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Qianggan is a traditional Chinese medicine (TCM) prescription composed of 16 herbs and is widely used in China for the treatment of chronic liver diseases, particularly nonalcoholic steatohepatitis (NASH) and metabolic dysfunction-associated fatty liver disease (MAFLD)[1][2][3][6]. The formula has demonstrated efficacy in preclinical models by improving hepatic steatosis, reducing inflammation, and modulating immune responses. Mechanistically, Qianggan acts through multiple pathways including modulation of lncRNA/circRNA immune ceRNA networks that regulate immune-related genes such as Cd28 and Il15[1], enhancement of natural killer (NK) cell activity with subsequent reduction in hepatocyte inflammation[6], improvement of glycometabolism pathways[3], and overall amelioration of liver injury markers. While its precise molecular targets are not fully elucidated due to its multi-component nature, it exerts immunomodulatory effects relevant to the pathogenesis of NASH/MAFLD.
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