中医药抗肝纤维化临床与基础研究进展

Progress of clinical and basic research on Liver Fibrosis with Traditional Chinese Medicine

本文首先介绍肝纤维化的现代医学研究进展,包括病理机制与诊断方法等;回顾中医学对肝纤维化的研究过程及其认识,指出我国的肝纤维化临床治疗学研究已经跻身世界前列。继而介绍我国抗肝纤维化新药与经过多中心临床试验的中药制剂,包括扶正化瘀方、复方鳖甲软肝片、复方861合剂等。接着介绍抗肝纤维化中药-扶正化瘀方的多途径作用机制与物质基础,如抗肝纤维化作用机制包括抗肝细胞脂质过氧化损伤与肝细胞凋亡、抑制肝星状细胞活化、改善肝窦毛细血管化等,而且针对肝纤维化的不同病理阶段,该方具有各自的药物配伍特点,目前已知该方的主要药效成分包括丹酚酸B、苦杏仁甙与虫草组分等。最后,展望中医药抗肝纤维化发展前景,一方面加强临床试验,提高临床研究水平,促进其国际化;另一方面,开展中医药治疗肝硬化的临床与基础研究,发展肝硬化的中医病机与治法新理论。

The article at first introduces the progresses of liver fibrosis with modern medicine, including pathogenesis and diagnosis etc. , and retrospect the TCM research history and understanding about liver fibrosis, point out that TCM has the advantages against liver fibrosis Chinese clinical investigation on liver fibrosis has now stay at world advanced level. Then the new TCM drugs or recipes with multicentre clinic trial were reviewed, such as Fuzheng Huayu capsule, 861 recipe and Biejia Ruangan tablet etc. For the mechanism of herbal medicine action against liver fibrosis, multiple actions of Fuzheng Huayu capsule were introduced, including protection of hepatocytes peroxidation and apoptosis, inhibition of hepatic stellate cells and improvement of hepatic sinusoidal capillarization etc.. Also the recipes showed the different herbal combinational actions depending on the pathological process, and there has now known that salvianolic acid B, and were the effective chemical component. At last prospective, we believe that the clinic investigation should be improved and internationalized of TCM antifibrotic research as clinical trial has been much more strengthened, and the basic and clinical probing on cirrhosis with TCM should be carried out now, and new TCM theory about cirrhotic mechanism and therapeutic strategy will be developed.