2型糖尿病（type 2 diabetes mellitus，T2DM）是一种常见的临床慢性病，近年来肝损伤在T2DM的发生发展中备受关注。持续性高血糖可导致肝细胞氧化应激和炎症反应，引起脂质代谢紊乱与胰岛素抵抗。肝脏受损无法有效调控血糖和脂质代谢会进一步加剧全身代谢紊乱。此外，肝细胞功能障碍影响胰岛素降解导致胰岛素抵抗进一步恶化，加速T2DM的进展。中医药凭借其多靶点、多环节的作用机制，不仅能改善肝损伤，还可调节糖脂代谢紊乱、调控炎症和氧化应激反应等，在防治T2DM肝损伤中展现出独特优势，使其成为防治糖尿病性肝损伤的重要手段。通过对中医药在改善T2DM肝损伤中的机制进行综述，为提升中医药在T2DM并发肝损伤治疗中的应用价值，为临床提供更有效的诊疗策略。

Type 2 diabetes mellitus (T2DM) is a common chronic clinical disease, and liver injury plays a significant role in its development and progression. Persistent hyperglycemia can lead to hepatocellular oxidative stress and inflammatory responses, causing lipid metabolism disorders and insulin resistance. Liver damage impairs the effective regulation of blood glucose and lipid metabolism, further exacerbating systemic metabolic disorders. Additionally, hepatocellular dysfunction affects insulin degradation, leading to worsening insulin resistance and promoting the progression of T2DM. Traditional Chinese medicine (TCM) has demonstrated unique advantages in preventing and treating T2DM-related liver injury through its multi-target and multi-pathway mechanisms. TCM not only improves liver injury but also regulates glucose and lipid metabolism disorders, modulates inflammation and oxidative stress responses, making it an important approach in treating diabetic liver injury. By reviewing the mechanisms of TCM in improving T2DM-related liver injury, this study aims to enhance the application value of TCM in treating T2DM-complicated liver injury and provide more effective diagnostic and therapeutic strategies for patients.

R285

国家自然科学基金面上项目（82074391）；浙江中医药大学科研基金人才专项（2021ZR04）