中药治疗胆汁淤积性肝病作用机制的研究进展

Research progress in mechanism of traditional Chinese medicine in treatment of cholestatic liver disease

胆汁淤积性肝病具有临床发病率高、病因复杂、发病机制不明确的特点。目前,有关胆汁淤积性肝病的有效治疗药物相对匮乏,中医药治疗胆汁淤积肝损伤(CLI)疗效及其作用机制研究备受关注。常用中药包括清热利湿类、活血化瘀类或凉血化痰类单味药及相关复方,其改善CLI的作用机制研究多聚焦在法尼醇X受体(FXR)、组成型雄甾烷受体(CAR)、早期生长因子-1(EGR-1)、核因子E2相关因子(Nrf-2)等通路。结合当前国内外研究现状,系统地阐述常见中药单味药和复方治疗CLI的药理作用机制,旨在为中药治疗CLI的临床应用提供依据,为中药创新药开发及其深入研究提供参考。

Cholestatic liver disease has the characteristics of high clinical incidence,complex etiology and unclear pathogenesis.At present,there are relatively few effective drugs for the treatment of cholestatic liver disease.Therefore,the research on the efficacy and mechanism of traditional Chinese medicine in the treatment of cholestatic liver injury(CLI)has attracted much attention.The commonly used traditional Chinese medicines include single herbs of clearing heat and removing dampness,promoting blood circulation and removing blood stasis,or cooling blood and resolving phlegm and their related compounds.Research on the mechanism of action of traditional Chinese medicine in improving CLI focuses on the signaling pathways including farnesoid X receptor(FXR),constitutive androstane receptor(CAR),early growth factor-1(EGR-1),and nuclear factor E2-related factor 2(Nrf2).By combining with the current research status at home and abroad,this paper will focus on the prevention and treatment of CLI with traditional Chinese medicine,and systematically describe the mechanism of action of common traditional Chinese medicine single herbs and compound prescriptions in the treatment of cholestasis.The significance of this review is to provide a basis for the clinical application of traditional Chinese medicine in the treatment of CLI,and further provide a reference for the development of innovative traditional Chinese medicine and its in-depth research.