The incidence rate of nonalcoholic steatohepatitis is gradually increasing year by year, which calls for an urgent need for effective therapeutic drugs. In recent years, various drugs have been developed, including anti-oxidative stress drugs, insulin sensitizers, PPAR agonists, thyroid receptor agonists, farnesoid X receptor agonists, ASK1 inhibitors, and pan-caspase inhibitors. This article reviews the clinical studies on the therapeutic drugs for nonalcoholic steatohepatitis and summarizes the efficacy and safety of each drug, in order to provide a reference for clinical practice.

The portal vein system is the main blood supply system of the liver, and damage to the portal vein system caused by cirrhotic portal hypertension may be the second hit to the liver. Protection of the portal vein will ensure sufficient blood supply of the liver and maintain its structure and function. Starting from the physiological structure and pathological changes of the portal vein, this article elaborates on the adverse effect of portal hypertension on the liver from the three new perspectives of thrombosis of the portal system, abnormal angiogenesis, and disturbance of hepatic sinusoidal homeostasis. It is suggested to change the current status of passive treatment of portal hypertension complications and encourage scientific exploration to reduce portal hypertension from multiple angles as early as possible to avoid repeated endoscopic devascularization of collateral circulation and splenectomy, so as to reduce various factors for the damage of the portal system, maintain the homeostasis of the portal system, and protect the liver.