中药及其复方抗肝纤维化作用机制的研究进展

肝纤维化是指由各种致病因子所致肝内结缔组织异常增生,导致肝脏中细胞外基质(ECM)的过度积累,纤维性瘢痕形成的病理过程。其持续恶化会逐步发展成肝硬化、肝衰竭、肝癌等严重肝脏疾病。由于肝纤维化及肝硬化早期可以逆转,因此控制肝纤维化这一可逆过程,对于肝硬化和肝癌的预防及治疗至关重要。近年来研究发现,中药治疗肝纤维化具有多靶点、毒副作用小、效果好等特点。该文对中药及其复方抗肝纤维化作用机制进行了归纳总结,包括中药可通过调节转化生长因子-β(TGF-β),血小板衍生生长因子(PDGF),血管内皮生长因子(VEGF),结缔组织生长因子(CTGF)等生长因子来抑制肝星状细胞(HSCs)活化和诱导活化的HSCs凋亡,促进脂联素的表达和抑制瘦素的分泌,抑制肝脏炎症反应,抗氧化应激,抑制肝窦内皮细胞毛细血管化等多个层面有效阻止肝纤维化的进展。因此中药能通过多机制和多层面抑制肝纤维化的发展,是治疗肝纤维化疾病的重要手段之一。

Mechanism of Traditional Chinese Medicine and Its Compound on Liver Fibrosis

Hepatic fibrosis refers to the pathological process of abnormal proliferation of intrahepatic connective tissue caused by various pathogenic factors,resulting in the excessive accumulation of extracellular matrix(ECM) in the liver and the formation of fibrous scar. Its continuous deterioration will gradually develop into liver cirrhosis,liver failure,liver cancer and other serious liver diseases. Because liver fibrosis and early liver cirrhosis can be reversed,it is very important to control the reversible process of liver fibrosis for the prevention and treatment of liver cirrhosis and liver cancer. In recent years,it has been found that traditional Chinese medicine(TCM) has the characteristics of multi-target,less toxic and side effects and good effect in the treatment of liver fibrosis. In this paper,the mechanism of anti-hepatic fibrosis of TCM and its compound was summarized. TCM can regulate transforming growth factor-β(TGF-β),platelet derived growth factor(PDGF),vascular endothelial growth factor(VEGF),connective tissue growth factor(CTGF) and other growth factors to inhibit the activation of(HSCs) and induce the apoptosis of activated HSCs,promote the expression of adiponectin and inhibit the secretion of leptin,inhibit the inflammatory reaction of liver,resist oxidant stress,inhibit the capillarization of hepatic sinusoidal endothelial cells,so as to effectively prevent the progress of liver fibrosis. Therefore,TCM can inhibit the development of liver fibrosis through multi-mechanism and multi-level,and is one of the important means to treat liver fibrosis.