Investigating the mechanism of Jiawei Xiaoyao San in treating metabolic associated fatty liver disease (MAFLD) based on the ileal microbiota-bile acid-FXR axis

Metabolic Associated Fatty Liver Disease (MAFLD) has become a main cause of chronic liver disease globally, necessitating the development of preventive and early therapeutic strategies. Traditional Chinese Medicine (TCM) plays a significant role in human metabolism, and Jiawei Xiaoyao San (JWXYS) has demonstrated notable ameliorative effects on liver stagnation and spleen deficiency-type liver disease. However, its potential mechanisms are still unclear. This study aimed to explore the therapeutic mechanism of JWXYS in treating chronic liver disease by establishing a rat model induced by a high-fat diet. The results revealed that JWXYS could reduce serum levels of total cholesterol (TC) triglycerides (TG) and aspartate aminotransferase (AST) in model rats, significantly improve the structure of liver lobule, reduce lipid deposition in hepatocytes, and reduce the abundance of harmful intestinal flora (such as Staphylococcus and Enterococcus). In addition, JWXYS improved gut microbiota imbalance, regulated bile acid and lipid metabolism, and maintained the overall health of rats. These findings provide a theoretical basis for using JWXYS to treat chronic fatty liver disease.