基于铁死亡探讨“健脾疏肝”法治疗代谢相关脂肪性肝病的新思路  

Exploration of New Idea of“Fortifying Spleen and Soothing Liver”Method for the Treatment of Metabolic Dysfunction Associated Fatty Liver Disease Based on Ferroptosis

作　　者：张欢 赵玉清 马丽娜•阿新拜 胡雨薇 张立平[1,2] ZHANG Huan;ZHAO Yuqing;Malina Axinbai;HU Yuwei;ZHANG Liping(Department of Gastroenterology,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学东方医院消化科,北京100078 [2]北京中医药大学,北京100029

出　　处：《中医药学报》2024年第1期58-63,共6页Acta Chinese Medicine and Pharmacology

基　　金：北京市自然科学基金项目(7212181);北京中医药大学重点攻关项目(2020-JYB-ZDGG-138)。

摘　　要：代谢相关脂肪性肝病(MAFLD)已经成为我国慢性肝病的主要原因,预计未来十年内可能逐渐成为终末期肝病、肝移植和原发性肝癌主要的致病因素之一。近年来多项研究已证实铁死亡在肝脏及代谢性疾病发生发展中的重要作用,中医药靶向铁死亡改善MAFLD的相关研究已逐步开展,以铁死亡为切入点探究中医药改善MAFLD的作用机制有望成为新的治疗契机。“健脾疏肝法”在MAFLD的临床及基础研究中被证实可以改善脂代谢紊乱、减轻肝脏脂质沉积,但作用机制尚未完全阐明。本文对铁死亡的途径进行总结,探讨铁死亡与肝脾理论的关联性以及中医药干预MAFLD的作用,以期进一步认识铁死亡的作用机制,理解健脾疏肝法的科学内涵,为MAFLD的中医药防治寻找新的研究思路。Metabolic dysfunction associated fatty liver disease(MAFLD)has become a major cause of chronic liver disease in China and is expected to become a major causative factor for end-stage liver disease,liver transplantation,and primary liver cancer in the next decade.In recent years,multiple studies have confirmed the important role of ferroptosis in the occurrence and development of liver and metabolic diseases.Research on traditional Chinese medicine(TCM)targeting ferroptosis to improve MAFLD has gradually been carried out.Exploring the mechanism of action of TCM to improve MAFLD from ferroptosis promises to be a new therapeutic opportunity.In clinical and basic research on MAFLD,the method of"fortifying spleen and soothing liver"has been shown to improve lipid metabolism disorders and reduce lipid deposition in the liver.However,the mechanism has not been fully elucidated.This paper summarizes the pathways of ferroptosis and explores the association between ferroptosis and the liver and spleen theory as well as the role of TCM intervention.The aim is to further understand the mechanism of ferroptosis,to understand the scientific connotation of the method of“fortifying spleen and soothing liver”,and to find new research ideas for the prevention and treatment of MAFLD in TCM.

关 键 词：代谢相关性脂肪肝 铁死亡 健脾疏肝法 中医药 

分 类 号：R256.4[医药卫生—中医内科学]