中药(TCM)已被广泛用于代谢疾病几个世纪,包括非酒精性脂肪性肝病(NAFLD)。目前,NAFLD已成为世界范围内最常见的慢性肝病,并可发展为非酒精性脂肪性肝炎(NASH),肝硬化,甚至肝细胞癌。然而,西医仍缺乏有效的治疗策略。NAFLD的发展是由多种机制驱动的,包括遗传因素,胰岛素抵抗,脂毒性,线粒体功能障碍,内质网应激,炎症,肠道菌群失调,和脂肪组织功能障碍。目前,某些药物,包括胰岛素增敏剂,他汀类药物,维生素E,熊去氧胆酸和甜菜碱,被证明对NAFLD的临床治疗有益。由于其复杂的发病机制,整合各种机制的个性化医疗可能为NAFLD患者提供更好的益处.中医整体观和辨证治疗NAFLD具有优势,类似于个性化医疗的原理。在中医,根据临床经验,NAFLD主要分为五种类型。它位于肝脏,与脾和肾功能密切相关。然而,由于中药的多组分特点,其在NAFLD治疗中的应用受到很大限制。在这次审查中,本文就NAFLD的发病机制和治疗进展作一综述,从西医和中医的角度来看。强调中西医结合具有互补优势,在NAFLD的预防和治疗中应该得到更多的重视。
Traditional Chinese medicine (TCM) has been widely used for several centuries for metabolic diseases, including non-alcoholic fatty liver disease (NAFLD). At present, NAFLD has become the most prevalent form of chronic liver disease worldwide and can progress to non-alcoholic steatohepatitis (NASH), cirrhosis, and even hepatocellular carcinoma. However, there is still a lack of effective treatment strategies in Western medicine. The development of NAFLD is driven by multiple mechanisms, including genetic factors, insulin resistance, lipotoxicity, mitochondrial dysfunction, endoplasmic reticulum stress, inflammation, gut microbiota dysbiosis, and adipose tissue dysfunction. Currently, certain drugs, including insulin sensitizers, statins, vitamin E, ursodeoxycholic acid and betaine, are proven to be beneficial for the clinical treatment of NAFLD. Due to its complex pathogenesis, personalized medicine that integrates various mechanisms may provide better benefits to patients with NAFLD. The holistic view and syndrome differentiation of TCM have advantages in treating NAFLD, which are similar to the principles of personalized medicine. In TCM, NAFLD is primarily classified into five types based on clinical experience. It is located in the liver and is closely related to spleen and kidney functions. However, due to the multi-component characteristics of traditional Chinese medicine, its application in the treatment of NAFLD has been considerably limited. In this review, we summarize the advances in the pathogenesis and treatment of NAFLD, drawn from both the Western medicine and TCM perspectives. We highlight that Chinese and Western medicine have complementary advantages and should receive increased attention in the prevention and treatment of NAFLD.