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Huazhiruogan is a Traditional Chinese Medicine (TCM) formula developed by Longhua Hospital, affiliated with the Shanghai University of Traditional Chinese Medicine, for the treatment of nonalcoholic fatty liver disease (NAFLD), now commonly referred to as metabolic dysfunction-associated steatotic liver disease (MASLD). The formula is designed based on the TCM principles of resolving phlegm, removing blood stasis, and softening the liver to restore metabolic balance. It is composed of several botanical ingredients, including *Crataegus pinnatifida* (Hawthorn), *Alisma plantago-aquatica* (Water Plantain), *Salvia miltiorrhiza* (Danshen), and *Cassia obtusifolia*. Pharmacological studies indicate that Huazhiruogan exerts its therapeutic effects by regulating lipid metabolism pathways, specifically through the activation of PPAR-alpha and PPAR-gamma and the downregulation of SREBP-1c, which collectively reduce hepatic steatosis and inflammation. The drug has advanced to Phase 3 clinical trials in China, demonstrating significant efficacy in reducing intrahepatic fat content and improving liver enzyme profiles.
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