非酒精性脂肪性肝炎中医药及其辅助疗法防治机制研究进展

Research Progress on the Prevention and Treatment Mechanism of Traditional Chinese Medicine and Its Adjuvant Therapy for Non-alcoholic Steatohepatitis

非酒精性脂肪性肝炎(non-alcoholic steatohepatitis,NASH)是临床常见的一种慢性进行性肝病,除了造成严重肝损伤,还是诱发肥胖、糖尿病、心肌梗死、动脉粥样硬化、脑卒中等全身代谢紊乱疾病以及心脑血管疾病的独立危险因素。目前,现代医学在NASH的防治中虽取得一定进展,但西药的不良反应又不可避免地增加了肝脏负担。近年来,随着中医药干预NASH研究的不断深入,中药以其不良反应小、配伍灵活的特点,展现出极大的优势和潜力。最近的药理学研究及临床试验表明,单味中药活性成分和中药复方均可以通过抗炎、调脂、保护肝细胞等途径多层次、多靶点、多方位协同起效,对NASH的防治发挥显著疗效。该文旨在综述中医药防治NASH的作用机制,以及对相关的中药单体、中药复方和中医辅助疗法进行评述,以期为合理有效防治NASH提供理论和实验研究依据,并作为临床实践的有益参考。

Non-alcoholic steatohepatitis(NASH)is a common chronic progressive liver disease in clinical practice.In addition to causing severe liver injury,it is also an independent risk factor for inducing obesity,diabetes,myocardial infarction,atherosclerosis,stroke and other systemic metabolic disorders,as well as cardiovascular and cerebrovascular diseases.At present,although modern medicine has made some progress in the prevention and treatment of NASH,the toxic side effects of Western medicine inevitably increase the burden on the liver.In recent years,with the continuous deepening of research on traditional Chinese medicine intervention in NASH,traditional Chinese medicine has shown great advantages and potential due to its small toxic side effects and flexible compatibility.Recent pharmacological research and clinical trials have shown that both single active ingredients and traditional Chinese medicine formulas can synergistically act at multiple levels,targets,and directions through anti-inflammatory,lipid-lowering,and liver cell protection pathways,exerting significant therapeutic effects on the prevention and treatment of NASH.This article aims to review the mechanism of action of traditional Chinese medicine in the prevention and treatment of NASH,as well as to evaluate the relevant traditional Chinese medicine monomers,compound formulas,and adjuvant therapies,in order to provide theoretical and experimental research basis for the rational and effective prevention and treatment of NASH,and to serve as a useful reference for clinical practice.