28 April 2025, Volume 35 Issue 4
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 397-401. https://doi.org/10.3969/j.issn.1005-0264.2025.004.001Portal-sinusoidal vascular disorder (PSVD) is one of the important causes of non-sclerosing portal hypertension. Due to a lack of awareness of this disease among some clinicians, certain PSVD patients may be misdiagnosed as having cryptogenic or autoimmune cirrhosis. The etiology and underlying mechanisms of PSVD are still unclear, and only symptomatic treatment is available in clinical practice. So far, there are no standardized diagnostic and treatment guidelines. This article summarizes the research progress of PSVD at home and abroad in recent years, in order to improve the early diagnosis rate of the disease and the accuracy of intervention.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 402-405. https://doi.org/10.3969/j.issn.1005-0264.2025.004.002Drug-induced liver injury (DILI) caused by platinum-based chemotherapy drugs is characterized by elevated aminotransferase, while vascular injury is relatively rare as a special clinical phenotype of DILI. It has been reported that DILI caused by platinum-based chemotherapy drugs is more common with hepatic sinus obstruction syndrome, while porto-sinusoidal vascular disorder (PSVD) caused by platinum-based chemotherapy drugs is rarely reported. This report describes a case with prominent clinical manifestations of portal hypertension and normal or nearly normal liver function. Liver function impairment and portal hypertension were not parallel. Extrahepatic vascular diseases were excluded by imaging. Although imaging suggested cirrhosis, liver transient elastography (TE) did not support cirrhosis, and liver biopsy histopathology also excluded cirrhosis, revealing characteristic histopathological features of PSVD. The patient was diagnosed with PSVD induced by platinum-based chemotherapy drugs. After one year of follow-up, the patient's condition remained relatively stable.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 406-409. https://doi.org/10.3969/j.issn.1005-0264.2025.004.003Objective: The objective was to evaluate the clinical efficacy of Tongyang Qushi Fang in patients with nonalcoholic fatty liver disease (NAFLD). Methods: 130 patients with NAFLD were randomly divided into the control group (62 cases) and the treatment group (68 cases). The control group received simple weight control, while the treatment group was given Tongyang Qushi Fang in addition to the routine treatment provided to the control group. Results: After 24 weeks of treatment, both groups showed a significant reduction in TCM syndrome scores, liver-spleen CT ratio, body weight, and BMI (P<0.05) . The treatment group showed a better decrease in TCM syndrome scores compared to the control group (P<0.05).The liver-spleen CT ratio improved in both groups, with statistically significant differences (P<0.05) The improvement of biochemical indexes such as alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , glutamyl transpeptidase (GGT) , alkaline phosphatase (Alp) , total cholesterol (TC) , triglyceride (TG) , high-density lipoprotein cholesterol (HDL-C) , low-density lipoprotein (LDL-C) and glycated hemoglobin (HbA1c) in the treatment group was superior to that in the control group(P<0.05). Conclusion: Tongyang Qushi Fang can improve the clinical efficacy in patients with cold-dampness-trapped spleen type NAFLD.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 410-414. https://doi.org/10.3969/j.issn.1005-0264.2025.004.004Objective: Exploring the diversity of the microbiota in patients with nonalcoholic fatty liver disease (NAFLD) and its correlation with liver fibrosis-related cytokines. Methods: A total of 137 patients with NAFLD treated in our hospital from January 2023 to December 2023 were selected as the NAFLD group, and 109 patients with healthy results in our hospital during the same period were selected as the control group. Stool samples were collected from all patients for analysis and comparison of intestinal flora, while fasting venous blood was collected for detection and comparison of liver fibrosis-related cytokines interleukin1β, 6, 12, 17, 21, 32 (IL-1β, IL-12, IL-17, IL-21, IL-32) and tumor necrosis factor α (TNF-α). Finally, the correlation between intestinal flora diversity and liver fibrosis related factors in NAFLD patients was analyzed. Results: IL-1β, IL-12, IL-17, IL-21, IL-32 and TNF-α in NAFLD group were significantly higher than those in control group, with statistical significance (P<0.05). Chao1 index, ACE index and Shannon index in NAFLD group were lower than those in control group, while Simpson index was higher than those in control group, with statistical significance (P<0.05). In the control group, Parabacteroides, Lactobacillus, Prevotella, Bifidobacterium, Flavobacterium and Oscillibacter had high abundance and were the main dominant bacteria. In the intestinal flora of NAFLD group, Bacteroides,Clostridiun_butyricum,Escherichia,Clostridiun_leptum,Enterobacteriaceae,Bacteroidetes,Eubacteriun,Streptococcus have a high abundance and are the main dominant bacteria. Parabacteroides, Lactobacillus, Prevotella, Bifidobacterium and Oscillibacter were negatively correlated with liver fibrosis-related cytokines. Bacteroides, Clostridiun_butyricum, Escherichia and Bacteroidetes were positively correlated with liver fibrosis related cytokines (P<0.05). Conclusion: Patients with NAFLD have significant abnormalities in the diversity of intestinal microflora and correlate with liver fibrosis-related cytokines.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 415-419. https://doi.org/10.3969/j.issn.1005-0264.2025.004.005Objective: This study, based on the theory of "soil impediment and wood stagnation," explores the value of body composition and liver function indicators in assessing traditional Chinese medicine(TCM) syndromes in metabolic associated fatty liver disease (MAFLD). Methods: 118 patients with MAFLD who first visited the Obesity Clinic at Hubei Provincial Hospital of Traditional Chinese Medicine between June and December 2022 were included in the study. The levels of body mass index (BMI), basal metabolic rate (BMR), visceral fat area (VFA), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil), hypersensitive C reactive protein (hs-CRP) and controlled decay parameter (CAP)were compared in four syndrome types: liver-depression and spleen-deficiency, phlegm-turbidity internal obstruction, dampness-heat accumulation and phlegm-blood stasis interconnection. Multivariate disordered multiple Logistic regression was used to analyze the predictors of TCM syndrome types in MAFLD patients. Results: There were 40 cases (34.0%) in the liver-depression and spleen-deficiency group, 24 cases (20.3%) in the phlegm-turbidity internal obstruction group, 34 cases (28.8%) in the dampness-heat accumulation group, and 20 cases (16.9%) in the phlegm-blood stasis interconnection group. The levels of BMR, TBil and DBil were significantly different (P<0.05) in four groups. The results of disordered multiple Logistic regression showed that TBil was the predictor of phlegm turbidity obstruction syndrome (OR=1.27,95% CI:1.032-1.565,P=0.024), taking liver-stagnation and splee-deficiency syndrome as reference. The variables were not statistically significant in the phlegm-turbidity internal obstruction syndrome group, ddampness-heat accumulation syndrome group, and phlegm-blood stasis interconnection syndrome group as reference (P>0.05). Conclusion: MAFLD patients with different TCM syndromes exhibit differences in BMR, TBil, and DBil levels. TBil is higher in the phlegm-damp obstruction syndrome group compared to the liver-stagnation and splee-deficiency syndrome group. TBil is a promising predictive factor for TCM syndromes in MAFLD and warrants further research.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 420-424. https://doi.org/10.3969/j.issn.1005-0264.2025.004.006Objective: To observe the curative effect of pegylated interferon(Peg IFN) α-2b in the treatment of chronic hepatitis B patients with abnormal alanine aminotransferase(ALT) after nucleotide analogues(NAs) treatment, and to provide reference for clinical treatment. Methods: Chronic hepatitis B patients treated with NAs for more than 4 years and with abnormal ALT were included in the control group and the combination group from January 2021 to March 2022. According to China's "Chronic Hepatitis B Prevention and Treatment Guidelines (2022 edition)", the control group continued to receive NAs,the combined group was treated with Peg IFN α-2b. Other liver function indexes such as ALT, hepatitis B surface antigen content and hepatitis B DNA quantitative determination (take the qualitative result as a decision statistical value) were observed in the two groups, and adverse drug reactions were monitored. After 48 weeks of treatment, the combination group was switched to single NAs treatment regardless of outcome, and follow-up was conducted for 1 year. Results: A total of 86 patients were included, 31 patients in the control group and 55 patients in the combination group. There was no statistically significant difference in baseline levels between the two groups. After 24 weeks of treatment, the content of hepatitis B virus surface antigen and the normal rate of ALT in combination group were better than those in control group (P<0.05). After 48 weeks of treatment, the negative rate of hepatitis B virus surface antigen, the normal ALT, and the negative rate of hepatitis B virus DNA in combination group were better than those in control group (P<0.05). After 1 year of follow-up, the content of hepatitis B virus surface antigen, normal rate of ALT, negative rate of hepatitis B virus surface antigen, negative rate of hepatitis B virus DNA in combination group were better than those in control group (P<0.05). Five patients in the combination group had adverse drug reactions during combination therapy and were given Peg IFN α-2b intermittenously. Eleven patients persisted in treatment due to minor adverse drug reactions. Conclusion: Although there is a certain proportion of controllable adverse drug reactions, combined Peg INF α-2b therapy can improve the clinical efficacy of chronic hepatitis B patients with abnormal ALT after treatment with NAs.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 425-429. https://doi.org/10.3969/j.issn.1005-0264.2025.004.007Objective: To explore the predictive value of serum eosinophil chemotactic factor (Eotaxin), neutrophil gelatinase-associated lipocalin (NGAL) and serum amyloid A (SAA) on adverse transfusion reactions in hepatitis B cirrhosis. Methods: A total of 80 hepatitis B cirrhosis patients who received blood transfusion treatment in our hospital from March 2021 to June 2023 were included. Of these, 39 patients who experienced adverse reactions were in the observation group, and 41 patients who did not experience adverse reactions were in the control group. Enzymelinked immunosorbent assay (ELISA) was used to detect serum levels of Eotaxin, NGAL, and SAA. Clinical data were collected, and multivariate logistic regression was applied to analyze factors influencing adverse transfusion reactions. Receiver Operating Characteristic (ROC) curve analysis was performed to assess the predictive value of serum Eotaxin, NGAL, and SAA in adverse transfusion reactions. Results: After blood transfusion, the serum levels of Eotaxin, NGAL and SAA in the observation group were higher than those in the control group (P＜0.05). Clinical data comparison found that there were differences in the number of blood transfusions, time from onset to transfusion, history of previous blood transfusions, and history of allergies between the two groups (P＜0.05), and the number of blood transfusions, time from onset to transfusion, previous transfusion history, allergy history, serum Eotaxin, NGAL and SAA levels were all factors that affected the occurrence of transfusion adverse reactions in hepatitis B cirrhosis (P＜0.05). ROC curve analysis showed that the area under the curve (AUC) of serum Eotaxin, NGAL, SAA and their combination in predicting adverse transfusion reactions in hepatitis B cirrhosis was 0.891, 0.736, 0.877 and 0.969, respectively, the combined predictive value of these three factors was higher than that of single prediction (Z the combination-Eotaxin=2.264, Z the combination-NGAL=4.215, Z the combination-SAA=2.768, P＜0.05). Conclusion: Serum Eotaxin, NGAL, and SAA levels are elevated in hepatitis B cirrhosis with adverse transfusion reactions, and the combination of these three factors has predictive value for adverse transfusion reactions.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 430-437. https://doi.org/10.3969/j.issn.1005-0264.2025.004.008Objective: To explore the mechanism of Xuefuzhuyu Decoction in treating liver fibrosis through network pharmacology and animal experiments. Methods: The main components and potential targets of Xuefuzhuyu Decoction were obtained using TCMSP, ETCM, HERB, SwissTarget Prediction, and other databases. Liver fibrosis disease targets were retrieved from Genecard, OMIM, DRUGBANK, and TTD, and common targets between Xuefuzhuyu Decoction and liver fibrosis were identified. A protein interaction network was constructed to identify core targets. KEGG and GO enrichment analyses were conducted using Metascape to identify potential pathways. A mouse model of liver fibrosis was induced using CCl4, and liver tissue pathology, collagen type I and III expression, hepatic hydroxyproline (HYP) content, αSMA immunohistochemistry, and liver function changes were observed after Xuefuzhuyu Decoction intervention. RTqPCR was used to verify the changes in mRNA levels of key targets. Results: Xuefuzhuyu Decoction has 292 intersecting targets with liver fibrosis diseases, with core targets including AKT1, HIF-1α, mTOR, etc. KEGG enrichment analysis mainly involves cancer pathways, PI3K-AKT signaling pathway, HIF-1α signaling pathway, MAPK signaling pathway, etc. Animal experiments have shown that Xuefuzhuyu Decoction can improve liver fibrosis in mice, reduce the content of HYP and the expression of type Ⅰ and Ⅲ collagen in liver tissue, decrease the expression of α-SMA, alleviate liver inflammation, and downregulate the mRNA levels of PI3K, AKT1, mTOR, and HIF-1α in the liver. Conclusion: Xuefuzhuyu Decoction can improve liver fibrosis in mice, and its mechanism may be related to the regulation of the PI3K-AKT1-mTOR/HIF-1α pathway.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 438-443. https://doi.org/10.3969/j.issn.1005-0264.2025.004.009Objective: To investigate the effect and mechanism of Pachymaran on nonalcoholic fatty liver disease (NAFLD) induced by high-fat diet. Methods: Thirty C57BL/6 mice were divided into normal diet, NAFLD, high-,medium- and low-dose pachymaran groups, with 6 mice in each group. Except the normal diet group, the other groups were fed high-fat diet to induce NAFLD. Pachymaran groups irrigation to 1 time a day, eight weeks in a row. Then gather the liver, serum level of each index, and HE staining to observe the liver pathology. Western blotting test amp activated protein kinase (AMPK) expression, RT-qPCR detection of triglyceride metabolism enzyme mRNA level. Results: The body weight and body fat of the high Pachymaran dose group decreased significantly after treatment and serum lipid related indicators decreased significantly (P<0.05). Tissue staining showed hepatocyte hypertrophy accompanied by cystic steatosis and increased hepatocyte lipid droplets in NAFLD group, and the above conditions were significantly reduced after treatment (P<0.05). Western blotting revealed that AMPK phosphorylation level significantly increased after the treatment, and RT-qPCR results triglyceride synthetase significantly reduced, degrading enzymes rise significantly (P<0.05). Conclusion: Pachymaran inhibits fat accumulation, hepatocyte degeneration, and damage in NAFLD mice. Its mechanism may involve the regulation of the AMPK pathway and improvement in triglyceride metabolism, thus modulating the pathological progression of NAFLD.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 444-450. https://doi.org/10.3969/j.issn.1005-0264.2025.004.010Objective: The study aimed to assess the therapeutic effects of Daning tablets and probiotics on non-alcoholic fatty liver disease (NAFLD) in rats, as well as their influence on the TLR4/NF-κBP65/MyD88/P38 signaling pathway in the liver. Methods: Forty male Sprague-Dawley rats were randomly assigned to a control group (n=10) fed a standard diet, and a NAFLD model group (n=30) fed a high-fat diet for 8 weeks to induce NAFLD. Following successful modeling, the NAFLD model group was subdivided into a model group (n=10), treatment 1 group (n=10, treated with Daning tablets), and treatment 2 group (n=10, treated with probiotics).Following an 8-week treatment period, the rats were euthanized and samples of peripheral blood and liver tissue were obtained. Subsequently, levels of endotoxin lipopolysaccharide (LPS), tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), total cholesterol (TC), triglycerides (TG), alanine aminotransferase (ALT), aspartate transaminase (AST), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), superoxide dismutase (SOD), and malondialdehyde (MDA) were quantified. HE staining was utilized for morphological analysis of liver tissues in each experimental group. Immunohistochemistry and Western blotting techniques were employed to assess the expression levels of Toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), nuclear factor κB P65 (NF-κB P65), P38 mitogen-activated protein kinase (P38 MAPK), phosphorylated P38 mitogen-activated protein kinase (P-P38), c-Jun N-terminal kinase (JNK), and caspase-1 in the liver tissues. Results: The TC, TG, ALT, AST,LDL-C, LPS, and MDA in the NAFLD model group were found to be significantly elevated compared to those in the control group. Conversely, HDL-C and SOD levels were significantly lower in the NAFLD model group. Additionally, the expression levels of TLR4, MyD88, NF-κB P65, P38 MAPK, P-P38, c-JUN, and Caspase-1 proteins in liver tissues were higher in the NAFLD model group compared to the control group. Treatment with groups 1 and 2 resulted in significantly decreased levels of TC, TG, ALT, AST, LDL-C, LPS, MDA, as well as reduced liver TC, TG, and free fatty acid (FFA) content compared to the model group. Conversely, SOD and HDL-C levels were significantly increased in the treatment groups. The levels of ALT, AST, LPS, and MDA in Treatment Group 2 were significantly lower than those in Treatment Group 1, while SOD and HDL-C levels were significantly increased. Liver TLR-4, MyD88, NF-kBP65, P38MAPK, P-P38, and Caspase 1 protein expression in Treatment Groups 1 and 2 were significantly lower than in the model group, with Treatment Group 2 showing lower levels compared to Treatment Group 1. Conclusion: The concurrent administration of Daning tablets and Bifidobacterium has been shown to effectively ameliorate hepatic function impairment in NAFLD rats by attenuating oxidative stress, reducing inflammatory cytokine levels, and potentially inhibiting TR4/NF-kBP65/My D88 activation, thereby exerting protective effects on the liver in NAFLD.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 451-456. https://doi.org/10.3969/j.issn.1005-0264.2025.004.011Objective: To investigate the effects of LINC00662 on the proliferation, migration, and invasion of hepatocellular carcinoma (HCC) cells by regulating the miR-144-3p/SRSF9 axis. Methods: HepG2 cells were divided into various groups: NC (non-transfected), si-NC, si-LINC00662, miR-NC, miR-144-3p mimic, si-LINC00662+inhibitor NC, si-LINC00662+miR-144-3p inhibitor, miR-144-3p mimics+pc-DNA, and miR-144-3p mimics+SRSF9. qRT-PCR was used to measure the expression levels of LINC00662, miR-144-3p, and SRSF9 mRNA in HCC tissue, different cells, and different HepG2 cell groups. EDU, scratch, and Transwell assays were used to assess HepG2 cell proliferation, migration, and invasion, respectively. A dual luciferase assay was used to verify the interaction between miR-144-3p, LINC00662, and SRSF9. Results: LINC00662 and SRSF9 mRNA expression was higher in HCC tissue compared to adjacent tissue, while miR-144-3p expression was lower (P<0.05). In HepG2 cells, LINC00662 and SRSF9 mRNA were elevated (P<0.05), and miR-144-3p was decreased (P<0.05). Inhibition of LINC00662 expression or overexpression of miR-144-3p could reduce the EDU positive cell rate, scratch healing rate, and invasive cell count in HepG2 cells (P<0.05). Inhibiting the expression of miR-144-3p and LINC00662 could increase the EDU positive rate, scratch healing rate and the number of invasive cells in HepG2 cells (P<0.05), and upregulation of SRSF9 and miR-144-3p expression could increase the EDU positive rate, scratch healing rate and the number of invasive cells in HepG2 cells (P<0.05). Dual luciferase reporter gene experiment showed a targeted regulatory relationship between miR-144-3p, LINC00662, and SRSF9 (P<0.05). Conclusion: LINC00662 is upregulated in HCC tissues and cells, and inhibition of LINC00662 expression can inhibit HCC cell proliferation, migration, and invasion by regulating the miR-144-3p/SRSF9 axis.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 457-463. https://doi.org/10.3969/j.issn.1005-0264.2025.004.012Objective: To investigate the application value of multimodal Magnetic Resonance Imaging(MRI) in the volume structure and functional connectivity changes of brain subregions in patients with mild and microhepatic encephalopathy. Methods: A total of 145 patients with cirrhosis admitted to our hospital from January 2022 to June 2024 were divided into MHE (n=74) and non-MHE (n=71) groups. After 1:1 propensity score matching, 50 patients from each group were compared for baseline characteristics and biochemical indices. All patients underwent head DWI, DTI, and rs-fMRI scans. We compared the volume structure of brain subregions, functional connectivity in different brain regions, and cognitive function scores between the groups. Multivariate logistic regression was used to analyze the correlation between brain subregion volume structure, functional connectivity, and MHE. Pearson correlation analysis was used to examine the relationships between changes in functional connectivity, cognitive dysfunction, and brain subregion volume structure. Results: When patients were matched based on propensity score matching, there was no statistically significant difference in baseline data between the two groups after matching (P>0.05).There were significant differences in biochemical indices (Alb, TBil, AMM, ALT) and PHES scores between the two groups (P<0.05).There were significant differences in ADC values between the MHE group and the non-MHE group in the white matter regions of the frontal and occipital lobes, the knee and pressure parts of the corpus callosum, the forelimb and hindlimb of the internal capsule, and the head of the caudate nucleus, and this result was statistically significant (P<0.05). The FA value in MHE group was significantly lower than that in non-MHE group (P<0.05).Compared with the non-MHE group, the functional connectivity of the right medial frontal gyrus, the left medial frontal gyrus and the right inferior temporal gyrus in the MHE group was significantly improved, while the functional connectivity of the right posterior central gyrus, the right superior marginal gyrus and the right posterior cingulate gyrus was significantly decreased.The multivariate logistic regression analysis revealed that the ADC values of the occipital and frontal white matter, the head of the caudate nucleus, and the knee and pressor part of the corpus callosum, as well as functional connection changes in the middle frontal gyrus, right posterior central gyrus, and right inferior temporal gyrus were all identified as significant risk factors for MHE onset (P<0.05). Additionally, the FA value in the knee of corpus callosum was found to be a protective factor for MHE (P<0.05).Patients in the MHE group demonstrated higher scores on the NCT-A test compared to those in the non-MHE group, while exhibiting lower scores on the DST and MoCA assessments.The scores of NCT-A were positively correlated with the FC changes in the right medial frontal gyrus (P<0.05). MoCA score was negatively correlated with FC changes in the right medial frontal gyrus, and positively correlated with the right superior marginal gyrus and right inferior temporal gyrus (P<0.05).ADC values in white matter of frontal and occipital brain, knee of corpus callosum and head of caudate nucleus were positively correlated with NCT-A (P<0.05). The white matter of frontal and occipital parts, knee of corpus callosum and head of caudate nucleus were negatively correlated with DST score (P<0.05). There was a negative correlation between FA value and NCT-A score in the knee of corpus callosum, and a positive correlation with DST score (P<0.05). Conclusion: Combining DWI, DTI, and rsfMRI techniques, we can reveal underlying abnormal changes in the structure and functional connectivity of brain subregions in MHE patients. These techniques provide a powerful tool for clinical MHE diagnosis and show great application potential.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 464-467. https://doi.org/10.3969/j.issn.1005-0264.2025.004.013Metabolic dysfunction associated fatty liver disease (MAFLD) is a kind of diseases associated with metabolic dysfunction. The occurrence of MAFLD tends to be younger and the burden of treatment continues to increase with the changes of lifestyle. Traditional Chinese medicine has good therapeutic effects on MAFLD. Xuanfu is the running channel of Qi-blood-body fluid. Xuanfu close and Qi-fluid disorder will lead to dysfunction of liver and spleen, producing pathological products, including stagnation, dampness, turbidity, phlegm and biood stasis. That is the demonstration of the disease progression from mild case to sthenia syndrome. Therefore, the core pathogenesis of MAFLD lies in Qi-fluid dysfunction in Xuanfu, and the key to treatment is "dispersing herbs eliminating sthenia." This paper will discuss the application value of this method in combination with Xuanfu theory in MAFLD, distinguishing and treating MAFLD from "six light to open Xuanfu". The authors desire to shed light on the treatment of MAFLD, the development of Xuanfu theory and the "dispersing herbs eliminating sthenia" theory.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 468-471. https://doi.org/10.3969/j.issn.1005-0264.2025.004.014Insomnia is a common clinical condition, often referred to in Traditional Chinese Medicine (TCM) as "unable to close the eyes", "unable to sleep", or "unable to lie down". According to the TCM theory of "the liver stores blood, and blood houses the soul" and "the soul moves with the spirit", this paper explores the relationship between insomnia, the movement of the soul, and the liver's role in storing blood. The main cause of liver-related insomnia, characterized by "the liver not housing the soul", is primarily due to the stagnation of liver Qi and the deficiency of liver blood. Treatment should focus on regulating liver Qi to ease stagnation, nourishing blood, and calming the soul, using comprehensive TCM approaches to ensure smooth liver Qi and sufficient liver blood, ultimately restoring the liver's ability to house the soul.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 472-476. https://doi.org/10.3969/j.issn.1005-0264.2025.004.015Nonalcoholic steatohepatitis (NASH) is a chronic liver disease that develops from nonalcoholic fatty liver disease, with its incidence steadily increasing each year. This paper suggests that the core pathogenesis of NASH is the internal accumulation of dampness and toxins, which is closely related to the liver's ability to regulate, the spleen's function of transformation, and the kidney's function of vaporization. Moreover, the internal accumulation of dampness and toxins is tightly linked to gut microbiota imbalance, which in turn affects the normal physiological functions of the liver, spleen, and kidneys. Based on the pathogenesis and treatment principles of NASH, this paper proposes acupuncture treatment targeting the liver, spleen, kidney, and their related meridians, using methods to regulate liver Qi, strengthen the spleen, and nourish the kidneys. This approach aims to clear dampness and toxins, improve gut microbiota imbalance, and provide insights for the diagnosis and treatment of NASH.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 477-480. https://doi.org/10.3969/j.issn.1005-0264.2025.004.016Objective: To explore the mechanism of supporting the theory of traditional Chinese medicine to regulate lipid metabolism disorder from the perspective of "intestinal-liver axis" theory. Methods: Taking the liver as the core to discuss: liver and spleen disorders, gold wood loss, intestinal turbidity forcing liver, liver and kidney loss of honor and other pathogenesis eventually lead to liver loss of catharsis, "ointment", "fat","phlegm", "blood stasis" and other abnormal accumulation, and then produce symptoms of lipid metabolism disorders related diseases. Based on the theory of visceral manifestation, the treatment ideas and medication of regulating liver were established from the perspectives of spleen, lung, intestine, kidney and liver. To clarify the theoretical connotation of the 'gut-liver axis' in modern medicine, according to the close relationship between liver metabolism and lipid metabolism disorders related diseases, focusing on the regulation of intestinal microflora by active ingredients of natural Chinese medicine, and exploring the reliable mechanism of traditional Chinese medicine to improve lipid metabolism disorders. Results: According to the theory of traditional Chinese medicine, the application of corresponding Chinese medicine under the treatment ideas of invigorating spleen and soothing liver, interconnecting Jinmu, Qingchangning liver and nourishing water and Hanmu can restore the liver's drainage and achieve the effect of clearing turbidification and lowering lipid. Through the analysis of the effective mechanism of the main active ingredients of traditional Chinese medicine, it is concluded that the use of medicines under the guidance of traditional Chinese medicine theory can improve the relative abundance of Bacteroides and the diversity of intestinal flora, and reduce the ratio of Firmicutes to Bacteroidetes and other intestinal bacterial colonies. Improve lipid metabolism disorders. Conclusion: The prevention and treatment of lipid metabolism disorders by traditional Chinese medicine may play a role in regulating intestinal flora through the "gut-liver axis", and improve the treatment of hyperlipidemia, non-alcoholic fatty liver disease, obesity and other lipid metabolism disorders related diseases.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 481-485. https://doi.org/10.3969/j.issn.1005-0264.2025.004.017Shang Han Lun is the first classical work of Traditional Chinese Medicine (TCM) with a relatively complete system of principles, methods, formulas, and prescriptions. It primarily discusses the series of pathological changes in the body after exposure to external pathogens and the methods for diagnosing and treating diseases based on pattern differentiation. Through long-term clinical practice, it has been found that many symptoms of liver disease closely align with the characteristics of the Shaoyang syndrome described in "Shang Han Lun." After applying pattern-based treatment according to the text, patients' symptoms can significantly improve, their quality of life markedly increases, and treatment outcomes are notable. A literature review reveals that there are currently only a few reports on treating liver diseases from the perspective of Shaoyang syndrome. This paper aims to combine the relevant content of Shaoyang syndrome in "Shang Han Lun" with clinical liver disease treatment, exploring the pathogenesis and treatment methods of liver diseases from the Shaoyang syndrome perspective, and summarizing related treatment principles, with the goal of providing new ideas and methods for the clinical treatment of liver diseases.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 486-489. https://doi.org/10.3969/j.issn.1005-0264.2025.004.018Alcoholic liver disease (ALD) is currently one of the main types of chronic liver diseases in China, and Traditional Chinese Medicine (TCM) offers unique advantages in treating ALD. Professor Lv Wenliang has creatively integrated traditional Chinese medical theory with Taoist philosophy, applying the theory of "Fire and Timing" in the diagnosis and treatment of ALD. Based on the overall treatment principle of "supporting the righteous and expelling the pathogenic factors, harmonizing the dissonance", he controls the "timing" of the liver, spleen, Qi and blood, and the balance of righteous and evil factors throughout the disease course. ALD is therefore divided into three stages for treatment: "Liver Qi stagnation and spleen deficiency, righteous Qi injured with hidden pathogens", "Qi stagnation and blood stasis, the battle between righteous and evil Qi", and "Chronic liver and kidney involvement, righteous deficiency and evil excess". The treatment is based on the symptoms of each stage, with prescriptions and medications chosen accordingly. By "precisely controlling the dosage, determining the timing of medication, and adjusting the treatment based on the changing pathogenesis", the medication's properties are adjusted to restore balance and harmony within the body. This approach effectively improves clinical symptoms in ALD patients and has significant implications for their long-term prognosis.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 490-493. https://doi.org/10.3969/j.issn.1005-0264.2025.004.019Metabolic dysfunction-associated steatotic liver disease (MASLD) is a metabolic related multisystem disorder and has become the most common cause of chronic liver disease, as well as a major risk factor for hepatocellular carcinoma. Relevant studies indicate that the pathological progression from metabolic associated simple steatosis (MASL) to metabolic associated steatohepatitis (MASH) is a critical step in the advancement of MASLD to liver fibrosis and liver cancer. Professor Xu Chunjun, a disciple of the renowned traditional Chinese medicine practitioner Guan Youbo, based on the "Central Region Theory" and the "Phlegm-Stasis Theory", believes that the primary cause of this progression is the accumulation of damp-heat, which serves as an intermediate pathogenesis in the disease's progression. Based on this, this article summarizes Professor Xu's unique clinical approach and methods for diagnosing and treating damp-heat accumulation type MASLD, aiming to provide valuable insights for the clinical treatment of MASLD.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 494-497. https://doi.org/10.3969/j.issn.1005-0264.2025.004.020This article summarizes Professor Liu Guangwei's experience in treating liver accumulation from the perspective of the "Shi Dao theory". The occurrence of liver accumulation is attributed to the blockage of the "meridian", which leads to qi stagnation, phlegm turbidity, blood stasis, and other accumulation in the liver. The treatment should be centered around unblocking the "meridian", with the first priority being to soft liver and sparse wood,it should be accompanied by methods such as regulating Qi and Blood, strengthening soil in the middle of health, warming the kidney, Tongli Sanjiao and so on,which have significant effects. And attach one medical case as evidence.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 498-502. https://doi.org/10.3969/j.issn.1005-0264.2025.004.021Primary liver cancer is one of the most common malignant tumors of the digestive system in China. Professor Luo Weisheng, a renowned TCM physician with over forty years of medical practice, has profound academic expertise and unique clinical experience in treating primary liver cancer. Professor Luo proposed the academic concept of "treating chronic liver diseases based on deficiency" asserting that primary liver cancer is located in the liver and is closely related to the spleen and kidneys. The underlying cause is the deficiency of Qi and blood in the body. When external pathogenic factors such as epidemic toxins, improper use of medications, or dietary excesses (such as alcohol) impair the body, the weakened righteous Qi cannot resist these external invasions, leading to the accumulation of blood stasis, phlegm, and dampness, which in turn causes the disease. In treatment, it is crucial to differentiate the state of the organs and the balance of deficiency and excess. The treatment should primarily focus on tonifying deficiency, with supplementary methods to purge excess. Additionally, Professor Luo formulated a unique prescription, the "Bazhen Lihe Kangxian prescription", adjusting the medication flexibly according to the symptoms, achieving satisfactory clinical results.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 503-507. https://doi.org/10.3969/j.issn.1005-0264.2025.004.022Liver cancer, one of the leading causes of death from malignant tumors, has a relatively well-defined etiology, but the exact mechanisms underlying tumor progression remain to be fully explored. The Hippo signaling pathway, which regulates cell proliferation and organ size, consists of a highly conserved kinase cascade (MST1/2, MAP4K, and LATS1/2) and downstream transcriptional co-activators (YAP and TAZ). Dysregulation of the Hippo pathway can lead to tumorigenesis and progression through amplification, mutations in upstream signaling factors, gene fusions, metabolic remodeling, and other mechanisms. This review summarizes the biological characteristics of the Hippo signaling pathway in recent years and its role and mechanisms in the occurrence and development of liver cancer.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 508-513. https://doi.org/10.3969/j.issn.1005-0264.2025.004.023Traditional Chinese medicine (TCM) has the unique advantages of multi-component, multi-target and multi-pathway in the treatment of NAFLD, and its clinical effect is significant, but its mechanism of action is still unclear. In recent years, the research on the mechanism of network pharmacology applied to the prevention and treatment of diseases with traditional Chinese medicine has developed rapidly.In this paper, by reviewing the literature on network pharmacology in the treatment of NAFLD with traditional Chinese medicine, This paper summarizes the mechanism of action of single or active ingredients, classical prescriptions and modern empirical formulae in the treatment of NAFLD from the aspects of drug active ingredients, gene targets, regulatory pathways and biological processes, in order to provide reference for the modern research and application of traditional Chinese medicine in the prevention and treatment of NAFLD.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 514-518. https://doi.org/10.3969/j.issn.1005-0264.2025.004.024Ferroptosis is a form of programmed cell death that differs significantly from other types of programmed cell death, such as necroptosis, necrosis, autophagy, and apoptosis, in various aspects including initial conditions, molecular characteristics, and mechanisms. In China, primary liver cancer (PLC) is widely regarded as the most common malignant tumor type, posing a significant risk to public health due to its high incidence and mortality rates. Therefore, timely diagnosis and treatment of primary liver cancer are particularly crucial in clinical practice. Recent scientific studies have revealed that ferroptosis plays a crucial role in the pathogenesis, insensitivity to treatment, and resistance of primary liver cancer, further confirming the close correlation between ferroptosis and the prevention and treatment of liver cancer. This article comprehensively reviews the significant characteristics of ferroptosis in primary liver cancer and the regulatory mechanisms of signaling pathways associated with it. The article also provides a detailed description and summary of the latest developments and future prospects of ferroptosis in the field of primary liver cancer research, aiming to provide new directions for the in-depth study and further development of malignant tumors, and to offer new therapeutic targets for future cancer treatment.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 519-523. https://doi.org/10.3969/j.issn.1005-0264.2025.004.025Cirrhosis is a common and serious chronic liver disease, which significantly affects the quality of life and prognosis of patients. In recent years, heme oxygenase -1(HO-1), as an antioxidant and anti-inflammatory enzyme, has attracted more and more attention in liver cirrhosis. This paper summarizes the relationship between liver cirrhosis and HO-1, focuses on the research progress of regulating HO-1 expression and relieving symptoms of liver cirrhosis by traditional Chinese medicine, reveals the potential and application prospect of traditional Chinese medicine in the treatment of liver cirrhosis, and provides important reference for future research direction and clinical application.
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Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases. 2025, 35(4): 524-528. https://doi.org/10.3969/j.issn.1005-0264.2025.004.026Chronic hepatitis B (CHB) and nonalcoholic fatty liver disease (NAFLD) are prevalent diseases of the liver, both of which are capable of causing liver fibrosis, cirrhosis and other adverse events. With the change of dietary structure and fast-paced lifestyle, the incidence of NAFLD is gradually increasing, which led to the proportion of CHB in patient with NAFLD substantially rising. For patients with NAFLD combined with CHB, there is no clear diagnosis and treatment standard has been perfected yet, the interactions and mechanisms between the two diseases are inconclusive, which brings obstacles to clinical diagnosis and treatment. In this article, we analyse the results of relevant researches, summarizing the interactions and prognoses concomitant CHB and NAFLD, including its association and mechanism between hepatitis B virus (HBV) infection and the development risk of NAFLD, the impact of antiviral therapy on NAFLD patients, the effect of NAFLD on antiviral therapy efficacy. The study found that CHB and NAFLD correlate with each other, however, there are controversies in the pathogenesis, treatment effect and prognosis, which have not yet been concluded, so it is worthwhile to carry out clinical and basic research in depth,to clarify the mechanism of effects between CHB and NAFLD as well as to provide theoretical guidance for clinical diagnosis and treatment.
