Advances in traditional Chinese medicine treatment of liver fibrosis in metabolic associated fatty liver disease

Zhijia ZHOU; Xinyue LI; Chao ZHENG; Xuehua SUN

doi:10.12449/JCH251002

Volume 41 Issue 10

Oct. 2025

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Advances in traditional Chinese medicine treatment of liver fibrosis in metabolic associated fatty liver disease

DOI: 10.12449/JCH251002

Zhijia ZHOU^{1, 2},
Xinyue LI³,
Chao ZHENG^{1, 2},
Xuehua SUN^{3
,
,
,}

1.
Department of Endocrinology，The Second Affiliated Hospital of Zhejiang University School of Medicine，Hangzhou 310000，China
2.
Zhejiang Provincial Key Laboratory of Traditional Chinese Medicine for Metabolic and Endocrine Diseases Research，Hangzhou 310000，China
3.
Department of Hepatology，Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine，Shanghai 200000，China

Research funding:

National Natural Science Foundation of China (82074336);

National Natural Science Foundation of China (82374251);

the 2023 Shanghai Leading Talent Program in Health and Wellness (2022LJ013);

the Discipline Construction Project of Pudong New Area Health Commission-Key Clinical Specialty in Traditional Chinese Medicine for Liver Diseases (PWZxq2022-04);

the 2022 Key Discipline Construction Project of High-level Traditional Chinese Medicine under the National Administration of Traditional Chinese Medicine （Discipline of TCM Hepatobiliary Diseases） (zyyzdxk-2023060);

the 2023 Central Government Transfer Payment to Local Projects-Capacity Building for Evidence-based TCM Prevention and Treatment of Hepatobiliary Diseases ;

Zhejiang Province “Pioneer” and “Leading Goose” R&D Tackling Program (2024C03269)

More Information

Corresponding author: SUN Xuehua， susan_sxh@shutcm.edu.com （ORCID： 0000-0003-3418-9537）
Received Date: 2025-07-15
Accepted Date: 2025-08-11
Published Date: 2025-10-25

Abstract

Abstract

Metabolic associated fatty liver disease （MAFLD） has become one of the most prevalent chronic liver disease worldwide， and its progression to liver fibrosis is a key influencing factor for prognosis and the risk of complications. In recent years， novel drugs， such as selective thyroid hormone receptor-β agonists， glucagon-like peptide-1 receptor agonists， and fibroblast growth factor 21 analogs， have shown preliminary efficacy in the treatment of MAFLD-related liver fibrosis； however， such drugs have limited overall effectiveness， and there is still a lack of ideal therapeutic strategy to address the disease across its different stages. Traditional Chinese medicine （TCM）， with its characteristics of multiple targets and systemic regulation， has shown unique advantages in this field. This article systematically reviews the basic and clinical research on the anti-fibrotic mechanisms of compound TCM prescriptions and their active components in recent years， focusing on the key processes including hepatic stellate cell activation， lipid metabolism disorders， oxidative stress， immune inflammation， and gut-liver axis dysfunction. Meanwhile， it is pointed out that there are still certain issues in current research， including ambiguities in the clarification of mechanisms， a lack of standardized evaluation systems， and the need to improve the quality of clinical evidence. Future research should emphasize the standardization and quality control of TCM herbal preparations and integrate emerging technologies， such as omics analysis， organoid models， and real-world data， to advance TCM intervention of MAFLD-related liver fibrosis toward well-defined mechanisms， clear therapeutic pathways， and robust scientific evidence. TCM is expected to play a vital role in the multi-dimensional targeted intervention and stage-specific management of MAFLD-related liver fibrosis， in order to provide new perspectives and comprehensive solutions for the precise treatment of chronic liver diseases.
- Metabolic Associated Fatty Liver Disease,
- Hepatic Fibrosis,
- Anti-Hepato Fibrosis Agents （TCD）,
- Therapeutics

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References(42)

References

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Advances in traditional Chinese medicine treatment of liver fibrosis in metabolic associated fatty liver disease

DOI: 10.12449/JCH251002

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Advances in traditional Chinese medicine treatment of liver fibrosis in metabolic associated fatty liver disease

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