Advances in traditional Chinese medicine for liver disease therapy in 2020

Liver diseases are gradually becoming a serious threat to human health worldwide. Although a number of medications have been introduced for the prophylaxis, diagnosis, and treatment of liver diseases, several limitations and challenges remain. Traditional Chinese medicine is frequently used to treat liver diseases and well known to protect hepatocytes and inhibit inflammation, oxidative stress, and fibrosis. However, given the complex composition of traditional Chinese medicine, clarifying the mechanisms behind its curative and protective effects is difficult. In this review, research progress on traditional Chinese medicine for the treatment of liver diseases in 2020 is summarized on the basis of the literature available in the PubMed database. Herbal extracts derived from traditional Chinese medicine, including flavonoids, polysaccharides, saponins, and alkaloids, and Chinese medicinal formulas, such as the classic decoctions Chaihu Shugan powder, Linggui Zhugan decoction, and Huanglian Jiedu decoction, have shown promising therapeutic efficacy in liver disease treatment. We summarized the findings of several studies on the active ingredients of traditional Chinese herbs used for liver disease treatment in 2020, focusing mainly on their ability to confer antiviral effects to treat hepatitis, regulate antioxidant levels and apoptosis to treat liver injury, inhibit inflammation and improve dysfunctions in amino acids and energy metabolism to treat alcoholic liver disease, reduce hepatic lipid deposition to treat nonalcoholic fatty liver disease, promote activated hepatic stellate cells to treat liver fibrosis, inhibit the proliferation or promote the apoptosis of liver cancer cells to treat hepatocellular carcinoma, and improve bile acid metabolism to treat cholestasis.