Traditional Chinese medicine for non-alcoholic fatty liver disease: an overview of systematic reviews with evidence mapping and metabolic outcome assessment

作者：Juanjuan Li, Ruimin Jiao, Wenquan Su, Wei Chen, Xiangyu Hu, Shuai Xu, Lie Xu, Weiwei Yao, Kejia Liu, Hong You, Jingjie Zhao · 发表于：Frontiers in Pharmacology · 年份：2025 · DOI：10.3389/fphar.2025.1675793 · 被引用次数：4 · 研究领域：Liver Disease Diagnosis and Treatment、Traditional Chinese Medicine Studies、Metabolomics and Mass Spectrometry Studies

The paradigm shift from non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated fatty liver disease (MAFLD) emphasizes metabolic pathogenesis, yet the efficacy of Traditional Chinese Medicine (TCM) under this framework remains unevaluated. Prior reviews focused on NAFLD with outdated data (<2020), lacking clinical translation tools and methodological standards for TCM systematic reviews and meta-analyses (SRs/MAs). This overview integrates NAFLD criteria, visualizes TCM efficacy via evidence mapping, proposes a methodological framework to standardize TCM SRs/MAs, and focuses on evaluating metabolism-related indicators. Nine databases were searched (from database inception to December 30, 2024) for TCM SRs/MAs in NAFLD. Methodological quality was assessed via AMSTAR-2, PRISMA/PRISMA-CHM, and GRADE. Evidence mapping visualized outcomes (liver enzymes, metabolism) to identify clinical priorities. Standardized reporting guidelines for TCM preparations were adhered to, and a ConPhYMP tool assessment evaluated botanical drugs composition and processing disclosure. Thirty-seven SRs/MAs (35 low/critically low quality) reported trends of reduced ALT (-8.2 U/L, 95% CI: -10.1 to -6.3), improved metabolic parameters (e.g., TG: -0.5 mmol/L), and enhanced B-ultrasound resolution (RR: 1.62), though these findings are limited by methodological flaws and low-quality evidence. Evidence mapping highlighted Xiaoyao Powder and Danning Tablet as top-performing formulas. A met...