二十五味松石丸（Ershiwuwei Songshi Pills，ESP）为藏医治疗肝胆疾病的常用经典方剂，具有清热解毒、疏肝利胆及化瘀等功效。通过梳理传统藏医药本草典籍及现代论著，系统考证了ESP的处方来源及历史变迁，初步探讨并核实组成药味的基原。现代研究表明ESP具有抗肝损伤、抗肝纤维化、改善非酒精性脂肪肝、抑菌及抗内毒素血症等作用。在现代临床应用中，ESP广泛用于治疗病毒性肝炎、脂肪肝、慢性胆囊炎及肝硬化等肝胆系统疾病。通过考证ESP的处方演变，归纳其药理作用和临床功效，为该成方制剂的临床合理应用和二次开发提供参考依据。

Ershiwuwei Songshi Pills (二十五味松石丸, ESP) is a classical formula commonly used in Tibetan medicine for treating hepatobiliary diseases. It possesses the effects of clearing heat and removing toxin, soothing liver and promoting bile secretion and resolving stasis. By reviewing ancient Tibetan medicinal books and modern publications, systematically verified the provenance and historical evolution of composition of the ESP, and preliminarily explored and confirmed the origins of the medicinal materials. Modern pharmacological studies indicated that the ESP has functions of anti-liver injury, anti-liver fibrosis, anti-non-alcoholic fatty liver, anti-bacteria and anti-endotoxemia, etc. Contemporary clinical studies revealed that the ESP is widely used in the treatment of hepatobiliary diseases, including viral hepatitis, fatty liver, chronic cholecystitis and cirrhosis. In this paper, the historical evolution, biological activities and clinical uses of ESP were summarized, which can provide a reference for the clinical rational application and further development of this classical formula.

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国家自然科学基金资助项目（82004069）;西南民族大学中央高校基本科研业务费专项（ZYN2024035）