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JKM > Volume 37(1); 2016 > Article
Tai-Hyeun: A Case Study on A Patient with Non-Alcoholic Fatty Liver Disease (NAFLD) by Using Ultrasound



The purpose of this study is to report the clinical effect of Shihosogan-tang extract on NAFLD through ultrasound.


The patient was treated with Shihosogan-tang extract. We observed the changes in symptoms and ultrasound imaging on a patient with NAFLD.


After treatment, the symptoms of the patient with NAFLD were decreased and ultrasound imaging were improved from moderate to mild grade.


The patient of NAFLD was improved in symptoms and ultrasound imaging.

Fig. 1.
Ultrasonography findings of liver at 2015.6.4.
(A): US image shows moderate obscuration of diaphragm and hepatic vessels due to fatty infiltration
(B): The echo-texture of the liver is brighter than the right kidney due to fatty liver
Fig. 2.
Ultrasonography findings of liver at 2015.9.4.
(A): The obscuration of diaphragm and hepatic vessels is lesser than Fig.1 (A)
(B): The difference in echogenicity between the liver and right kidney is lesser than Fig.1 (B)
Fig. 3.
Ultrasonography findings of liver at 2015.12.22.
(A): US image shows slight obscuration of diaphragm and hepatic vessels
(B): The difference in echogenicity between the liver and right kidney is lesser than Fig.1 (B)
Table 1.
The improvement of clinical symptoms
Date 2015.6.4. 2015.7.2. 2015.9.4. 2015.11.4. 2015.12.21.

疲勞 +++ +++ ++ ++ +
上熱感 ++ ++ + + ±
易怒 +++ +++ ++ + ±
偏頭痛 ++ ++ ++ + +
消化不良 +++ ++ ++ + ±

Symptom Grade : +++ severe, ++ moderate, + mild, ± trace

Table 2.
Classification of Fatty Liver by Scararige
구 분 판 정 기 준
輕症 (mild) 우측 신실질의 에코(echo)보다 간실질의 에코가 약간 증가된 상태로 간내 혈관들이나 횡격막이 잘 보이는 경우
中等度 (moderate) 우측 신실질의 에코보다 간실질의 에코가 중간 정도 증가된 상태로 간내 혈관들이나 횡격막이 약간 불분명하게 보이는 경우
重症 (severe) 우측 신실질의 에코보다 간실질의 에코가 심하 게 증가된 상태로 간내 혈관들이나 횡격막이 거 의 보이지 않는 경우


1.. Sim CS. Abdominal Ultrasound. Seoul: Yeo Mun Gak;2002. p. 268

2.. Liver System Association of Internal Medicine. Liver System of Internal Medicine. 5th ed. Seoul: Nado;2013. 38:p. 321–5.

3.. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med. 2002; 346:1221–31.

4.. Kim SY. The Association of Nonalcoholic Fatty Liver Disease with Metabolic Syndrome [dissertation]. Seoul: Ewha Womans Univ;2006.

5.. Caturelli E, Squillatne MM, Andriulli A, Rapaccini GL. Hypoechoic lesions in the ‘bright liver’ : A reliable indicator of fatty change. A prospective study. J Gastroenterol Hepatol. 1992; 7:469–72.

6.. Joseph AE, Saverymuttu SH, al Sam S, Cook MG, Maxwell JD. Comparison of liver histology with ultrasonography in assessing diffuse parenchymal liver disease. Clin Radiol. 1991; 43:1. 26–31.

7.. Hong MU, Hong H. Practical Chinise Medicine of Digestive Disease. 1st ed. Tianjin: Tianjin Science & Technology Translation & Publishing CO;1994. p. 235

8.. Scatarige JC, Scott WW, Donovan PJ, Siegelman SS, Sanders RC. Fatty infiltration of the liver: ultrasonographic and computerized tomographic correlation. J Ultrasound Med. 1984; 3:9–14.

9.. Kim HK, Gwon YO, Kim JY, Gwak KS, Choi RH, Jeong JM, et al. Comparatives Studty of Serum Transaminase Level and Liver Biopsy Finding in Fatty Liver. Journal of Korean Medical Association. 1988; 31:1. 79–84.

10.. Kim SH, Kang DH, Lee SH, Yun CH. Causes of Fatty Liver Diagnosed by Abdominal Ultrasonography. Korean J Fam Med. 1995; 16:11. 785–794.

11.. Cho KH, Hong MH, Yu HD, Lee TH, Cho AK, Park YK, et al. Clinical Significance of Fatty Liver diagnosed by Abdominal Ultrasonography. Korean J Fam Med. 1993; 14:11. 734–742.

12.. Im CS, Kim SS. Risk Factors Associated with Metabolic Syndrome in Ultrasonographic Fatty Liver. Korean J Obes. 2008; 17:3. 124–131.

13.. Hultcrantz R, Gabrielsson N. Patients with persistent elevation of aminotransferases: investigation with ultrasonography, radionuclide imaging and liver biopsy. J Intern Med. 1993; 233:7–12.

14.. Fishbein MH, Gardner KG, Potter CJ, Schmalbrock P, Smith MA. Introduction of fast MR imaging in the assessment of hepatic steatosis. Magn Reson Imaging. 1997; 15:287–93.

15.. Mclane J. Analysis of common side effects of isotretinoin. J Am Acad Dermatol. 2001; 45:S188–94.

16.. Rodondi N1, Darioli R, Ramelet AA, Hohl D, Lenain V, Perdrix J, et al. “High risk for hyperlipidemia and the metabolic syndrome after an episode of hypertriglyceridemia during 13-cis retinoic acid therapy for acne: a pharmacogenetic study.”. Ann Intern Med. 136:2002; 582–9.

17.. McCarter TL, Chen YK. “Marked hyperlipidemia and pancreatitis associated with isotretinoin therapy.”. Am J Gastroenterol. 1992; 87:1855–8.

18.. Wysowski DK, Pitts M, Beitz J. “An analysis of reports of depression and suicide in patients treated with isotretinoin.”. J Am Acad Dermatol. 2001; 45:515–9.

19.. Ryu KJ, Kim JH, Han C, Park JH, Kwon SR. A Case Report of Panic Disorder with Functional Gastrointestinal Disturbance. J of Oriental Neuropsychiatry. 2009; 20:2. 187–196.

20.. Oh KC. A Clinical report on Panic Disorder with Nausea treated by Shihosogantang-gami. J of the Korea Institute of Oriental Medical Diagnostics. 2012; 16:3. 59–68.

21.. Lee SR, Ryu HY. Effects of Ondamtang, Samulansintang and Shihosogansan Water Extract on the Obesity and Stress. J of Oriental Neuropsychiatry. 1992; 3:1. 25–45.

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