Professor Pei Yongqing's Empirical Formula for Fatty Liver: Chaihu Weiling Tang
Fatty liver disease is a common ailment of modern times. Mild fatty liver can usually be reversed by controlling diet and increasing exercise, but moderate or severe fatty liver requires medication. In clinical treatment of fatty liver, Professor Pei Yongqing created an empirical formula, Chaihu Weiling Tang: Chaihu (Bupleuri Radix) 12 g, Huangqin (Scutellariae Radix) 10 g, Fabanxia 12 g, Cangzhu (Atractylodis Rhizoma) 15 g, Houpo 15 g, Chenpi 10 g, Fuling 30 g, Zhuling (Polyporus) 15 g, Zexie 25 g, Baizhu (Atractylodis Macrocephalae Rhizoma) 12 g, Yujin (Curcumae Radix) 15 g, Chuanlianzi 12 g, Sheng Zhizi (Gardeniae Fructus) 6 g.
Professor Pei's formula combines Xiaochaihu Tang, Pingwei San, and Siling San, mainly for fatty-liver patients with liver-gallbladder heat stagnation and spleen-stomach dampness excess. According to his experience, moderate fatty liver takes about 4–6 months of treatment to clear, and severe fatty liver about nine months to cure. During treatment the patient must also strictly avoid certain foods, eat mainly a vegetarian diet, and exercise more. Fatty liver is a common disease closely tied to lifestyle; a large proportion of adults over forty have it.
The overall prevalence of fatty liver among Chinese residents is about 25%—a fairly high figure. Fatty liver has become the second most common liver disease after viral hepatitis; severe fatty liver can progress to cirrhosis, imposing a heavy burden on patients and families. Preventing and treating it is therefore important for protecting liver health. Most fatty liver is related to obesity: 30–50% of obesity cases are complicated by fatty liver, and in severe obesity the fatty-liver rate reaches as high as 61–94%. Yet not all fatty-liver patients are obese: about 75–95% of long-term heavy drinkers also show fat infiltration of the liver.
Some people who lose weight rapidly also develop fatty liver, because a sudden large increase in fat breakdown consumes hepatic glutathione (GSH), sharply raising hepatic malondialdehyde and lipid peroxides, damaging hepatocytes. So weight loss must be scientific and gradual. In addition, long-term malnutrition and chronic diseases such as diabetes can also cause fatty liver, so the diet must be balanced and not one-sidedly bland. Some patients who have long been vegetarian also develop fatty liver, which often puzzles them greatly.
Pregnancy in women can also induce fatty liver; in particular, fatty liver appearing in the 34th–40th week of a first pregnancy often has a poor prognosis, with maternal and infant mortality as high as 80% and 70%. Some drugs or chemical toxins also cause fatty liver by inhibiting protein synthesis—for example tetracycline, adrenal corticosteroids, puromycin, cyclohexylamine, emetine, and arsenic, lead, silver, and mercury. Some lipid-lowering drugs used for weight loss can also cause fatty liver by interfering with lipoprotein metabolism. Other diseases (such as tuberculosis and viral hepatitis) and medications used in treating them (such as hormones) can likewise cause fatty liver.
Cancer patients with a history of fatty liver easily develop abnormal liver function during integrated Chinese-Western anticancer treatment. Among cancer patients, whether fat or thin, there are many with fatty liver, with elevated triglycerides and cholesterol.
Controlling diet and losing weight alone can no longer improve their liver function; Professor Pei's approach to fatty liver is worth such patients' reference. If patients do not change their lifestyle, fatty liver rebounds very easily even after cure. The causes of fatty liver are varied; patients whose fatty liver arises from different causes should, while actively treating it, adjust their lifestyle in a targeted way to avoid recurrence.