugs (especially elastase, clofibrate, bezafibrate and hypolipidemic drugs), or even induce liver damage and increase fat accumulation in the liver. However, due to cardiovascular and cerebrovascular diseases are the main factors influencing life, nutrition disorders so whether fatty liver patients required the use of lipid-lowering drugs should decrease blood lipids and improve atherosclerosis and prevent cardiovascular and stroke, consider more aspects and on fat deposition in the liver, liver cell damage and fibrosis effect etc.. One thing can be sure that the majority of lipid-lowering drugs for the role of liver fat loss is limited, so the simple fatty liver may not be the indication of the use of lipid-lowering drugs. For patients with fatty hepatitis and cirrhosis, by keeping the stool, adjust the intestinal flora, reduce the absorption of endotoxin and other measures to prevent intestinal endotoxemia, the prognosis of the disease may have a certain influence.

Six, traditional Chinese medicine treatment

Animal studies found that salvia, chuanxiong, cassia, hawthorn, Alisma, polygonatum, rhubarb and many other traditional Chinese medicine can reduce blood lipids, promote extinction in fatty liver, even with the protective effect of liver cells, prevention and treatment of liver fibrosis. Therefore, according to the principle of prescription of traditional Chinese medicine dialectical therapy, or select the salvia Danning tablets such as medicine, to relieve symptoms, promote liver fat subsided, prevention and treatment of complications. Japan reported that large and small Bupleurum Decoction in the treatment of fatty liver is effective, there are many other applications of the compound, as well as Xuezhikang, tablets and other Chinese medicine. The biggest advantage of traditional Chinese medicine is that the side effects are relatively small, so it has broad application and development prospects. But up to now, there is not a kind of traditional Chinese medicine prescription which can cure various fatty liver. Some of the so-called traditional Chinese medicine for the treatment of fatty liver, which is introduced in advertisements, is not reliable. In addition, the long-term use of large doses of Chinese medicine, especially traditional Chinese medicine compound, will lead to liver and kidney function damage and other drug-induced diseases, should not be carried out on patients with Chinese medicine non-toxic misleading.

Obesity, type 2 diabetes, hypertension and fatty liver disease or even a large class can be regarded as the new "city of modern life or fashionable disease disease, its occurrence mainly sedentary lifestyle and diet of high fat and high calorie and increasingly fierce competition environment is closed. In addition, excessive and excessive feeding, snacks and night eating, do not eat breakfast and dinner, the quality is too high and too late, irregular diet can disrupt metabolism dynamics, provide the conditions for the onset of obesity and fatty liver. Therefore, it is necessary to correct their unhealthy diet and lifestyle. The behavior modification therapy of fatty liver aims to prevent and treat diseases by changing the bad habits and habits of patients with fatty liver and their high risk groups. It is mainly suitable for obesity, type 2 diabetes, hyperlipidemia and fatty liver and alcoholic liver disease, adjuvant therapy, the available charts of the diet, weight diary, chewing therapy and reasonable distribution of meals and other methods, and to encourage them to participate in sports, to understand "what to do than sit a real strong" this truth; the latter should abstain from all alcoholic beverages, including beer, low Yellow Wine, and pay attention to prevention and treatment of alcohol dependence and abstinence syndrome.

 

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