Narrative review of bile-based traditional Chinese medicines for liver diseases

Photo by Toxic Smoker / Unsplash

Frontiers in Medicine Published April 24, 2026 Medically reviewed April 24, 2026 DOI ↗ By Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

Key Takeaway

Note that this narrative review lacks reported safety data and specific population details for bile-based TCM in liver disease.

This source is a narrative review focusing on the use of bile-based traditional Chinese medicines for the treatment of liver diseases. The authors provide a qualitative synthesis of the current literature surrounding these agents within this therapeutic context. No specific sample sizes, intervention details, or primary outcomes were reported in the provided text, limiting the ability to quantify effects.

The review addresses the topic of liver diseases without detailing specific comparators or adverse event rates. The authors acknowledge that key details such as population characteristics and follow-up durations were not reported. This absence of granular data prevents a robust assessment of the intervention's performance or tolerability.

Limitations of the review include the lack of reported safety data and the absence of specific study populations. The narrative format does not provide pooled effect sizes or confidence intervals. Practice relevance is constrained by these gaps, as clinicians cannot rely on the review for definitive guidance on dosing or risk management.

Overall, the review offers a qualitative overview but lacks the quantitative rigor of a systematic review or meta-analysis. The certainty of any conclusions is low due to the missing numerical data and the non-randomized nature of the evidence synthesis. Clinicians should interpret these findings with caution given the incomplete reporting of outcomes and safety signals.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedApr 2026

View Original Abstract ↓

Bile-based traditional Chinese medicines comprise a special category of medicinal materials that have distinct value in the treatment of liver diseases. Bile acids are the primary active components of bile-based TCMs. These components exert significant therapeutic effects by targeting key signaling pathways related to disease progression through bile acid receptors such as FXR and TGR5. Herein, we comprehensively review the chemical composition, pharmacological effects, and clinical applications of bile-based TCMs with a particular focus on their potential and recent research progress in the treatment of liver diseases. The bile acid components of bile-based TCMs have dual “Yin and Yang” effects in the treatment of liver diseases. They show therapeutic actions such as anti-inflammation, hepatoprotection and anti-fibrosis, and they may also promote disease through certain constituents like TCA and GCA. This dual nature creates a complex balance between benefit and risk. It highlights the mechanistic complexity of bile-based TCMs in treating liver diseases and presents new challenges for their precise clinical application. Future research needs to thoroughly analyze the composition and efficacy of bile-based TCMs, clarify their mechanisms of action and pharmacological effects, and explore component modification and combination therapies. This will provide a scientific basis and innovative ideas for precise application of bile-based TCMs and development of new, more effective and safer treatment options for patients with liver diseases.