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中药对肝纤维化肝窦毛细血管化的抑制作用及其机制
DOI: 10.12449/JCH260524
利益冲突声明：本文不存在任何利益冲突。
作者贡献声明：王龙负责设计论文框架，起草论文；宋安东负责检索相关文献；李国花负责论文修改；马丽和贾婷婷负责指导撰写文章并最后定稿。
Inhibitory effect and mechanism of traditional Chinese medicine on liver fibrosis and hepatic sinusoidal capillarization
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摘要: 肝窦毛细血管化是肝纤维化发生的先发事件，抑制肝窦毛细血管化能有效改善肝纤维化的病理进程。多项研究证实，中药在抑制肝窦毛细血管化方面作用显著。本文系统综述了相关中药的有效成分、单体及复方，总结其抑制肝窦毛细血管化的作用机制，并从中医角度分析中药干预肝窦毛细血管化的理论依据，旨在为肝纤维化的治疗提供思路补充和文献依据。Abstract: Hepatic sinusoidal capillarization is the first event in the process of fibrogenesis， and inhibiting hepatic sinusoidal capillarization can effectively improve the pathological process of liver fibrosis. Various studies have shown that traditional Chinese medicine can significantly inhibit hepatic sinusoidal capillarization. This article systematically reviews the effective constituents， monomers， and compound prescriptions of traditional Chinese medicine， summarizes their mechanism of action in inhibiting hepatic sinusoidal capillarization， and analyzes the theoretical core of traditional Chinese medicine in inhibiting hepatic sinusoidal capillarization from the perspective of traditional Chinese medicine， in order to provide ideas and literature support for the treatment of liver fibrosis.
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表 1 中药复方抑制肝窦毛细血管化的作用机制
Table 1. Mechanism of action of traditional Chinese medicine compound in inhibiting sinusoidal capillarization
复方 药物组成 功效 作用机制 研究阶段 扶正化瘀方［13］ 丹参、桃仁和虫草菌丝 扶正化瘀 VEGF/VEGFR-2 动物实验：SD雄性大鼠，腹腔注射
二甲基亚硝胺建立肝纤维化模型柔肝抑纤饮［21］ 鸡血藤、当归、杭芍、川牛
膝、鳖甲和枸杞等养血柔肝、
活血通络降低胶原蛋白和层粘连
蛋白动物实验：Wistar雄性大鼠，腹腔注
射二甲基亚硝胺建立肝纤维化模型抗纤Ⅰ号胶
囊［23］丹参、三七、桃仁、当归、生
地黄、山楂和沙参滋补肝肾、健脾
益气、活血化瘀降低胶原蛋白和层粘连
蛋白动物实验：Wistar雄性大鼠，皮下注
射四氯化碳-橄榄油建立模型疏肝健脾
活血方［32］鳖甲、桃仁、大黄、莪术、丹
参、三七、白术、茯苓、大
枣、桂枝、香附和甘草活血化瘀、温通
经脉、行气散瘀下调VEGF、VEGFR-2蛋白
表达动物实验：分离大鼠HSC和LSEC，
含药血清干预芪术颗粒［35-36］ 黄芪、莪术、柴胡和丹参等 益气活血、
化瘀通络抑制整合素αvβ3-FAK-Ras/
MAPK信号通路；调控Ang-
1、Ang-2/Tie2信号通路动物实验：Wistar雄性大鼠，腹腔注
射四氯化碳-橄榄油建立模型清毒调肝方［39］ 柴胡、黄芩、白花蛇舌草、
桃仁、黄芪、党参、半夏、山
楂、五味子、女贞子、猪苓、
重楼、生姜、大枣和炙甘草疏肝健脾、清热
解毒、扶正化瘀干预LSEC去窗孔化和内皮
下基底膜沉积动物实验：SD雄性大鼠，尾静脉注
射刀豆蛋白A建立肝纤维化模型芪甲柔肝方［40］ 黄芪、当归、三棱、莪术、鳖
甲、桃仁、红花、丹参、土鳖
虫和甘草益气养血、
化瘀通络调控VEGF/SRF/c-FOS
信号通路动物实验：SD雄性大鼠，皮下注射
四氯化碳-橄榄油建立肝纤维化
模型注：VEGF，血管内皮生长因子；VEGFR-2，血管内皮生长因子受体2；HSC，肝星状细胞；LSEC，肝窦内皮细胞；MAPK，丝裂原活化蛋白激酶；Ang，血管生成素；Tie2，血管生成素受体2；SRF，血清应答因子。
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表 2 中药单体抑制肝窦毛细血管化的作用机制
Table 2. Mechanism of traditional Chinese medicine monomers in inhibiting hepatic sinusoidal capillary metaplasia
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