Evidence- based Treatment for A Case with Non- alcoholic Steatohepatitis

Objective To make an individualized treatment plan for a case of non- alcoholic steatohepatitis( NASH)by using methods of evidence- based medicine. Methods A 37- year- old man was diagnosed as moderate NASH on April23rd,2012. After clinical problems were put forward,evidence from 1990 to 2012 was collected from the Cochrane library,PubMed,Embase and Chinese Journal Full- text Database( CNKI). Treatment protocols were made according to the search results,combined with patient preferences and physicians' clinical experience. Results A total of 12 meta- analysis or systematic reviews,10 RCTs and 2 cohort studies were included. The results were analyzed and a therapy plan was formulated as follows:low- fat and low- carbohydrate diet,moderate- intensity activities 200 min / week,body weight loss to the goal of 79 kg,taking pioglitazone 30 mg / d. After a six- month follow up,the patient's anorexia and hepatalgia were improved,and ultrasound showed mild fatty liver. Conclusion Integration of lifestyle intervention,weight control,drugs improving insulin resistance and drugs of liver protection can improve the outcome and life quality in non- alcoholic fatty liver patient,but long- term effect needs further observation.