中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 41 Issue 10
Oct.  2025
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2025  >  41(10): 1961-1967

Research advances in traditional Chinese medicine treatment of chronic hepatitis B-associated liver fibrosis

DOI: 10.12449/JCH251001

  • Department of Liver Diseases，Beijing Hospital of Traditional Chinese Medicine，Capital Medical University，Beijing 100010，China

Research funding:

Beijing Natural Science Foundation (7252217)

More Information
  • Corresponding author: XU Chunjun， xu1409@sina.com （ORCID： 0000-0003-0834-0336）
  • Received Date: 2025-07-16
  • Accepted Date: 2025-09-04
  • Published Date: 2025-10-25
    Abstract
  • Chronic hepatitis B-associated liver fibrosis is the key pathological stage in disease progression to liver cirrhosis and even hepatocellular carcinoma. Although antiviral therapy can effectively inhibit HBV replication， reversal of liver fibrosis remains a significant challenge in contemporary clinical practice， and some patients still face the risk of disease progression. With the distinctive advantages of “multiple targets and holistic regulation”， traditional Chinese medicine （TCM） has gradually formed a comprehensive prevention and treatment strategy integrating traditional theories and modern scientific research evidence. “Weakened body resistance and blood stasis” are the core pathogenesis of liver fibrosis and exist throughout the course of the disease， and therefore， the treatment of this disease should focus on stage-specific differentiation and address both the symptoms and root causes. In recent years， significant progress has been achieved in both clinical and basic research. This article systematically reviews the clinical effect and mechanism of action of classic TCM prescriptions （such as Biejia Decoction Pill， Dahuang Zhechong Pill， and Xiaochaihu Decoction）， modern Chinese patent drugs， and core TCM drugs （such as Salvia miltiorrhiza， Astragalus membranaceus， and Bupleurum chinense） in the treatment of liver fibrosis. It also analyzes the current challenges in evidence quality and precise medication and proposes future research directions. It is recommended to enhance the role of TCM in the prevention and treatment of liver diseases by deepening research on the “disease-syndrome-prescription-effect-target” association and conducting high-level clinical trials and real-world studies.

     

    • FullText(HTML)
  • loading
    • References(48)
  • [1]
    BURKI T. WHO’s 2024 global hepatitis report[J]. Lancet Infect Dis, 2024, 24( 6): e362- e363. DOI: 10.1016/S1473-3099(24)00307-4.
    [2]
    YAN RY, SUN MH, YANG HY, et al. 2024 latest report on hepatitis B virus epidemiology in China: Current status, changing trajectory, and challenges[J]. Hepatobiliary Surg Nutr, 2025, 14( 1): 66- 77. DOI: 10.21037/hbsn-2024-754.
    [3]
    WANG YK, WANG MQ, LIU CR, et al. Global burden of liver cirrhosis 1990-2019 and 20 years forecast: Results from the global burden of disease study 2019[J]. Ann Med, 2024, 56( 1): 2328521. DOI: 10.1080/07853890.2024.2328521.
    [4]
    LIAW YF. Reversal of cirrhosis: An achievable goal of hepatitis B antiviral therapy[J]. J Hepatol, 2013, 59( 4): 880- 881. DOI: 10.1016/j.jhep.2013.05.007.
    [5]
    CHANG TT, LIAW YF, WU SS, et al. Long-term entecavir therapy results in the reversal of fibrosis/cirrhosis and continued histological improvement in patients with chronic hepatitis B[J]. Hepatology, 2010, 52( 3): 886- 893. DOI: 10.1002/hep.23785.
    [6]
    MARCELLIN P, GANE E, BUTI M, et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: A 5-year open-label follow-up study[J]. Lancet, 2013, 381( 9865): 468- 475. DOI: 10.1016/S0140-6736(12)61425-1.
    [7]
    ZHANG LJ, SCHUPPAN D. Traditional Chinese Medicine(TCM) for fibrotic liver disease: Hope and hype[J]. J Hepatol, 2014, 61( 1): 166- 168. DOI: 10.1016/j.jhep.2014.03.009.
    [8]
    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.
    [9]
    Hepatobiliary Specialized Committee of China Association of Chinese Medicine, Liver Diseases Specialized Committee of China Medical Association of Minorities. The clinical guidelines of diagnosis and treatment of chronic hepatitis B with traditional Chinese medicine(2018)[J]. J Clin Hepatol, 2018, 34( 12): 2520- 2525. DOI: 10.3969/j.issn.1001-5256.2018.12.007.

    中华中医药学会肝胆病专业委员会, 中国民族医药学会肝病专业委员会. 慢性乙型肝炎中医诊疗指南(2018年版)[J]. 临床肝胆病杂志, 2018, 34( 12): 2520- 2525. DOI: 10.3969/j.issn.1001-5256.2018.12.007.
    [10]
    LI H. Advances in anti hepatic fibrotic therapy with Traditional Chinese Medicine herbal formula[J]. J Ethnopharmacol, 2020, 251: 112442. DOI: 10.1016/j.jep.2019.112442.
    [11]
    ZHANG TY, YANG Y, WANG BJ, et al. Meta-analysis of influences of Biejiajian Pill combined with entecavir on serum liver fibrosis markers of compensatory period of hepatitis b cirrhosis: Protocol of systematic review and meta-analysis[J]. Medicine(Baltimore), 2019, 98( 51): e18458. DOI: 10.1097/MD.0000000000018458.
    [12]
    CUI XY, ZHANG RH, LI YF, et al. Bie Jia Jian pill ameliorates BDL-induced cholestatic hepatic fibrosis in rats by regulating intestinal microbial composition and TMAO-mediated PI3K/AKT signaling pathway[J]. J Ethnopharmacol, 2025, 337( Pt 2): 118910. DOI: 10.1016/j.jep.2024.118910.
    [13]
    WEI FF, LANG YK, GONG DD, et al. Effect of Dahuang Zhechong formula on liver fibrosis in patients with chronic hepatitis B: A meta-analysis[J]. Complement Ther Med, 2015, 23( 1): 129- 138. DOI: 10.1016/j.ctim.2014.12.011.
    [14]
    TIAN YY, MA BB, YU SY, et al. Clinical antitumor application and pharmacological mechanisms of Dahuang Zhechong Pill[J]. Chin Herb Med, 2023, 15( 2): 169- 180. DOI: 10.1016/j.chmed.2023.02.002.
    [15]
    WANG ZX, LI YB, WANG XB, et al. Precision strike strategy for liver diseases trilogy with Xiao-Chai-hu decoction: A meta-analysis with machine learning[J]. Phytomedicine, 2025, 142: 156796. DOI: 10.1016/j.phymed.2025.156796.
    [16]
    HUANG YZ, LU J, XU YL, et al. Xiaochaihu decorction relieves liver fibrosis caused by Schistosoma japonicum infection via the HSP47/TGF-β pathway[J]. Parasit Vectors, 2020, 13( 1): 254. DOI: 10.1186/s13071-020-04121-2.
    [17]
    QIANG R, ZHANG Y, WANG YH. Mechanisms of xiaochaihu decoction on treating hepatic fibrosis explored by network pharmacology[J]. Dis Markers, 2022, 2022: 8925637. DOI: 10.1155/2022/8925637.
    [18]
    YU XJ, LAI GQ, WEI C, et al. Study on mechanism of Xiaoyao powder treating liver fibrosis based on bioinformatics data[J]. Chin Arch Tradit Chin Med, 2021, 39( 1): 110- 114. DOI: 10.13193/j.issn.1673-7717.2021.01.029.

    余学竟, 赖国权, 韦翠, 等. 基于网络大数据研究逍遥散治疗肝纤维化的作用机制[J]. 中华中医药学刊, 2021, 39( 1): 110- 114. DOI: 10.13193/j.issn.1673-7717.2021.01.029.
    [19]
    CHEN X, MOU LL, CHEN DD, et al. Anti-fibrosis effect and mechanism of Xiaoyao powder on experimental liver fibrosis rat model[J]. Tradit Chin Drug Res Clin Pharmacol, 2014, 25( 3): 241- 244. DOI: 10.3969/j.issn.1003-9783.2014.03.001.

    陈曦, 牟璐璐, 陈丹丹, 等. 逍遥散对肝纤维化大鼠模型抗纤维化作用及其机制研究[J]. 中药新药与临床药理, 2014, 25( 3): 241- 244. DOI: 10.3969/j.issn.1003-9783.2014.03.001.
    [20]
    LI SM, DAI LJ, FENG L, et al. Effect of Xiaoyaosan medicated serum on MMP-1 and TIMP-1 secretion of human hepatic stellate cells[J]. Lishizhen Med Mater Med Res, 2016, 27( 9): 2134- 2136. DOI: 10.3969/j.issn.1008-0805.2016.09.029.

    李绍民, 代立娟, 冯澜, 等. 逍遥散含药血清对人肝星形细胞分泌MMP-1和TIMP-1的影响[J]. 时珍国医国药, 2016, 27( 9): 2134- 2136. DOI: 10.3969/j.issn.1008-0805.2016.09.029.
    [21]
    CHEN XM, LIU QW, LI Y, et al. Analysis of core functional components in Yinchenhao Decoction and their pathways for treating liver fibrosis[J]. J South Med Univ, 2024, 44( 8): 1508- 1517. DOI: 10.12122/j.issn.1673-4254.2024.08.09.

    陈星梅, 刘琴文, 李镱, 等. 茵陈蒿汤治疗肝纤维化的核心功能成分群以及潜在通路[J]. 南方医科大学学报, 2024, 44( 8): 1508- 1517. DOI: 10.12122/j.issn.1673-4254.2024.08.09.
    [22]
    SUN MY. Innovative research on Yinchenhao decoction and its derived formulas in preventing and treating liver fibrosis based on the“formula-syndrome correlation” theory[C]// Proceedings of the 16th National Academic Conference on Traditional Chinese Medicine for Liver and Gallbladder Diseases. 2015: 20- 27.

    孙明瑜. 基于"方证相关"理论的茵陈蒿汤类方防治肝纤维化创新研究[C]// 第十六届全国中医肝胆病学术会议论文集. 2015: 20- 27.
    [23]
    MENG S, XING S. Chemical study on classic prescription: Yinchenhao decoction[J]. Asia Pac Tradit Med, 2009, 5( 8): 173- 175.

    孟姝, 邢尚. 经方——茵陈蒿汤的化学研究[J]. 亚太传统医药, 2009, 5( 8): 173- 175.
    [24]
    DU JJ, LIU HW, YAN HM, et al. On the effect of Jiawei Yiguan Decoction in treating hepatic fibrosis of liver-kidney yin deficiency type[J]. Jilin J Chin Med, 2021, 41( 1): 62- 65. DOI: 10.13463/j.cnki.jlzyy.2021.01.018.

    杜进军, 刘惠武, 严红梅, 等. 加味一贯煎治疗肝肾阴虚型肝纤维化[J]. 吉林中医药, 2021, 41( 1): 62- 65. DOI: 10.13463/j.cnki.jlzyy.2021.01.018.
    [25]
    WANG K, WANG FZ, CHU CW, et al. Experimental study on modified Yiguan decoction against hepatic fibrosis[J]. J Guiyang Coll Tradit Chin Med, 2006, 28( 1): 61- 63. DOI: 10.3969/j.issn.1002-1108.2006.01.038.

    王昆, 王凤洲, 褚春薇, 等. 一贯煎加味抗肝纤维化的实验性研究[J]. 贵阳中医学院学报, 2006, 28( 1): 61- 63. DOI: 10.3969/j.issn.1002-1108.2006.01.038.
    [26]
    LIU P, HU YY, LIU C, et al. Multicenter clinical study on Fuzhenghuayu capsule against liver fibrosis due to chronic hepatitis B[J]. World J Gastroenterol, 2005, 11( 19): 2892- 2899. DOI: 10.3748/wjg.v11.i19.2892.
    [27]
    WU S, MA XB, ZHOU CJ, et al. Effect of Fuzhenghuayu compound on hepatocyte expression of Nrf2 in a mouse model of hepatic fibrosis[J]. Chin J Hepatol, 2014, 22( 8): 609- 615. DOI: 10.3760/cma.j.issn.1007-3418.2014.08.012.

    吴硕, 马兴彬, 周成军, 等. 扶正化瘀方对肝纤维化小鼠肝细胞中Nrf2表达的影响[J]. 中华肝脏病杂志, 2014, 22( 8): 609- 615. DOI: 10.3760/cma.j.issn.1007-3418.2014.08.012.
    [28]
    HU YY, LIU P, LIU C, et al. The value of serum markers in evaluating liver fibrotic changes[J]. Chin J Hepatol, 2006, 14( 3): 174- 177. DOI: 10.3760/j.issn:1007-3418.2006.03.005.

    胡义扬, 刘平, 刘成, 等. 基于肝组织病理动态变化情况探讨血清学指标在肝纤维化诊断中的意义[J]. 中华肝脏病杂志, 2006, 14( 3): 174- 177. DOI: 10.3760/j.issn:1007-3418.2006.03.005.
    [29]
    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.
    [30]
    MIAO L, YANG WN, DONG XQ, et al. Combined anluohuaxianwan and entecavir treatment significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection[J]. Chin J Hepatol, 2019, 27( 7): 521- 526. DOI: 10.3760/cma.j.issn.1007-3418.2019.07.009.

    苗亮, 杨婉娜, 董晓琴, 等. 安络化纤丸联合恩替卡韦治疗可显著提高慢性乙型肝炎病毒感染者肝纤维化的改善率[J]. 中华肝脏病杂志, 2019, 27( 7): 521- 526. DOI: 10.3760/cma.j.issn.1007-3418.2019.07.009.
    [31]
    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.1007-3418.2019.04.006.

    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.
    [32]
    LU W, GAO YH, WANG ZZ, et al. Effects of Anluohuaxianwan on transforming growth factor-β1 and related signaling pathways in rats with carbon tetrachloride-induced liver fibrosis[J]. Chin J Hepatol, 2017, 25( 4): 257- 262. DOI: 10.3760/cma.j.issn.1007-3418.2017.04.005.

    卢玮, 高玉华, 王珍子, 等. 安络化纤丸对肝纤维化大鼠转化生长因子β1及相应信号通路的影响[J]. 中华肝脏病杂志, 2017, 25( 4): 257- 262. DOI: 10.3760/cma.j.issn.1007-3418.2017.04.005.
    [33]
    ZHAO Y, CAO YZ, LI XP. Efficacy of tenofovir alafenamide fumarate combined with Ganshuang granules in the treatment of chronic hepatitis B with liver fibrosis and its effects on immune function and inflammatory status of patients[J]. Hainan Med J, 2023, 34( 10): 1383- 1387. DOI: 10.3969/j.issn.1003-6350.2023.10.004.

    赵媛, 曹耀章, 李小鹏. 富马酸丙酚替诺福韦联合肝爽颗粒治疗慢性乙肝肝纤维化的疗效及对患者免疫功能和炎症状态的影响[J]. 海南医学, 2023, 34( 10): 1383- 1387. DOI: 10.3969/j.issn.1003-6350.2023.10.004.
    [34]
    QIU R, TAO YP, WU D. Analysis of the therapeutic effect of Ganshuang Granule combined with tenofovir on chronic hepatitis B patients with liver fibrosis[J]. J Pract Tradit Chin Intern Med, 2024, 38( 5): 127- 129. DOI: 10.13729/j.issn.1671-7813.Z20222144.

    邱榕, 陶云平, 吴迪. 肝爽颗粒联合替诺福韦治疗慢性乙型肝炎肝纤维化的疗效分析[J]. 实用中医内科杂志, 2024, 38( 5): 127- 129. DOI: 10.13729/j.issn.1671-7813.Z20222144.
    [35]
    WU WT, CHEN WB, CHEN XY. Treatment of antipsychotics induced mild hepatic damage by Dangfei Liganning Tablet: An efficacy observation[J]. Chin J Integr Tradit West Med, 2014, 34( 5): 554- 555, 561.

    吴伟梯, 陈文斌, 陈晓烨. 当飞利肝宁片治疗抗精神病药物所致轻度肝功能损伤疗效观察[J]. 中国中西医结合杂志, 2014, 34( 5): 554- 555, 561.
    [36]
    TONG QX, WU YY, XU B, et al. Study on the effect of heluoshugan capsule on liver fibrosis induced by Schistosoma japonicum infection in mice[J]. Chin J Parasitol Parasit Dis, 2006, 24( 2): 129- 132. DOI: 10.3969/j.issn.1000-7423.2006.02.012.

    童巧霞, 吴艳艳, 徐标, 等. 和络舒肝胶囊抗小鼠血吸虫性肝纤维化作用的研究[J]. 中国寄生虫学与寄生虫病杂志, 2006, 24( 2): 129- 132. DOI: 10.3969/j.issn.1000-7423.2006.02.012.
    [37]
    ZHANG G, ZHANG FC, WANG TC, et al. The effects of Chinese national medicine of Huoxueruanjian compound on SMAD signal in hepatic stellate cell and its significance[J]. Chin J Hepatol, 2004, 12( 4): 213- 215. DOI: 10.3760/j.issn:1007-3418.2004.04.008.

    张国, 张法灿, 王天才, 等. 活血软坚方对肝星状细胞Smad信号的影响及意义[J]. 中华肝脏病杂志, 2004, 12( 4): 213- 215. DOI: 10.3760/j.issn:1007-3418.2004.04.008.
    [38]
    CHEN JL, YANG X, ZHANG Q, et al. Effect of ursodeoxycholic acid with traditional Chinese medicine on biochemical response in patients with primary biliary cholangitis: A real-world cohort study[J]. Chin J Hepatol, 2018, 26( 12): 909- 915. DOI: 10.3760/cma.j.issn.1007-3418.2018.12.007.

    陈佳良, 杨雪, 张群, 等. 熊去氧胆酸联合中药治疗对原发性胆汁性胆管炎患者生物化学应答的影响: 一项基于真实世界的队列研究[J]. 中华肝脏病杂志, 2018, 26( 12): 909- 915. DOI: 10.3760/cma.j.issn.1007-3418.2018.12.007.
    [39]
    AN JH, NI W, QIAO J. Therapeutic efficacy and quality of life investigation of traditional Chinese medicine-based therapy of chronic hepatitis B-related liver fibrosis[J]. Chin J Hepatol 2014, 22( 1): 30- 32. DOI: 10.3760/cma.j.issn.1007-3418.2014.01.007.

    安纪红, 倪文, 乔杰. 中药治疗慢性乙型肝炎肝纤维化的疗效观察及生存质量研究[J]. 中华肝脏病杂志, 2014, 22( 1): 30- 32. DOI: 10.3760/cma.j.issn.1007-3418.2014.01.007.
    [40]
    LI D, ZHU M, ZHOU CH, et al. Effect of Liuweiwuling tablet on biochemical and virological parameters, and quality of life in patients with hepatitis B virus-related cirrhosis: A protocol for a systematic review and meta-analysis[J]. Medicine(Baltimore), 2020, 99( 37): e22065. DOI: 10.1097/MD.0000000000022065.
    [41]
    ZHAO MN, MU F, LIN R, et al. Chinese medicine-derived salvianolic acid B for disease therapy: A scientometric study[J]. Am J Chin Med, 2024, 52( 5): 1359- 1396. DOI: 10.1142/S0192415X2450054X.
    [42]
    XIAO Z, LIU W, MU YP, et al. Pharmacological effects of salvianolic acid B against oxidative damage[J]. Front Pharmacol, 2020, 11: 572373. DOI: 10.3389/fphar.2020.572373.
    [43]
    ZHONG Y, LI JC, ZHU XM, et al. A comprehensive review of bupleuri radix and its bioactive components: With a major focus on treating chronic liver diseases[J]. J Ethnopharmacol, 2024, 330: 118244. DOI: 10.1016/j.jep.2024.118244.
    [44]
    YU LF, YU P, CAO YC, et al. Mechanism of Radix Bupleuri and Hedysarum Multijugum Maxim drug pairs on liver fibrosis based on network pharmacology, bioinformatics and molecular dynamics simulation[J]. PLoS One, 2025, 20( 1): e0318336. DOI: 10.1371/journal.pone.0318336.
    [45]
    GONG X, SHAN LL, CAO SS, et al. Notoginsenoside R1, an active compound from Panax notoginseng, inhibits hepatic stellate cell activation and liver fibrosis via MAPK signaling pathway[J]. Am J Chin Med, 2022, 50( 2): 511- 523. DOI: 10.1142/S0192415X22500197.
    [46]
    TAO AE, ZHANG Y, GAN ZK, et al. Isolation, structural features, and bioactivities of polysaccharides from Panax notoginseng: A review[J]. Int J Biol Macromol, 2024, 280( Pt 1): 135765. DOI: 10.1016/j.ijbiomac.2024.135765.
    [47]
    LIANG N, KONG DZ, MA SS, et al. Radix Sophorae flavescentis versus no intervention or placebo for chronic hepatitis B[J]. Cochrane Database Syst Rev, 2019, 4( 4): CD013089. DOI: 10.1002/14651858.CD013089.pub2.
    [48]
    SONG LY, MA YT, FANG WJ, et al. Inhibitory effects of oxymatrine on hepatic stellate cells activation through TGF-β/miR-195/Smad signaling pathway[J]. BMC Complement Altern Med, 2019, 19( 1): 138. DOI: 10.1186/s12906-019-2560-2.
    • 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

    Tables(1)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (154) PDF downloads(73) 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