Gastroenterology School-Interuniversity Research Centre on Foods, Nutrition and Gastrointestinal Tract (CIRANAD), 2nd University of Naples, 80131 Naples, Italy.
World J Gastroenterol. 2011 May 14;17(18):2288-301. doi: 10.3748/wjg.v17.i18.2288.
Herbal products are increasingly used, mainly in chronic liver disease. Extracts of milk thistle, Silymarin and silybin, are the most prescribed natural compounds, with different indications, but with no definitive results in terms of clinical efficacy. This review analyzes the available studies on the effects of the purified product silybin, both as a free and a conjugated molecule, on liver cells or on experimentally induced liver damage, and in patients with liver disease. We searched PUBMED for articles pertaining to the in vitro and in vivo effects of silybin, its antifibrotic, anti-inflammatory, and antioxidant properties, as well as its metabolic effects, combined with the authors' own knowledge of the literature. Results indicate that the bioavailability of silybin phytosome is higher than that of silymarin and is less influenced by liver damage; silybin does not show significant interactions with other drugs and at doses < 10 g/d has no significant side effects. Experimental studies have clearly demonstrated the antifibrotic, antioxidant and metabolic effects of silybin; previous human studies were insufficient for confirming the clinical efficacy in chronic liver disease, while ongoing clinical trials are promising. On the basis of literature data, silybin seems a promising drug for chronic liver disease.
草药产品的应用日益广泛，主要用于慢性肝病。水飞蓟素、水飞蓟宾和奶蓟草提取物是最常被开的天然化合物，具有不同的适应证，但在临床疗效方面尚无明确结果。本文分析了关于纯化的水飞蓟宾（游离和结合形式）对肝细胞或实验性肝损伤的影响，以及对肝病患者的影响的现有研究。我们在 PUBMED 上搜索了有关水飞蓟宾的体外和体内作用、其抗纤维化、抗炎和抗氧化特性以及代谢作用的文章，并结合了作者对文献的了解。结果表明，水飞蓟宾植物提取物的生物利用度高于水飞蓟素，且受肝损伤的影响较小；水飞蓟宾与其他药物无明显相互作用，且在<10 g/d 的剂量下无明显副作用。实验研究清楚地表明了水飞蓟宾的抗纤维化、抗氧化和代谢作用；以前的人体研究不足以证实其在慢性肝病中的临床疗效，而正在进行的临床试验则有很大的希望。基于文献数据，水飞蓟宾似乎是一种有前途的治疗慢性肝病的药物。
