苓桂术甘汤治疗非酒精性脂肪性肝病——从经典到临床的转化医学研究

柳涛; 刘保成; 吴涛; 党延启; 张彤; 肖伟; 季光

doi:10.16305/j.1007-1334.2022.2112134

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苓桂术甘汤治疗非酒精性脂肪性肝病——从经典到临床的转化医学研究

学科新探 | 更新时间：2022-07-13

- 苓桂术甘汤治疗非酒精性脂肪性肝病——从经典到临床的转化医学研究
- Linggui Zhugan Decoction for the treatment of non⁃alcoholic fatty liver disease： a translational medicine study from classics to clinics
- 上海中医药杂志 2022年56卷第5期页码：8-12
- 作者机构：
  
  1.上海中医药大学附属龙华医院脾胃病科，上海中医药大学脾胃病研究所（上海 200032）
  2.上海中医药大学中医健康服务协同创新中心（上海 201203）
  3.上海中医药大学交叉科学研究院（上海 201203）
  4.上海中医药大学中药学院（上海 201203）
- 作者简介：
  
  柳涛，男，博士，副主任医师，主要从事中医药防治消化系统疾病的临床和基础研究工作
  季光，主任医师，教授，博士研究生导师； E-mail：jiliver@shutcm.edu.cn
- 基金信息：
  
  国家自然科学基金国际合作重点项目(81620108030)
- DOI：10.16305/j.1007-1334.2022.2112134
  中图分类号：
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柳涛,刘保成,吴涛等.苓桂术甘汤治疗非酒精性脂肪性肝病——从经典到临床的转化医学研究[J].上海中医药杂志,2022,56(05):8-12.

LIU Tao,LIU Baocheng,WU Tao,et al.Linggui Zhugan Decoction for the treatment of non⁃alcoholic fatty liver disease： a translational medicine study from classics to clinics[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(05):8-12.
柳涛,刘保成,吴涛等.苓桂术甘汤治疗非酒精性脂肪性肝病——从经典到临床的转化医学研究[J].上海中医药杂志,2022,56(05):8-12. DOI： 10.16305/j.1007-1334.2022.2112134.

LIU Tao,LIU Baocheng,WU Tao,et al.Linggui Zhugan Decoction for the treatment of non⁃alcoholic fatty liver disease： a translational medicine study from classics to clinics[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(05):8-12. DOI： 10.16305/j.1007-1334.2022.2112134.

摘要

非酒精性脂肪性肝病（NAFLD）已经成为全球流行的慢性肝病，目前还缺乏针对性治疗药物。在“病痰饮者，当以温药和之”中医经典理论指导下，课题组创造性地将苓桂术甘汤用于NAFLD脾阳虚证的治疗，首次发现了苓桂术甘汤通过肝细胞膜甲状腺激素受体途径提高脂肪酸水溶性和增加脂肪酸β氧化的作用新途径，并通过多组学技术手段发现和验证了苓桂术甘汤治疗NAFLD的系统药理学机制。课题组多中心、随机、双盲、安慰剂对照临床试验证实苓桂术甘汤可以改善NAFLD脾阳虚证患者的胰岛素抵抗，首次提供了苓桂术甘汤治疗现代慢病的循证医学证据。苓桂术甘汤被列入国家“十三五”重大新药创制首批经典名方支持项目，已按要求完成各项研究任务，并完成首个经典名方新药注册。上述工作为推动中医传统理论和经典方剂在现代临床慢病防治中的转化应用作出了示范。

Abstract

Non-alcoholic fatty liver disease （NAFLD） has become a globally prevalent chronic liver disease， and there is still a lack of targeted therapy. Guided by the classical theory of traditional Chinese medicine （TCM） that “those who has phlegm syndrome should be treated with warm medicine”， our research group creatively applied Linggui Zhugan Decoction （LGZG） to the treatment of NAFLD patients with spleen-yang deficiency syndrome， and found that LGZG can improve fatty acid water solubility and increase fatty acid β-oxidation by working on the the pathway of hepatocyte membrane thyroid hormone receptor. We also discovered and validated the systemic pharmacological mechanism of LGZG in the treatment of NAFLD through multi-omics techniques. Our group confirmed through a multicenter， randomized， double-blind， placebo-controlled clinical trial that LGZG could improve insulin resistance in NAFLD patients with spleen-yang deficiency syndrome， which for the first time provided the evidence-based clinical evidence for the treatment of modern chronic diseases with LGZG. LGZG was included in the first batch of classic formula support projects in the 13th Five-Year Plan of China for the invention of major new drugs. We have completed all the research tasks as required and also the new drug registration of the first classic formula of Linggui Zhugan Decoction. The above-mentioned work is a milestone for promoting the translation and application of traditional Chinese medicine theories and classic formulas in the prevention and treatment of chronic diseases in modern clinics.

关键词

非酒精性脂肪性肝病代谢相关脂肪性肝病痰饮病苓桂术甘汤经典名方转化医学

Keywords

non-alcoholic fatty liver diseasemetabolic associated fatty liver diseasephlegm syndromeLinggui Zhugan Decoctionclassic formulatranslational medicine

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