中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 6
Jun.  2023
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(6): 1280-1286

Role of traditional Chinese Medicine in prevention and treatment of chronic hepatitis B liver fibrosis: Current status, challenges, and thoughts

DOI: 10.3969/j.issn.1001-5256.2023.06.004

  • Department of Hepatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China

Research funding:

The Thirteenth Five Year Plan for Major and Special Programs of the National Science and Technology of China (2018ZX10725506-003);

The Thirteenth Five Year Plan for Major and Special Programs of the National Science and Technology of China (2018ZX10725505-004);

Guangdong Basic and Applied Basic Research Fund Project (2022A1515110825);

The General Project of Guangdong Provincial Bureau of Traditional Chinese Medicine (20211189);

The General Project of Guangdong Provincial Bureau of Traditional Chinese Medicine (20225022);

The General Project of Guangdong Provincial Bureau of Traditional Chinese Medicine (20231116);

The Science and Technology Research Project of Traditional Chinese Medicine of Guangdong Provincial Hospital of Chinese Medicine (YN10101903);

The Science and Technology Research Project of Traditional Chinese Medicine of Guangdong Provincial Hospital of Chinese Medicine (YN2016XP03);

The Science and Technology Research Project of Traditional Chinese Medicine of Guangdong Provincial Hospital of Chinese Medicine (YN2022DB04);

Chi Xiaoling of Project of Inheritance Workshop of Famous Old Chinese Medicine Experts of State Administration of Traditional Chinese Medicine (Guozhong Pharmaceutical Human Education Letter [2022]No.75);

The Fifth Batch of National Research and Training Programs for Clinical Talents of traditional Chinese Medicine (Guozhong Pharmaceutical Human Education Letter 2022]No.1)

More Information
  • Corresponding author: CHI Xiaoling, chixiaolingqh@163.com (ORCID: 0000-0003-3193-1943)
  • Received Date: 2023-04-01
  • Accepted Date: 2023-05-01
  • Published Date: 2023-06-20
    Abstract
  • In recent years, significant breakthroughs have been made in the research on the role of traditional Chinese medicine (TCM) in the prevention and treatment of chronic hepatitis B liver fibrosis. In terms of clinical research, several multicenter randomized double-blind controlled studies have been conducted with liver pathological changes as the main efficacy evaluation indicator, which have improved the level of evidence in clinical research on the TCM prevention and treatment of liver fibrosis. As for basic research, in-depth studies have been conducted on the mechanism of action of TCM in intervening against liver fibrosis at various levels, including the effect on HSC activation, apoptosis and autophagy, inhibition of liver inflammatory injury, immunoregulation, and inhibition of hepatic sinusoidal capillarization, thereby highlighting the advantages and research difficulties of TCM through "multiple components, targets, and pathways". Under the guidance of Implementation Plan for the Major Projects of Revitalizing and Developing TCM, it is crucial to conduct high-quality clinical and basic research on TCM in the treatment of liver fibrosis, produce high-quality industry achievements, and thus help TCM to be recognized around the world.

     

    • FullText(HTML)
  • loading
    • References(37)
  • [1]
    SORIANO V, ALVAREZ C, EDAGWA B, et al. Ultra-long-acting (XLA) antivirals for chronic viral hepatitis[J]. Int J Infect Dis, 2022, 114: 45-50. DOI: 10.1016/j.ijid.2021.10.052.
    [2]
    LIU YQ, ZHANG C, LI JW, et al. An-Luo-Hua-Xian Pill improves the regression of liver fibrosis in chronic hepatitis B patients treated with entecavir[J]. J Clin Transl Hepatol, 2023, 11(2): 304-313. DOI: 10.14218/JCTH.2022.00091.
    [3]
    RONG G, CHEN Y, YU Z, et al. Synergistic effect of Biejia-Ruangan on fibrosis regression in patients with chronic hepatitis B treated with entecavir: A multicenter, randomized, double-blind, placebo-controlled trial[J]. J Infect Dis, 2022, 225(6): 1091-1099. DOI: 10.1093/infdis/jiaa266.
    [4]
    JI D, CHEN Y, BI J, et al. Entecavir plus Biejia-Ruangan compound reduces the risk of hepatocellular carcinoma in Chinese patients with chronic hepatitis B[J]. J Hepatol, 2022, 77(6): 1515-1524. DOI: 10.1016/j.jhep.2022.07.018.
    [5]
    CHENG DY, ZHAO ZM, WAN G, et al. Impact of Fuzheng Huayu tablet on antiviral effect of entecavir in patients with hepatitis B cirrhosis[J]. Hepatobiliary Pancreat Dis Int, 2022, 21(5): 479-484. DOI: 10.1016/j.hbpd.2022.03.007.
    [6]
    XIAO HM, SHI MJ, JIANG JM, et al. Efficacy and safety of AnluoHuaxian pills on chronic hepatitis B with normal or minimally elevated alanine transaminase and early liver fibrosis: A randomized controlled trial[J]. J Ethnopharmacol, 2022, 293: 115210. DOI: 10.1016/j.jep.2022.115210.
    [7]
    Chinese Society of Traditional Chinese Medicine Hepatobiliary Diseases. Expert consensus on the clinical application of Biejia Jianwan in the treatment of liver fibrosis[J]. Chin J Integr Tradit West Med Liver Dis, 2020, 30(6): 577-578, 584. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXGB202006031.htm

    中华中医药学会肝胆病学分会. 鳖甲煎丸治疗肝纤维化临床应用专家共识[J]. 中西医结合肝病杂志, 2020, 30(6): 577-578, 584. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXGB202006031.htm
    [8]
    Chinese Society of Traditional Chinese Medicine Hepatobiliary Diseases. Expert consensus on the clinical application of Ganshuang Granules in the treatment of liver fibrosis[J]. Chin J Integr Tradit West Med Liver Dis, 2020, 30(5): 481-482. DOI: 10.3969/j.issn.1005-0264.2020.05.033.

    中华中医药学会肝胆病分会. 肝爽颗粒治疗肝纤维化临床应用专家共识[J]. 中西医结合肝病杂志, 2020, 30(5): 481-482. DOI: 10.3969/j.issn.1005-0264.2020.05.033.
    [9]
    WANG T, JIN W, HUANG Q, et al. Clinical efficacy and safety of eight traditional chinese medicine combined with entecavir in the treatment of chronic hepatitis B liver fibrosis in adults: A network meta-analysis[J]. Evid Based Complement Alternat Med, 2020, 2020: 7603410. DOI: 10.1155/2020/7603410.
    [10]
    YE F, XUE BY, WU MH, et al. Study on treating chronic hepatitis and hepatic fibrosis by eliminating damp -heat toxin and blood stasis[J]. Chin Arch Tradit Chin Med, 2007, 25(12): 2477-2480. DOI: 10.3969/j.issn.1673-7717.2007.12.020.

    叶放, 薛博瑜, 吴勉华, 等. 重视对慢性肝炎肝纤维化进程中湿热瘀毒证治研究[J]. 中华中医药学刊, 2007, 25(12): 2477-2480. DOI: 10.3969/j.issn.1673-7717.2007.12.020.
    [11]
    LIN SN, HUANG B, ZHU YP, et al. Clinical observation on treating fibrosis of liver due to chronic virus B hepatitis with Zhuanggan Zhuyujian[J]. Chin J Integr Trad West Med Dig, 2010, 18(4): 230-232. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXPW201004005.htm

    林寿宁, 黄彬, 朱永苹, 等. 壮肝逐瘀煎治疗慢性乙型肝炎肝纤维化临床观察[J]. 中国中西医结合消化杂志, 2010, 18(4): 230-232. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXPW201004005.htm
    [12]
    WANG JY, ZHANG MZ. Controlled clinical studies on liver fibrosis due to hepatitis B by treatment of tonifying kidney and softening liver[J]. J Liaoning Univ Tradit Chin Med, 2014, 16(6): 118-120. DOI: 10.13194/j.issn.1673-842x.2014.06.043.

    王见义, 张美珠. 补肾柔肝方治疗乙肝后肝纤维化临床对照研究[J]. 辽宁中医药大学学报, 2014, 16(6): 118-120. DOI: 10.13194/j.issn.1673-842x.2014.06.043.
    [13]
    ZHU YL, CHI XL. Therapeutic effects of Heheshuyang recipe combined with entecavir on patients with chronic hepatitis B[J]. Guangxi Med J, 2015, 37(3): 321-323. DOI: 10.11675/j.issn.0253-4304.2015.03.11.

    朱娅莉, 池晓玲. 和合疏养方联合恩替卡韦治疗慢性乙型肝炎临床疗效观察[J]. 广西医学, 2015, 37(3): 321-323. DOI: 10.11675/j.issn.0253-4304.2015.03.11.
    [14]
    ZHUO YX, PENG MN, LIN M, et al. Evaluation of clinical effect of therapy of soothing liver and invigorating spleen for treatment of hepatitis B associated hepatic fibrosis[J]. J Guangzhou Univ Tradit Chin Med, 2020, 37(11): 2063-2068. DOI: 10.13359/j.cnki.gzxbtcm.2020.11.003.

    卓永祥, 彭梦楠, 林明, 等. 运用疏肝健脾法治疗乙肝肝纤维化的临床疗效评价[J]. 广州中医药大学学报, 2020, 37(11): 2063-2068. DOI: 10.13359/j.cnki.gzxbtcm.2020.11.003.
    [15]
    WANG L, LU W, GAO YH, et al. Effect of Anluohuaxianwan on the expression of matrix metalloproteinases and their inhibitors in rat liver with fibrosis[J]. Chin J Hepatol, 2019, 27(4): 267-273. DOI: 10.3760/cma.j.issn.l007-3418.2019.04.006.

    王林, 卢玮, 高玉华, 等. 安络化纤丸对肝纤维化大鼠肝组织基质金属蛋白酶及其抑制物表达的影响[J]. 中华肝脏病杂志, 2019, 27(4): 267-273. DOI: 10.3760/cma.j.issn.l007-3418.2019.04.006.
    [16]
    SHEN B, DENG L, LIU Y, et al. Effects of novel Fufang Biejia Ruangan Tablets with sheep placenta as substitute for Hominis Placenta on CCl4-induced liver fibrosis[J]. Chin Herb Med, 2022, 14(1): 104-110. DOI: 10.1016/j.chmed.2021.09.013.
    [17]
    DONG BS, LIU FQ, YANG WN, et al. Huangqi Decoction, a compound Chinese herbal medicine, inhibits the proliferation and activation of hepatic stellate cells by regulating the long noncoding RNA-C18orf26-1/microRNA-663a/transforming growth factor-β axis[J]. J Integr Med, 2023, 21(1): 47-61. DOI: 10.1016/j.joim.2022.11.002.
    [18]
    ZHANG Y, HUA L, LIN C, et al. Pien-Tze-Huang alleviates CCl4-induced liver fibrosis through the inhibition of HSC autophagy and the TGF-β1/Smad2 pathway[J]. Front Pharmacol, 2022, 13: 937484. DOI: 10.3389/fphar.2022.937484.
    [19]
    ZHENG Y, ZHAO T, WANG J, et al. Curcumol alleviates liver fibrosis through inducing autophagy and ferroptosis in hepatic stellate cells[J]. FASEB J, 2022, 36(12): e22665. DOI: 10.1096/fj.202200933RR.
    [20]
    CHEN CH, CHEN MF, HUANG SJ, et al. Saikosaponin a induces apoptosis through mitochondria-dependent pathway in hepatic stellate cells[J]. Am J Chin Med, 2017, 45(2): 351-368. DOI: 10.1142/S0192415X17500227.
    [21]
    MA C, WANG C, ZHANG Y, et al. Phillygenin inhibited M1 macrophage polarization and reduced hepatic stellate cell activation by inhibiting macrophage exosomal miR-125b-5p[J]. Biomed Pharmacother, 2023, 159: 114264. DOI: 10.1016/j.biopha.2023.114264.
    [22]
    WANG SW, LAN T, ZHENG F, et al. Effect of extract of Quzhou Aurantii Fructus on hepatic inflammation and NF-κB/NLRP3 inflammasome pathway in CCl4-induced liver fibrosis mice[J]. China J Chin Mater Med, 2021, 46(6): 1474-1479. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZY202106021.htm

    王思为, 蓝天, 郑芳, 等. 衢枳壳提取物对CCl4诱导的肝纤维化小鼠肝脏炎症及NF-κB/NLRP3炎性体通路的影响[J]. 中国中药杂志, 2021, 46(6): 1474-1479. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZY202106021.htm
    [23]
    XU J, ZHONG ML, WANG YF, et al. Study on intervention of DCP on MAPK signaling pathway to inhibit inflammatory response and alleviate progression of liver fibrosis in rats[J]. Chin Pharmacol Bull, 2022, 38(4): 531-537. DOI: 10.12360/CPB202106059.

    徐杰, 钟明利, 王跃峰, 等. 狗肝菜多糖干预MAPK信号通路抑制炎症反应缓解大鼠肝纤维化进程[J]. 中国药理学通报, 2022, 38(4): 531-537. DOI: 10.12360/CPB202106059.
    [24]
    CHANG QQ, PAN YF, YANG JY, et al. Antiliver fibrosis formula of fuzheng huayu alleviates inflammatory response[J]. Evid Based Complement Alternat Med, 2022, 2022: 5752803. DOI: 10.1155/2022/5752803.
    [25]
    JIANG C, IWAISAKO K, CONG M, et al. Traditional Chinese Medicine Fuzheng Huayu prevents development of liver fibrosis in mice[J]. Arch Clin Biomed Res, 2020, 4(5): 561-580. DOI: 10.26502/acbr.50170125.
    [26]
    GUO XH, ZHENG Y, WANG JH, et al. Research progress on the role of traditional Chinese medicine in the occurrence of liver fibrosis based on miRNA mediated activation of NLRP3 inflammasomes[J]. China J Chin Mater Med, 2022, 47(9): 2409-2418. DOI: 10.19540/j.cnki.cjcmm.20211009.401.

    郭新华, 郑洋, 王佳慧, 等. 基于miRNA介导的NLRP3炎症小体活化探讨中医药在肝纤维化发生中作用的研究进展[J]. 中国中药杂志, 2022, 47(9): 2409-2418. DOI: 10.19540/j.cnki.cjcmm.20211009.401.
    [27]
    MO C, XIE SW, GAO L, et al. Baoganning formula alleviates liver fibrosis in mice by inhibiting hepatic IDO1 expression and promoting phenotypic maturation of dendritic cells[J]. J South Med Univ, 2021, 41(7): 1002-1011. DOI: 10.12122/j.issn.1673-4254.2021.07.06.

    莫婵, 谢淑雯, 高磊, 等. 复方保肝宁减轻小鼠肝纤维化的机制: 抑制肝脏组织中的IDO1进而促进树突状细胞表型成熟[J]. 南方医科大学学报, 2021, 41(7): 1002-1011. DOI: 10.12122/j.issn.1673-4254.2021.07.06.
    [28]
    PENG Y, YANG T, HUANG K, et al. Salvia miltiorrhiza ameliorates liver fibrosis by activating hepatic natural killer cells in vivo and in vitro[J]. Front Pharmacol, 2018, 9: 762. DOI: 10.3389/fphar.2018.00762.
    [29]
    LIU YT, LV WL. Research progress in astragalus membranaceus and its active components on immune responses in liver fibrosis[J]. Chin J Integr Med, 2020, 26(10): 794-800. DOI: 10.1007/s11655-019-3039-1.
    [30]
    CHEN L, XIA S, WANG S, et al. Naringenin is a potential immunomodulator for inhibiting liver fibrosis by inhibiting the cGAS-STING pathway[J]. J Clin Transl Hepatol, 2023, 11(1): 26-37. DOI: 10.14218/JCTH.2022.00120.
    [31]
    WU HJ, WU SD, CHI XL, et al. Regulating effect of hehe shuyang tang on immunologic function of chronic hepatitis B patients with liver-stagnation and spleen-deficiency syndrome[J]. J New Chin Med, 2016, 48(5): 99-102. DOI: 10.13457/j.cnki.jncm.2016.05.038.

    吴惠君, 吴树铎, 池晓玲, 等. 和合疏养方对肝郁脾虚证慢性乙型肝炎患者免疫功能的调节作用[J]. 新中医, 2016, 48(5): 99-102. DOI: 10.13457/j.cnki.jncm.2016.05.038.
    [32]
    WU Y, LI Z, XIU AY, et al. Carvedilol attenuates carbon tetrachloride-induced liver fibrosis and hepatic sinusoidal capillarization in mice[J]. Drug Des Devel Ther, 2019, 13: 2667-2676. DOI: 10.2147/DDDT.S210797.
    [33]
    LIU P. Inhibition of pathological angiogenesis of Chinese medicine against liver fibrosis[J]. Chin J Integr Med, 2016, 22(8): 569-572. DOI: 10.1007/s11655-016-2468-3.
    [34]
    Liver Disease Committee, Chinese Association of Integrative Medicine. Guidelines for the diagnosis and treatment of liver fibrosis in integrative medicine practice (2019)[J]. J Clin Hepatol, 2019, 35(7): 1444-1449. DOI: 10.3969/j.issn.1001-5256.2019.07.007.

    中国中西医结合学会肝病专业委员会. 肝纤维化中西医结合诊疗指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(7): 1444-1449. DOI: 10.3969/j.issn.1001-5256.2019.07.007.
    [35]
    ZHANG LJ, SUN MY, NING BB, et al. Xiayuxue Decoction ([symbols; see text]) attenuates hepatic stellate cell activation and sinusoidal endothelium defenestration in CCl4-induced fibrotic liver of mice[J]. Chin J Integr Med, 2014, 20(7): 516-523. DOI: 10.1007/s11655-014-1862-y.
    [36]
    LU J, ZHOU N, HUANG Y, et al. Effects of Shugan Jianpi Huoxue Decoctionon expression of VEGF/VEGFR in hepatic stellate cells liver sinusoidal endothelial cell co-culture system[J]. J Tradit Chin Med, 2019, 60(3): 242-247. DOI: 10.13288/j.11-2166/r.2019.03.015.

    鲁军, 周凝, 黄棪, 等. 疏肝健脾活血方对肝星状细胞/肝窦内皮细胞共培养体系中VEGF/VEGFR表达的影响[J]. 中医杂志, 2019, 60(3): 242-247. DOI: 10.13288/j.11-2166/r.2019.03.015.
    [37]
    GAO L, YANG X, LI Y, et al. Curcumol inhibits KLF5-dependent angiogenesis by blocking the ROS/ERK signaling in liver sinusoidal endothelial cells[J]. Life Sci, 2021, 264: 118696. DOI: 10.1016/j.lfs.2020.118696.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索
    Get Citation
    PDF
    XML

    Article Metrics

    Article views (597) PDF downloads(107) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return