[Novel targets and drugs for the treatment of portal hypertension in liver cirrhosis].

Portal hypertension in liver cirrhosis is a key factor driving decompensation and mortality, and pharmacological therapy has been the cornerstone of treatment. Although traditional medications, mainly non-selective β-receptor blockers, have played an important role in preventing decompensated events such as variceal bleeding, there still exist difficulties such as low response rates and high side effects, which complicate meeting the treatment requirements. In recent years, with the deepening understanding of the disease, drug intervention is shifting from simply reducing portal blood flow direction to strategies that remodel the hepatic microenvironment and target the gut-hepatic axis. This article systematically summarizes novel intervention strategies that target hepatic microenvironment remodeling, such as hepatic sinusoidal endothelial cell dysfunction, procoagulant states, and hepatocyte phenotypic transformation. Simultaneously, it focuses on reviewing the research progress on gut microbiota regulation and targeting portal vein therapy based on the "mid-blood flow" theory.