江汉大学学报(自然科学版) ›› 2023, Vol. 51 ›› Issue (3): 75-81.doi: 10.16389/j.cnki.cn42-1737/n.2023.03.008

• 医学 • 上一篇    

肝纤维化发病机制及中医药抗肝纤维化的研究进展

李青青,杨红胜,李金斗,方 萌,刘宇炜*   

  1. 江汉大学 医学部,湖北 武汉 430056
  • 发布日期:2023-06-09
  • 通讯作者: 刘宇炜

Research Progress on Pathogenesis of Liver Fibrosis and Anti-liver Fibrosis of Traditional Chinese Medicine

LI Qingqing,YANG Hongsheng,LI Jindou,FANG Meng,LIU Yuwei*   

  1. School of Medicine,Jianghan University,Wuhan 430056,Hubei,China
  • Published:2023-06-09
  • Contact: LIU Yuwei

摘要: 肝脏疾病已经成为当今影响人类身体健康和生活质量的重要因素,也是全球健康领域所 面临的重大挑战,需要引起足够的重视。肝纤维化的进一步发展可导致肝硬化、肝癌等重症肝 病。虽然许多科学研究都表明,肝纤维化早期具有可逆性,但这个逆转过程非常缓慢,甚至在并 发症影响下,其逆转显得极为渺茫。因此,深入研究其发病机制并积极寻找有效药物对肝纤维化 的治疗具有深刻意义。肝纤维化的病因主要包括慢性病毒性肝炎、酒精性肝病、非酒精性脂肪性 肝病、胆汁淤积、寄生虫病以及自身免疫性疾病等。目前,其发病机制尚未完全明确,关键环节表 现为肝星状细胞活化,并进一步转化为肌成纤维细胞。特征表现为大量细胞外基质过度增生与 异常沉积,导致肝脏结构破坏和假小叶生成。同时肝纤维化伴随着多种细胞因子的紊乱与氧化应 激反应等,这一过程涉及机体内多条重要的信号传导通路。在治疗肝纤维化方面,由于其复杂的 发病机制,目前尚未找到确切有效的西药。而传统中医药,因其具有多靶点、辨证论治的优势,在 肝脏疾病包括肝纤维化的研究与治疗方面已经取得了较为不错的进展。部分单味中药、中药复 方以及中药单体在抗肝纤维化治疗中发挥了积极作用,但其抗肝纤维化具体的药理作用机制仍 有待进一步探索。就肝纤维化的病因、发病机制以及中医药抗肝纤维化的研究进展进行了综述。

Abstract: Liver disease has become an important factor affecting human health and quality of life today,and it is also a major challenge in the field of global health,which needs to be paid enough attention to. The further development of liver fibrosis may lead to severe liver diseases such as liver cirrhosis and liver cancer. Although many scientific studies have shown that liver fibrosis is reversible in the early stage,this process is very slow,even extremely impossible under the influence of complications. Therefore,it is of great significance to study its pathogenesis deeply and search for effective drugs for treating liver fibrosis actively. The causes of liver fibrosis mainly include chronic viral hepatitis,alcoholic liver disease, non-alcoholic fatty liver disease,cholestasis,parasitic diseases,and autoimmune diseases. At present,the pathogenesis of liver fibrosis has not been understood completely. Its key link is the activation of hepatic stellate cells, which are further transformed into myofibroblasts. It is characterized by excessive proliferation and abnormal deposition of a large amount of extracellular matrix,resulting in the destruction of liver structure and the formation of pseudolobules. Meanwhile,it is accompanied by the disturbance of various cytokines and oxidative stress,which involves many important signal transduction pathways in the body. For treating liver fibrosis,no exact and effective western medicine has yet been found due to its complex pathogenesis. Traditional Chinese medicine has made relatively good progress in the research and treatment of liver diseases,including liver fibrosis, because of its advantages of multiple targets and syndrome differentiation. Some single traditional Chinese medicines,compounds,and monomers have played a positive role in treating liver fibrosis,but the extensional pharmacological mechanism of their anti-liver fibrosis remains to be further explored. This paper reviews the etiology and pathogenesis of liver fibrosis and the research progress of traditional Chinese medicine in anti-liver fibrosis.