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本文综述AMP活化蛋白激酶（AMP-activated protein kinase,AMPK）通路介导中医药改善非酒精性脂肪性肝病（non-alcoholic fatty liver disease,NAFLD）的分子机制及近5年研究进展。NAFLD发病涉及糖脂代谢紊乱、炎症及线粒体功能障碍。AMPK作为能量代谢核心枢纽，通过调控脂肪酸合成、氧化、自噬及炎症在NAFLD中起关键作用。研究表明，多种中药单体（如萜类梓醇、黄酮葛根素、生物碱小檗碱、苷类黄芪甲苷、酚类和厚朴酚、多糖金银花多糖等）通过靶向激活AMPK或其上游激酶（LKB1、CaMKKβ、AdipoR1等），抑制脂质合成关键因子（SREBP-1c、FAS、ACC），促进脂肪酸氧化（PPARα、CPT-1），改善胰岛素抵抗，增强自噬（ULK1、LC3），并抑制炎症（NF-κB）和氧化应激（Nrf2），多维度改善NAFLD。中药复方（如经典名方泽泻汤、五苓散、当归芍药散，经验效方芪术方、六味降脂汤，中成药消脂方、脑心清等）凭借多成分协同，更系统地调控AMPK下游网络（如LKB1/AMPK/PGC-1α、AMPK/mTOR/ULK1、AMPK/SIRT1），综合促进脂质分解、抑制合成，增强自噬及抗炎，体现中医“疏肝健脾”“活血化浊”等治法的科学内涵。综上，中医药通过靶向AMPK重塑肝脏能量代谢稳态，为NAFLD防治提供了重要分子证据及中西医融合基础；未来需克服模型异质性，深入解析复方协同机制及通路交互作用，并推动临床转化。
Abstract：This article reviews the molecular mechanism and progress in the last 5 years of the AMP-activated protein kinase(AMPK) pathway-mediated improvement of non-alcoholic fatty liver disease(NAFLD) by traditional Chinese medicine(TCM). The pathogenesis of NAFLD involves disorders of glucose and lipid metabolism, inflammation and mitochondrial dysfunction. AMPK, as a core hub of energy metabolism, plays a key role in NAFLD by regulating fatty acid synthesis, oxidation, autophagy and inflammation. Studies have shown that a variety of herbal monomers(e.g., the terpene catalpol, the flavonoid geraniol, the alkaloid berberine, the glycosides astragaloside, phenols and thujaplicins, and the polysaccharides honeysuckle polysaccharides) inhibit the key factors of lipid synthesis(SREBP-1c, FAS, ACC), promote fatty acid oxidation(PPARα, CPT-1), improves insulin resistance, enhances autophagy(ULK1, LC3), and inhibits inflammation(NF-κB) and oxidative stress(Nrf2) to improve NAFLD in a multidimensional manner by targeting the activation of AMPK or its upstream kinases(LKB1, CaMKKβ, AdipoR1, etc.). By virtue of the synergistic effect of multiple components, the TCM compound formula(e.g. the classic formula Zexie Decoction, Wuling Powder, and Danggui Shaoyao Powder; the empirical formula Qishu Formula, and Liuwei Jiangzhi Decoction; and the proprietary Chinese medicines Elimination of Lipids Fang, and Cerebro-Cardio-Clear, etc.) can regulate the downstream network of AMPK(e.g. LKB1/AMPK/PGC-1α, AMPK/mTOR/ULK1, and AMPK/SIRT1) in a systematic way, and comprehensively promote the catabolism of lipids, inhibit synthesis, enhance autophagy and anti-inflammation, reflecting the scientific connotation of Chinese medicine′s treatment methods such as “dredging the liver and strengthening the spleen” and “activating the blood and resolving turbidities”. In conclusion, Chinese medicine provides important molecular evidence and the basis for the integration of Chinese and Western medicine for the prevention and treatment of NAFLD by targeting AMPK to remodel the homeostasis of liver energy metabolism. In the future, we need to overcome the heterogeneity of the model, deeply analyze the synergistic mechanism of the compound and the interaction of the pathways, and promote the clinical translation.
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基本信息:
DOI：10.13210/j.cnki.jhmu.20250806.003
中图分类号:R259
引用信息:
[1]曹峰铭,胡锋杰,周英.AMPK通路介导中医药改善非酒精性脂肪肝的分子机制及研究进展[J].海南医科大学学报,2026,32(02):148-160.DOI:10.13210/j.cnki.jhmu.20250806.003.
基金信息:
新疆维吾尔自治区自然科学基金项目（2022D01C450）; 天池英才引进计划项目（030106062529）~~
2025-08-26
2025-08-26
2025-08-26