山楂及其药对改善代谢相关脂肪性肝病的药理作用机制
DOI: 10.12449/JCH260927
利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:管雅捷负责设计论文框架,起草论文;张琪振、吴文静、崔蓓蕾和徐俊姣负责搜集相关文献;宋艺佳负责论文修改;赵文霞、刘鸣昊负责拟定写作思路,指导撰写文章并最后定稿。
Pharmacological mechanism of hawthorn fruit and its herb pairs for improving metabolic dysfunction-associated fatty liver disease
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摘要: 代谢相关脂肪性肝病(MAFLD)已成为全球首要的慢性肝脏疾病。山楂作为经典的药食同源中药,具有消食化积、活血化瘀的功效。现代药理学研究表明,山楂及其活性成分在调节脂质代谢、改善胰岛素抵抗、抑制炎症反应、延缓肝纤维化及保护肝细胞等方面展现出多元药理活性,精准契合MAFLD“多重打击”的病理特征,在MAFLD的防治中展现出显著优势。药对配伍是中医药发挥增效减毒作用的关键策略。临床实践中,常将山楂与丹参、泽泻、决明子和茯苓等药物配伍,通过“相须相使”增强疗效,拓展其在MAFLD不同证型中的应用。本文系统梳理了山楂干预MAFLD的核心药理机制及其经典药对的研究进展,旨在为山楂及其配伍的深度开发与MAFLD的临床精准干预提供科学参考。Abstract: Metabolic dysfunction-associated fatty liver disease (MAFLD) has become the leading chronic liver disease worldwide. As a classic food-medicine homologous Chinese herb, hawthorn fruit has the functions of promoting digestion to resolve food stagnation and activating blood circulation to resolve blood stasis. Modern pharmacological studies have shown that hawthorn fruit and its active components exert diverse pharmacological activities in regulating lipid metabolism, improving insulin resistance, inhibiting inflammatory response, delaying hepatic fibrosis, and protecting hepatocytes. These effects precisely match the “multiple-hit” pathological features of MAFLD, and thus hawthorn fruit shows significant advantages in the prevention and treatment of MAFLD. Drug pair combination is a key strategy in traditional Chinese medicine to enhance efficacy and reduce toxicity. In clinical practice, hawthorn fruit is often combined with Salvia miltiorrhiza, Alisma orientalis, cassia seed, and Poria cocos, and such combination adheres to the principle of “mutual reinforcement and assistance” to enhance efficacy and expand their application in different syndromes of MAFLD. This article systematically reviews the core pharmacological mechanisms of hawthorn fruit in intervening against MAFLD and the research advances in its classic drug combinations, in order to provide a scientific reference for the in-depth development of hawthorn fruit and its combinations and the precise clinical intervention of MAFLD.
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