Traditional Chinese medicine treatment of liver failure for 60 years： From clinical insights to scientific discoveries
- VernacularTitle:中医治疗肝衰竭60年： 从临床洞见到科学发现
- Author:
Xiaoyu HU
1
Author Information
- Publication Type:Journal Article
- Keywords: Liver Failure; Traditional Chinese Medicine Therapy; Integrated Chinese Traditional and Western Medicine Therapy; Acupuncture Moxibustion Therapy
- From: Journal of Clinical Hepatology 2025;41(6):1016-1024
- CountryChina
- Language:Chinese
- Abstract: Liver failure is a critical illness with a high fatality rate， and its treatment still faces great challenges. This article systematically reviews the achievements of inheritance and innovation in the field of traditional Chinese medicine （TCM） treatment of liver failure in China for the past 60 years. As for clinical research， it was found in the early exploration stage that Yinchenhao decoction combined with Western medicine treatment had a marked therapeutic effect， and enema therapy had shown a certain therapeutic effect， laying a foundation for subsequent research. In the era of evidence-based medicine， the TCM pathogenesis theories were established based on the understanding of “deficiency in origin and excess in superficiality” in liver failure， such as “jaundice due to spleen deficiency and invasion of pathogenic factors”， “Qi-deficiency and blood-stasis jaundice”， and “jaundice due to spleen-kidney Yang deficiency”. Based on the dynamic evolution of TCM syndromes， it is found that HBV-related acute-on-chronic liver failure presents the characteristics of “early excess and late deficiency”， and a framework of staged syndrome differentiation-based treatment has been established as removing excess in the early stage （detoxicating and resolving stasis） and tonifying deficiency in the late stage （warming Yang and securing collapse）. As for technological innovation， artificial liver combined with TCM， colonic lavage， and acupuncture and moxibustion has highlighted the advantages of the synergistic effect between multiple targets. Basic research has revealed that Yinchenhao Decoction regulates liver function through the intestinal flora-metabolism axis， the drug combination of Radix Paeoniae Rubra-Radix Aconiti Lateralis Preparata reshapes macrophage polarization， Schisandra chinensis lignans and Schisandra polysaccharides target GSH/GPX4 to modulate lipid homeostasis， and electroacupuncture stimulates ST36 （zusanli） to activate liver regeneration signal， thereby clarifying the molecular mechanism of the treatment principles such as “clearing heat and detoxicating” and “warming Yang and securing collapse”. Current challenges include the heterogeneity of clinical evidence， insufficient association between syndromes and biomarkers， and the bottleneck of cutting-edge technology integration. In the future， it is necessary to establish a two-way closed-loop research paradigm for clinical and basic research， focus on the intestinal microecology-immunity-energy metabolism network， and promote the upgrading of precise TCM treatment.
