Traditional Chinese medicine, liver fibrosis, intestinal flora: is there any connection?—a narrative review

This paper aims to analyze how intestinal flora regulates liver fibrosis pathogenesis and to evaluate the regulatory effect of traditional Chinese medicine (TCM) on the intestinal flora, providing new insights into liver fibrosis treatment. Destruction of the intestinal microbiome can lead to liver fibrosis development, accelerating the intestinal microbiome's disruption. TCM can effectively regulate the intestinal flora, helping prevent and treat liver fibrosis. This review discusses the mechanisms behind intestinal flora changes in liver fibrosis and how TCM can regulate these changes. We searched PubMed, the Wanfang database, and CNKI for "liver fibrosis", "intestinal microflora", and "intestinal microbiota" and reviewed the retrieved literature. We detail the prevention and treatment options for liver fibrosis though the use of TCM in regulating intestinal flora. We also highlight the influence of the intestinal flora on liver fibrosis and present the research regarding the prevention and treatment of liver fibrosis using TCM. We also describe the effects of TCM on the intestinal flora. TCM can effectively regulate the intestinal flora to prevent and treat liver fibrosis through the liver-intestine axis.