社團法人臺灣臨床藥學會

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【綜合評述】非酒精性肝臟疾病及其治療
Nonalcoholic Fatty Liver Disease Treatment
非酒精性肝臟疾病、非酒精性肝炎、水飛薊、Nonalcoholic Fatty Liver Disease (NAFLD), Non-alcoholic steatohepatitis (NASH), Silymarin
龔紹龍Siu-Lung Kung1 、許旭東Hsu-Tung Hsu1 、黃玉瑩Yu-Ying Huang*1 、李芷葶Jr-Ting Lee2
1西園醫院藥劑科 、2三峽榮民之家
非酒精性肝臟疾病 (nonalcoholic fatty liver disease, NAFLD) 影響開發國家中3 分之1 的成人,兒童人口也正在增加中,這是一個正在萌發的健康問題,它的主要特徵是脂肪大量堆積 ( 以triglycerides, TG 為主)。病程進展主要是先形成單純性脂肪肝,再引起非酒精性肝炎 (non-alcoholic steatohepatitis, NASH),進而造成肝纖維化甚至是肝硬化等。
目前NAFLD 尚無特定理想治療藥物,治療方針主要是改善潛在危險因子或使用藥物控制慢性疾病進展為主,建議依形成脂肪肝原因對症加以治療,如:體重過重導致的脂肪肝,須適度減輕體重;長期接觸傷害肝臟的化學物質或藥物,引起的脂肪肝,則須立即停止使用這些藥物;疾病引起的脂肪肝,如C 型肝炎、糖尿病、血脂肪過高等,須針對源頭著手,治療C肝、血糖、控制血脂肪;若是體質因素導致TG太高,則須服用降血脂藥物,才能改善脂肪肝。

Nonalcoholic fatty liver disease (NAFLD) is a burgeoning health problem that affects one-third of adults and an increasing numbers of children in developed countries. It is characterized by fat accumulation, mostly as triglycerides (TG), in the liver that may progress throughout hepatic steatosis and inflammation (nonalcoholic steatohepatitis; NASH) toward fibrosis and cirrhosis.
As of now, NAFLD still does not have a primary medicine for treatment. Treatment methods mainly focus on dealing with risk factors or using medicine to control chronic disease. It is recommended to apply treatment based on the cause of fatty liver accumulation. For example, diet program should be applied for fatty liver caused by overweight. Immediate stop of usage of chemical substances or medicines that are harmful to the liver. For fatty liver caused by diseases, such as hepatitis C, diabetes mellitus, or excessive blood lipids, these will require treatments specifically targeting the disease based on the root cause. However, if the excessive TG value was due to individual’s body characteristics, then he or she will need to apply lipidlowering drugs to reduce the accumulation of fatty liver.
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