中医药调控免疫相关通路治疗代谢相关脂肪性肝病研究进展*

作者：马新蕾1，欧泽莹1，黄丹琳1，金梦婷1，黄洁梅1，郑树楠2，罗伟诗1

单位：1.东莞市中医院，广东 东莞 523000； 2.揭西县灰寨镇中心卫生院，广东 揭阳 515428

引用：引用：马新蕾，欧泽莹，黄丹琳，金梦婷，黄洁梅，郑树楠，罗伟诗.中医药调控免疫相关通路治疗代谢相关脂肪性肝病研究进展[J].中医药导报,2026,32(5):150-156.

DOI：10.13862/j.cn43-1446/r.2026.05.024

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摘要：通过文献阅读与整理，阐述中医药调控免疫相关通路治疗代谢相关脂肪性肝病（MAFLD）的研究进展。MAFLD是全球高发慢性肝病，免疫炎症紊乱是其进展为非酒精性脂肪性肝炎及肝纤维化的核心驱动因素，其中医“肝郁脾虚、痰湿瘀阻”病机演变与免疫炎症进程高度契合。中医药以多成分、多靶点、多通路特性发挥作用，核心靶向Toll样受体4/核因子κB（TLR4/NF-κB）、NOD样受体热蛋白结构域相关蛋白3（NLRP3）炎症小体、丝裂原活化蛋白激酶（MAPK）、磷脂酰肌醇3激酶/蛋白激酶B（PI3K/Akt）等免疫相关通路，通过抑制炎症因子释放、调节巨噬细胞极化、改善氧化应激等缓解肝脏损伤。本文总结了黄芩苷、小檗碱及下瘀血汤、调肝脂汤等的调控机制，分析中医扶正祛邪理论与现代免疫调控的契合点，为MAFLD治疗提供参考。

关键词：代谢相关脂肪性肝病；中医药；免疫相关通路；综述

Abstract：

Through literature reading and analysis, this article elaborates on the research progress of traditional Chinese medicine (TCM) in regulating immune-related pathways for the treatment of metabolic-associated fatty liver disease (MAFLD). MAFLD is a highly prevalent chronic liver disease worldwide. Immune-inflammatory dysregulation is the core driving factor for its progression to non-alcoholic steatohepatitis and liver fibrosis. The evolution of TCM pathogenesis of "liver stagnation and spleen deficiency, phlegm-dampness and blood stasis obstruction" is highly consistent with the immune-inflammatory process. TCM exerts its effects through multi-component, multi-target, and multi-pathway characteristics, primarily targeting immune-related pathways such as Toll-like receptor 4/nuclear factor κB (TLR4/NF-κB), NOD-like receptor thermal protein domain-associated protein 3 (NLRP3) inflammasome, mitogen-activated protein kinase (MAPK), and phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt). It alleviates liver injury by inhibiting the release of inflammatory factors, regulating macrophage polarization, and improving oxidative stress. This article summarizes the regulatory mechanisms of baicalin, berberine, Xiayuxue Decoction (下瘀血汤), and Tiaoganzhi Decoction (调肝脂汤), analyzes the convergence between TCM's theory of "strengthening healthy qi and eliminating pathogenic factors" and modern immunomodulation, and provides a reference for the treatment of MAFLD.

Key words：metabolic-associated fatty liver disease; traditional Chinese medicine; immune-related pathways; review

发布时间：2026-05-23

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