A review of non-alcoholic fatty liver disease with a special focus on evidence-based Unani therapeutic approaches: a scoping review

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a chronic metabolic liver disorder affecting nearly one-quarter of the global population. It is closely associated with obesity, type 2 diabetes mellitus, dyslipidaemia, and other components of metabolic syndrome, and may progress to non-alcoholic steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. Despite its increasing prevalence, effective pharmacological options remain limited, and sustained lifestyle modification continues to be the cornerstone of management. In Unani medicine, conditions resembling NAFLD are described under Sū’-i-Mizāj Kabid Bārid and Waram al-Kabid Balghamī. A scoping review methodology was employed to map the breadth of available evidence on NAFLD from both conventional and Unani medical perspectives. Electronic databases PubMed, ScienceDirect, DOAJ, Google Scholar, and the AYUSH Research Portal were searched using predefined Boolean search strings. Classical Unani texts were examined manually. Unani literature describes therapeutic approaches centred on ʿ Ilāj bi’l-Ghidhā (diet therapy), ʿIlāj bi’l-Tadbīr (regimenal therapy), and ʿIlāj bi’l-Dawā (pharmacotherapy). Several single and compound formulations possessing hepatoprotective, antioxidant, hypolipidaemic, anti-inflammatory, and hypoglycaemic properties have shown potential benefits in preclinical and clinical studies. Available evidence suggests that Unani interventions may offer therapeutic benefit in NAFLD; however, well-designed clinical trials are required to establish their safety and efficacy.