摘要
非酒精性脂肪肝(NAFLD)是一种与代谢密切相关的慢性肝病,主要特征为肝细胞内脂质异常沉积。近年来,随着肥胖及代谢综合征的患病率不断上升,NAFLD已成为全球最常见的慢性疾病。NAFLD的发病机制复杂多样,涉及糖脂代谢、氧化应激及炎症反应等多个信号通路的交叉调控,其中Toll样受体4(TLR4)信号通路在NAFLD的发生与进展中起关键作用。TLR4通路异常激活,促使促炎性细胞因子释放,诱导氧化应激并加重胰岛素抵抗,从而加速NAFLD的恶化。研究表明,中医药在调控TLR4信号通路方面展现出潜在的治疗作用,能够显著改善NAFLD的症状及病理特征。该综述总结了近5年国内外关于中药通过TLR4信号通路干预NAFLD的实验研究进展,涵盖了多糖、萜类、生物碱、黄酮类等多种中药活性成分及中药复方。研究发现,中药活性成分及复方通过多靶点、多途径调节TLR4信号通路,能有效改善脂质代谢紊乱,减轻胰岛素抵抗,调节肠道菌群,并抑制炎症反应与氧化应激,从而延缓NAFLD的进程。通过深入分析NAFLD的病理机制,探讨TLR4信号通路作为治疗靶点的潜力,为中医药在NAFLD治疗中的应用提供理论支持,并为未来的临床研究和新药开发提供新的视角和方向,以推动NAFLD治疗策略的创新和发展。
Non-alcoholic fatty liver disease(NAFLD)is a chronic liver disease closely related to metabolism,which is mainly characterized by abnormal lipid deposition in hepatocytes.In recent years,with the increasing prevalence of obesity and metabolic syndrome,NAFLD has become one of the most common chronic diseases in the world.The pathogenesis of NAFLD is complex and varied,involving the cross-regulation of multiple signaling pathways such as glucose-lipid metabolism,oxidative stress,and inflammation.The TLR4 signaling pathway plays a key role in the development and progression of NAFLD,and abnormal activation of this pathway accelerates the deterioration of NAFLD by promoting the release of pro-inflammatory cytokines,inducing oxidative stress,and exacerbating insulin resistance.Studies have shown that traditional Chinese medicine(TCM)can regulate the TLR4 signaling pathway to alleviate the symptoms and pathological features of NAFLD.The present review summarizes the experimental research progress in the TCM regulation of the TLR4 signaling pathway in treating NAFLD in the past 5 years,covering a wide range of TCM active ingredients(such as polysaccharides,terpenoids,alkaloids,flavonoids)and compound prescriptions.The active ingredients and compound prescriptions of TCM can effectively ameliorate lipid metabolism disorders,reduce insulin resistance,regulate intestinal flora,and inhibit inflammation and oxidative stress by regulating the TLR4 signaling pathway via multiple targets and pathways,thus slowing down the progression of NAFLD.Through in-depth analysis of the pathological mechanisms of NAFLD and exploration of the potential of TLR4 signaling pathway as a therapeutic target,we can provide theoretical support for the application of TCM in the treatment of NAFLD,as well as new perspectives and directions for future clinical research and new drug development,thereby promoting the innovation and development of therapeutic strategies for NAFLD.
作者
苏志威
薛娟
孙俊
范恒
朱锐
计春燕
SU Zhiwei;XUE Juan;SUN Jun;FAN Heng;ZHU Rui;JI Chunyan(Hubei University of Chinese Medicine,Wuhan 430065,China;Hubei Hospital of Integrated Traditional Chinese and Western Medicine,Wuhan 430015,China;Union Hospital,Huazhong University of Science and Technology,Wuhan 430022,China)
出处
《中国实验方剂学杂志》
北大核心
2025年第5期291-299,共9页
Chinese Journal of Experimental Traditional Medical Formulae
基金
湖北省时珍工程人才项目(鄂卫函2024-256号)
湖北省中西医结合医院“杏林人才工程”院级科研重点项目(H2023Z005)
鄂州市科技计划项目(鄂州科技发2023-32号)。
作者简介
第一作者:苏志威,在读硕士,从事中西医结合治疗消化系统疾病研究,E-mail:772564110@qq.com;通信作者:计春燕,硕士,主任医师,硕士生导师,从事中西医结合治疗消化系统疾病研究,E-mail:574900945@qq.com。
