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中药复方逆转肝纤维化及早期肝硬化的作用机制
DOI: 10.12449/JCH240924
利益冲突声明：本文不存在任何利益冲突。
作者贡献声明：张鹏负责课题设计，资料分析，撰写论文；郑世豪、苟思媛、谢金池、杨先照参与检索文献、修改论文；张鹏、叶永安拟定写作思路并最后定稿。
The mechanism of compound traditional Chinese medicine prescriptions in reversal of liver fibrosis and early liver cirrhosis
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摘要: 肝纤维化、肝硬化是多种慢性肝病进展后的共同结局。研究表明，肝纤维化及一定程度的肝硬化是可以逆转的。中药复方逆转肝纤维化、早期肝硬化疗效确切，但作用机制尚未完全明确。本文通过梳理国内外相关文献，总结了中药复方起效涉及的6个主要机制表型（即抑制肝脏炎症与调控免疫，调控肝星状细胞活化及细胞外基质生成，促进细胞外基质降解，逆转肝窦毛细血管化，调控肝脏细胞再生以及调节肠道菌群），并分析了各个表型领域研究的进展与不足。未来中药复方研究可围绕上述表型进行实验探索和验证，对有确切作用的表型上下游信号进一步深入探究。本文旨在帮助厘清中药复方疗效机制研究的方向和思路，为阐明中药复方科学实质提供依据。Abstract: Liver fibrosis and cirrhosis are the common outcomes of various chronic liver diseases after progression， and studies have shown that liver fibrosis and early liver cirrhosis can be reversed. Compound traditional Chinese medicine prescriptions have a marked therapeutic effect in reversing liver fibrosis and early liver cirrhosis， and their mechanism of action remains unclear. By reviewing related articles in China and globally， this article summarizes the six main phenotypic mechanisms involved in the efficacy of compound traditional Chinese medicine prescriptions， i.e.， inhibiting liver inflammation and regulating liver immune response， regulating hepatic stellate cell activation and extracellular matrix （ECM） generation， promoting ECM degradation， reversing hepatic sinusoidal capillarization， regulating hepatocyte regeneration， and regulating gut microbiota， and in addition， this article also analyzes the advances and shortcomings in current studies on each phenotype. Future studies on compound traditional Chinese medicine prescriptions should focus on experimental exploration and rescue experiments to verify the above phenotypes and further explore the upstream and downstream signaling pathways with a marked effect. This article aims to help clarify the direction and ideas of studies on the therapeutic mechanism of compound traditional Chinese medicine prescriptions， in order to provide a basis for clarifying the scientific essence of compound traditional Chinese medicine prescriptions.
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Key words:
- Liver Fibrosis /
- Liver Cirrhosis /
- Drugs， Chinese Herbal
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