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http://dx.doi.org/10.22246/jikm.2019.40.1.13

A Systematic Review of Korean Medicine for Non-Alcoholic Fatty Liver Disease  

Lee, Yu-ri (Dept. of Korean Internal Medicine of Hepatology, College of Korean Medicine, Daegu Haany University)
Cho, Na-kyung (Dept. of Korean Internal Medicine of Hepatology, College of Korean Medicine, Daegu Haany University)
Choi, Hong-sik (Dept. of Korean Internal Medicine of Hepatology, College of Korean Medicine, Daegu Haany University)
Kim, Seung-mo (Dept. of Korean Internal Medicine of Hepatology, College of Korean Medicine, Daegu Haany University)
Kim, Kyung-soon (Dept. of Korean Internal Medicine of Hepatology, College of Korean Medicine, Daegu Haany University)
Publication Information
The Journal of Internal Korean Medicine / v.40, no.1, 2019 , pp. 13-37 More about this Journal
Abstract
Objectives: The purpose of this study was to assess the effects of Korean medicine for non-alcoholic fatty liver disease (NAFLD). We analyzed the result of randomized controlled trials (RCTs) that applied Korean medicine to NAFLD patients through meta analysis and systematic review. Methods: The key question was to the effects of Korean medicine for NAFLD patients according to the PICO-SD (participants, intervention, comparison, outcome, study design) and we included only RCTs. We searched 10 databases including NDSL, KMBASE, KISS, KISTI, KoreaMed, Koreantk, OASIS, Cochrane, Pubmed, EMBASE without a language restriction. We assessed risk of bias by Cochrane group's Risk of Bias tool. Results: The finally selected 12 RCTs were analyzed. Total number of participants was 1189 (male 719, female 470) as 684 and 505 in the oriental medicine group (i.e. herbal drugs, acupuncture, acupoint embedding therapy) and control group (conventional drugs, placebo), respectively. The meta analysis results of examining 7 RCTs comparing the therapeutic efficacy of herbal medicine with that of Western medicine showed statistically significant (p<0.05) differences in the efficacy evaluation, liver function test results, blood lipids, and TNF-${\alpha}$. Furthermore, the meta analysis results of investigating 3 RCTs comparing the therapeutic efficacy of herbal medicine with that of a placebo showed statistically significant (p<0.05) differences in the liver function test results, blood lipids, and waist circumference. Conclusions: The research showed that Korean medicine for NAFLD can be effective treatment. But more studies are required to enhance the level of evidence and we should report on safety.
Keywords
non-alcoholic fatty liver disease; Korean medicine; systematic review; meta analysis;
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1 Kasper DL, Fauci AS, Hauser S, Longo D, Jameson JL, Loscalzo J. Harrison's Principles of Internal Medicine 19th Edition. Seoul: McGraw-Hill Education Korea, Ltd. and Medical Information Provider; 2015, p. 2931-5.
2 Cheon GJ, Kim YD. Role of pharmacologic treatment of NAFLD: Cons. The Korean journal of internal medicine2018;spr:251-6.
3 Brolin RE, Bradley LJ, Taliwal RV. Unsuspected cirrhosis discovered during elective obesity operations. Archives of surgery 1998;133(1):84-8.   DOI
4 Dallal RM, Mattar SG, Lord JL, Watson AR, Cottam DR, Eid GM, et al. Results of laparoscopic gastric bypass in patients with cirrhosis. Obesity Surgery 2004;14(1):47-53.   DOI
5 Jeongughanuigwadaehag gangyenaegwahaggyosil. Gangyenaegwahag. Seoul: Nado; 2013, p. 321-8.
6 Chen L, Jiang YK, Cai YB. Effects of resolving phlegm method on fibrinolytic status in non-alcoholic steatohepatitis patients of phlegm and blood-stasis syndrome. Chinese Journal of Integrated Traditional and Western Medicine 2006;26(12):1090-3.   DOI
7 Liu G, Guan GJ, Qi TG, Fu YQ, Li XG, Sun Y, et al. Protective effects of Salvia miltiorrhiza on rats with streptozotocin diabetes and its mechanism. Journal of Chinese Integrative Medicine 2005;3(6):459-521.   DOI
8 Kweon YM, Lee JE, Park SD. The preventive effect of Bupleuri radix on liver damage induced by acetaminophen in the rats. Kor J Herbology 2004;19(4):91-104.
9 Lee E, Lee JC. Effects of Siho(Bupleuri Radix) extracts on serum lipid composition and antioxidant system in rat fed high fat diet. The Korean Journal of Oriental Medical Prescription 2003;11(1):151-9.
10 Lindor KD, Kowdley KV, Heathcote EJ, Harrison ME, Jorgensen R, Angulo P, et al. Ursodeoxycholic acid for treatment of nonalcoholic steatohepatitis: results of a randomized trial. Hepatology 2004;39(3):770-8.   DOI
11 Leuschner UF, Lindenthal B, Herrmann G, Arnold JC, Rössle M, Cordes HJ, et al. NASH Study Group. High-dose ursodeoxycholic acid therapy for nonalcoholic steatohepatitis: a doubleblind, randomized, placebo-controlled trial. Hepatology 2010;52(2):472-9.   DOI
12 Meng SX. Observation on therapeutic effect of acupuncture for treatment of patients with nonalcoholic steatohepatitis. Chinese acupuncture & moxibustion2009;29(8):616-24.
13 Gu CL, Zhang YK, Fu YX, Yang SF, Li XQ. Effect of Tiaozhi Yanggan Decoction(调脂养肝 汤) in treating patients with non-alcoholic fatty liver. Chinese Association of Traditional and Western Medicine2007;13(4):275-9.
14 Petyaev IM, Dovgalevsky PY, Chalyk NE, Klochkov VA, Kyle NH, Bashmakov YK. Reduction of Liver Span and Parameters of Inflammation in Nonalcoholic Fatty Liver Disease Patients Treated with Lycosome Formulation of Phosphatidylcholine: A Preliminary Report. International Journal of Chronic Diseases2018;2018:1-7.
15 Korea Orphan & Essential Drug Center. Thiola. http://www.kodc.or.kr. Accessed April. 30, 2018.
16 Huang Z, Song S, Tan K, Chu J, Zhu X, Zeng Y. Non-alcoholic fatty liver disease of liver stagnation and spleen deficiency pattern treated with acupoint embedding therapy: a randomized controlled trial. Chinese acupuncture & moxibustion 2016;36(2):119-42.
17 Ji G, Fan JG, Chen JJ, Lu LG, Xing LJ, Zheng PY, et al. Effectiveness of Danning Tablet in Patients with non-alcoholic Fatty Liver of damp-heat Syndrome Type: A Multicenter Randomized Controlled Trial. Journal of Chinese Integrative Medicine2008;6(2):128-34.   DOI
18 Li L, Zhang XJ, Lan Y, Xu L, Zhang XZ, Wang HH. Treatment of non-alcoholic fatty liver disease by Qianggan Capsule(强肝胶囊). Chinese Association of Traditional and Western Meedicin 2010;16(1):23-7.
19 Lou SY, Wang WJ. Effects of Yiqi Sanju Formula on non-alcoholic fatty liver disease: a randomized controlled trial. Journal of Chinese Integrative Medicine2008;6(8):793-8.   DOI
20 Panahi Y, Kianpour P, Mohtashami R, Jafari R, SimentalMendia LE, Sahebkar A. Efficacy and Safety of Phytosomal Curcumin in Non-Alcoholic Fatty Liver Disease: A Randomized Controlled Trial. Drug research 2017;37(4):244-51.
21 Rahmani S, Asgary S, Askari G, Keshvari M, Hatamipour M, Feizi A, et al. Treatment of Non-alcoholic Fatty Liver Disease with Curcumin: A Randomized Placebo-controlled Trial. Phytotherapy Research2016;30(9):1540-8.   DOI
22 Zhang SJ, Chen ZX, Jiang KP, Cheng YH, Gu YL. The effect of QuYuHuaTanTongLuo Decoction on the non-alcoholic steatohepatitis. Complement Ther Med2008;16(4):192-8.   DOI
23 Mulrow C, Lawrence V, Jacobs B, Dennehy C, Sapp J, Ramirez G, et al. Report on milk thistle: effects on liver disease and cirrhosis and clinical adverse effects. Evidence report/technology assessment 2000;21:1-3.
24 Lazo M, Solga SF, Horska A, Bonekamp S, Diehl AM, Brancati FL, et al. Effect of a 12-month intensive lifestyle intervention on hepatic steatosis in adults with type 2 diabetes. Diabetes Care 2010;33(10):2156-219.   DOI
25 Marra F, Bertolani C. Adipokines in liver diseases. Hepatology 2009;50(3):957-1026.   DOI
26 Tang JM, Liang HQ, Wang HG, Lin MT, Zhang LM, Chen SD. Efficacy of Zaozhu Yinchen Recipe for Treating Non-alcoholic Steatohepatitis and its Effect on Free Fatty Acid and TNF-alpha. Chinese Journal of Integrated Traditional and Western Medicine2016;36(5):544-52.
27 Wang YL. Yiqi Huoxue Recipe combined with polyene phosphatidylcholine capsule in treating 50 patients with non-alcoholic fatty hepatitis. Chinese Journal of Integrated Traditional and Western Medicine2007;27(2):162-6.   DOI
28 Kim DH, Lee SH, Kim SH, Lee SH, Kim BK. Herbal Medicine(Hyeolbuchukeo-tang, Xuefu Zhuyu Decoction) for Insomnia Disorder: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Journal of oriental neuropsychiatry 2017;28(4):319-32.   DOI
29 Gu JH, Kim ES, Park YC, Jung IC, Lee EJ. A Systematic Review of Bee Venom Acupuncture for Knee Osteoarthritis. Journal of oriental rehabilitation medicine2017;27(3):47-60.
30 Han IS, Shin JH, Cho YY, Park HM, Yang CS, Jeong MJ, et al. Qu-Ji-Du-Huang-Wan for Essential Hypertension : Systemic Review and Meta-analysis. J Physiol & Pathol Korean Med 2017;31(2):118-25.   DOI
31 Kim SY, Park JE, Seo HJ, Lee YJ, Jang BH, Son HJ, et al. NECA's guidance for undertaking systematic reviews and meta-analyses for intervention. National Evidence-based Healthcare Collaborating Agency 2011.
32 Hyun J, Lee JB, Kim SY, Han CW. Clinical Effectiveness of Acupuncture in the Treatment of Non-Alcoholic Fatty Liver Disease: A Systematic Review. The Journal of Internal Korean Medicine 2018;39(6):1206-24.   DOI
33 Herbal medicine Compilation Committee of College of Oriental Medicine. Herbal Medicine. 2nd edition. Seoul: Jeongseonsa; 2011, p. 186-8, 411-2, 452-3, 458-9.
34 Park YH, Yoo SR, Son CG. Overview for Prevalence and Pathology of Non-Alcoholic Fatty Liver Disease. Korean J Orient Int Med 2011;32(1):26-32.
35 Lee YK, Jang DH, Kim JH, Yoo JS, Ku JR, Jung YS, et al. Comparison of Pakistani and Chinese Ephedra Herba-Containing Gangjihwan in the Improvement Effects of Nonalcoholic Fatty Liver Disease in a High Fat Diet-Fed NAFLD Mouse Model. Herbal Formula Science 2014;22(1):113-22.   DOI
36 Jang DH, Kim JH, Yoo JS, Yoon M, Ku JR, Seok HJ, et al. Gangjihwan Improves Nonalcoholic Fatty Liver Disease in High Fat Diet-Fed C57BL/6N Mice. Kor J Herbology 2014;29(2):47-54.   DOI
37 Roh JS, Lee HR, Ahn YJ, Yoon MC, Shin SS. Massa Medicata Fermentata improves fatty liver in high fat diet-fed nonalcoholic fatty liver disease's mouse model. Kor J Herbology 2014;29(2):23-31.   DOI
38 Jang DH, Jung YS, Kim JH, Kim BC, Seok HJ, Yoo JS, et al. Comparison of Gangjihwan and Combination of Gangjihwan and Gamisochehwan in the Improvement Effects of Nonalcoholic Fatty Liver Disease in a High Fat Diet-Fed NAFLD Mouse Model. Herbal formula science 2014;22(1):167-76.   DOI
39 Panahi Y, Alishiri GH, Parvin S, Sahebkar A. Mitigation of systemic oxidative stress by curcuminoids in osteoarthritis:results of a randomized controlled trial. Journal of Dietary Supplements2016;13(2):209-29.   DOI
40 Panahi Y, Ghanei M, Hajhashemi A, Sahebkar A. Effects of curcuminoids-piperine combination on systemic oxidative stress, clinical symptoms and quality of life in subjects with chronic pulmonary complications due to sulfur mustard: a randomized controlled trial. Journal of Dietary Supplements 2016;13(1):93-105.   DOI
41 Panahi Y, Hosseini MS, Khalili N, Naimi E, Majeed M, Sahebkar A. Antioxidant and anti-inflammatory effects of curcuminoid-piperine combination in subjects with metabolic syndrome: a randomized controlled trial and an updated meta-analysis. Clinical nutrition 2015;34(6):1101-9.   DOI
42 Sahebkar A. Are curcuminoids effective C-reactive protein-lowering agents in clinical practice? Evidence from a meta-analysis. Phytotherapy Research 2014;28(5):633-42.   DOI
43 Panahi Y, Sahebkar A, Amiri M, Davoudi SM, Beiraghdar F, Hoseininejad SL, et al. Improvement of sulphur mustard-induced chronic pruritus, quality of life and antioxidant status by curcumin: results of a randomised, double-blind, placebocontrolled trial. British Journal of Nutrition 2012;108(7):1272-81.   DOI
44 Panahi Y, Saadat A, Beiraghdar F, Sahebkar A. Adjuvant therapy with bioavailability-boosted curcuminoids suppresses systemic inflammation and improves quality of life in patients with solid tumors: a randomized double-blind placebocontrolled trial. Phytotherapy Research 2014;28(10):1461-7.   DOI
45 Panahi Y, Sahebkar A, Parvin S, Saadat A. A randomized controlled trial on the anti-inflammatory effects of curcumin in patients with chronic sulphur mustard-induced cutaneous complications. Annals of Clinical Biochemistry: an international journal of biochemistry in medicine2012;49(Pt6):580-8.   DOI
46 Li HB, Fang KY, Lu CT, Li XE. Study on lipid-regulating function for the extracts and their prescriptions from Semen Cassiae and fructus crataegi. Journal of Chinese Medicinal Materials2007;30(5):573-8.   DOI
47 Chuengsamarn S, Rattanamongkolgul S, Luechapudiporn R, Phisalaphong C, Jirawatnotai S. Curcumin extract for prevention of type 2 diabetes. Diabetes Care 2012;35(11):2121-8.   DOI
48 Chuengsamarn S, Rattanamongkolgul S, Phonrat B, Tungtrongchitr R, Jirawatnotai S. Reduction of atherogenic risk in patients with type 2 diabetes by curcuminoid extract: a randomized controlled trial. J Nutr Biochem 2014;25(2):144-50.   DOI
49 Sahebkar A. Low-density lipoprotein is a potential target for curcumin: novel mechanistic insights. Basic & Clinical Pharmacology & Toxicology 2014;114(6):437-8.   DOI
50 The Korean Association for the Study of the Liver. Non-Alcoholic Fatty Liver Disease Guidelines. Seoul: Doseochulpan jingihoeg; 2013, p. 12-33.
51 Park SH, Jeon WK, Kim SH, Kim HJ, Park DI, Cho YK, et al. Prevalence and risk factors of non-alcoholic fatty liver disease among Korean adults. J Gastroenterol Hepatol 2006;21(1):138-43.   DOI
52 Bae JC, Cho YK, Lee WY, Seo HI, Rhee EJ, Park SE, et al. Impact of nonalcoholic fatty liver disease on insulin resistance in relation to HbA1c levels in nondiabetic subjects. Am J Gastroenterol2010;105(11):2389-95.   DOI
53 Choi SY, Kim D, Kim HJ, Kang JH, Chung SJ, Park MJ, et al. The relation between non-alcoholic fatty liver disease and the risk of coronary heart disease in Koreans. Am J Gastroenterol 2009;104(8):1953-60.   DOI
54 Kang DG, Yun YG, Ryoo JH, Lee HS. Antihypertensive effect of water extract of danshen on renovascular hypertension through inhibition of the renin angiotensin system. Am J Chin Med 2002;30(1):87-93.   DOI
55 Niu C, Chen C, Chen L, Cheng K, Yeh C, Cheng J. Decrease of blood lipids induced by Shan-Zha (fruit of Crataegus pinnatifida) is mainly related to an increase of $PPAR{\alpha}$ in liver of mice fed high-fat diet. Hormone and Metabolic Research 2011;43(9):625-55.   DOI
56 Zhang ZP, You TT, Zou LY, Wu T, Wu Y, Cui L. Effect of a compound Danshen preparation in preventing long-term gastric lipid emulsion administration-induced nonalcoholic steatohepatitis in rats. Journal of Southern Medical University 2008;28(7):1109-22.   DOI