中药治疗非酒精性脂肪性肝纤维化的研究现状

Traditional Chinese medicines for treatment of non-alcoholic fibrosing steatohepatitis

非酒精性脂肪性肝纤维化是非酒精性脂肪性肝炎(NASH)进展为终末期肝病的关键病理阶段,其有效治疗亟待解决。中药具有多组分及多途径、多靶点作用的特点,对非酒精性脂肪性肝纤维化具有综合治疗的优势,可通过调节肝脏脂质代谢、抑制氧化应激反应及肝细胞凋亡、调节炎症、纤维化相关基因的表达等阻止肝脂肪变、炎症及纤维化的发生与进展。

The incidence of non - alcoholic fatty liver disease （NAFLD） continues to rise globally. Later stages of NAFLD are characterized by severe structural and functional perturbations in the liver, with the progressive clinical manifestations being fibrosis and cirrhosis, leading to end - stage liver disease. Thus, the pathogenic process of hepatic fibrosis has been a principal target of efforts to develop therapeutic inter- ventions capable of suppressing NAFLD progression, with tile aim of protecting liver function and ultimately promoting patient quality of life and survival. Extensive research has uncovered several of the molecular factors and signaling pathways leading to the excessive synthesis and deposition of extracellular matrix （ECM） or collagen, including those of inflammation, oxidative stress and apoptosis. In this review, we dis- cuss the potential of traditional Chinese medicine （TCM） herbs for inhibiting or resolving fibrosis by interacting with the various underlying mechanisms. In particular, the Fuzheng Huayu recipe （FZHY） is comprehensively discussed, from its various reported effects on liver func- tion enzymes and ECM -/cytokine - producing cells to lipid metabolism. In addition, other promising TCM agents and strategies are dis- cussed from the perspective of their therapeutic effects studied and demonstrated in cell culture systems, animal models and human clinical studies.