基于“见肝实脾”理论探讨代谢相关脂肪性肝病的防治  

Prevention and treatment of metabolism associated fatty liver disease based on the theory of“treating Liver by nourishing spleen”

作　　者：杨志婷 吕冠华[1] 范颖[2] YANG Zhiting

机构地区：[1]辽宁中医药大学附属第二医院,辽宁沈阳1100321 [2]辽宁中医药大学,辽宁沈阳110847

出　　处：《中医临床研究》2025年第2期60-64,共5页Clinical Journal Of Chinese Medicine

基　　金：辽宁省中医药管理局辽宁省名中医传承工作室建设项目(辽中医药发[2022]1号)。

摘　　要：代谢相关脂肪性肝病(Metabolic Associated Fatty Liver Disease,MAFLD)是遗传易感个体由于营养过剩和胰岛素抵抗引起的慢性代谢应激性肝病,以肝细胞脂质沉积为特征。此病已成为威胁人类健康最常见的肝脏疾病之一。MAFLD发病机制复杂且尚未有明确的治疗药物,目前西医通过干预饮食,减轻体质量,联合使用降血脂、血糖、血压药物进行治疗。中医认为本病以脾虚运化失常为本,痰饮、湿热、瘀血蕴结肝体为标。临床中多采用疏肝健脾、祛湿化浊、清热活血散瘀之法,亦或配合针刺来改善症状,保肝降酶。本研究从中西医结合的角度出发,基于“见肝实脾”理论,通过经络联系及脏腑的生理功能来探讨MAFLD的防治;通过探讨肠道菌群、代谢综合征和免疫功能障碍与本病的联系,来明确中医治疗手段的可行性与有效性,更好地把握其病因、病机和症状。Metabolic associated fatty liver disease(MAFLD)is a chronic metabolic stress liver disease caused by overnutrition and insulin resistance in genetically susceptible individuals,characterized by lipid deposition in liver cells.It has become one of the most common liver diseases that threaten human health.Its pathogenesis is complex and there is no clear treatment medicines.At present,Western medicine treats it through intervention diet,weight reduction,combined use of drugs to reduce blood lipids,blood sugar and blood pressure.Traditional Chinese medicine believes that spleen deficiency and abnormal transportation and transformation are the causes of the disease,while phlegm,damp heat and blood stasis in the liver are the symptoms of the disease.In clinical practice,traditional Chinese medicine mostly adopts the methods of soothing the liver and strengthening the spleen,removing dampness and turbidity,clearing heat,activating blood circulation and dispersing blood stasis,or combined with acupuncture to improve symptoms,protect the liver and reduce enzymes.From the perspective of integrated traditional Chinese and Western medicine,based on the theory of“Treating liver by nourishing spleen”,this paper discusses the prevention and treatment of metabolism associated fatty liver disease through the connection of meridians and collaterals and the physiological function of Zang Fu(脏腑).This paper discusses the relationship between intestinal flora,metabolic syndrome and immune dysfunction and the disease,so as to clarify the feasibility and effectiveness of traditional Chinese medicine treatment,and better grasp its etiology,pathogenesis and symptoms.

关 键 词：治未病 代谢相关脂肪性肝病 肠道菌群 代谢综合征 免疫功能障碍 

分 类 号：R575.5[医药卫生—消化系统]