- 现金
- 222032 元
- 精华
- 285
- 帖子
- 67620
- 注册时间
- 2001-11-10
- 最后登录
- 2023-5-7
|
1楼
发表于 2003-11-22 17:33
THE AMERICAN JOURNAL OF GASTROENTEROLOGY
Volume 98 , Issue 11 , Pages 2485-2490
Vitamin E and vitamin C treatment improves fibrosis in patients with
nonalcoholic steatohepatitis *
Stephen A. Harrison a * , Sigurd Torgerson a,d , Paul Hayashi c , John Ward
a,e and Steven Schenker b
Received: 1/17/2003. Accepted: 3/25/2003.
--------------------------------------------------------------------------------
Abstract
Objective
Nonalcoholic steatohepatitis (NASH) is a common cause of liver disease.
Although usually indolent, this disease can progress to cirrhosis in some
patients. There is currently no proven medical therapy for the treatment of
NASH. The aim of our study was to evaluate the efficacy of combination
?-tocopherol (vitamin E) and vitamin C in reducing histologic inflammation
and fibrosis.
Methods
This was a prospective, double-blind, randomized, placebo-controlled trial
with a total enrollment of 49 patients; 45 patients completed the study. All
patients were randomized to receive either vitamins E and C (1000 IU and
1000 mg, respectively) or placebo daily for 6 months, based on their initial
histologic diagnosis of NASH. Additionally, all patients were given standard
weight-loss counseling and encouraged to follow a low fat diet (<30 fat
g/day). The pre- and posttreatment liver biopsies were reviewed by a single
pathologist, who was blinded to the patient's medication. Biopsies were
scored based on a modification of the scoring system published by Brunt et
al. (Am J Gastroenterol 1999;94:2467-74). A score of 0-4 was possible for
fibrosis, and a score of 0-6 was possible for inflammation and hepatocyte
degeneration and necrosis. In addition, body mass index, glycohemoglobin,
lipids, and liver enzymes were followed throughout the study.
Results
Forty-five patients completed 6 months of therapy without significant side
effects. Vitamin treatment resulted in a statistically significant
improvement in fibrosis score (p = 0.002). No changes were noted in
inflammation with treatment.
Conclusions
Vitamin E and vitamin C, in the doses used in this study, were well
tolerated and were effective in improving fibrosis scores in NASH patients.
No improvement in necroinflammatory activity or ALT was seen with this
combination of drug therapy. A larger, multicenter, longer-term trial with
vitamin E and vitamin C seems to be warranted.
|
|