基于中医理论谈代谢相关脂肪性肝病饮食处方制定

A brief analysis of the formulation of dietary prescriptions for metabolic-related fatty liver disease based on the theory of traditional Chinese medicine

非酒精性脂肪性肝病更名为代谢相关脂肪性肝病(MAFLD),超重/肥胖成为诊断条件之一,临床中肥胖症与脂肪肝的关系密切。对于脂肪肝的防治措施,指南推荐均将改变不良生活行为习惯、保持健康体重(减重)放在基础治疗的首要因素。根据患者个体情况制定科学、健康的饮食处方是保持健康体重、平衡人体营养、加快MAFLD康复的重要临床干预措施。中医药拥有基于生活实践和临床经验的理论思想,如辨证论治、体质理论、药物、食物性味属性、天人合一等观念。现代膳食营养处方的制定大多没有考虑患者不同个体体质的差异性和食物的药食偏性、中医食疗功效。本文拟从中医体质辨识理论、药食同源、时间医学等中医理论思想谈超重和肥胖相关的MAFLD患者的饮食处方制定思路,为临床营养干预和指导提供新的思路。

Non-alcoholic fatty liver disease was renamed as metabolic-associated fatty liver disease(MAFLD).Overweight/obesity has become one of the diagnostic conditions.Obesity is closely related to fatty liver in clinical practice.For the prevention and treatment of fatty liver,the guidelines recommend that changing bad life habits and maintaining a healthy weight(weight loss)are the primary factors in basic treatment.Formulating scientific and healthy dietary prescriptions according to the individual conditions of patients is an important clinical intervention to maintain a healthy weight,balance human nutrition,and accelerate the recovery of metabolic-related fatty liver disease.Traditional Chinese medicine has some theoretical ideas based on life practice and clinical experiences,such as syndrome differentiation and treatment,physique theory,homology of medicine and food,and the concept of harmony between man and nature.Most of the formulation of modern dietary nutrition prescriptions does not take into account the differences in the physiques of different individuals in the patient population,the medicinal and edible properties of the food,and the therapeutic effects of traditional Chinese medicine.This article intends to discuss the dietary prescription formulation ideas for the overweight and obesity-related MAFLD population from the traditional Chinese medicine physique identification theory,the homology of medicine and food,and time medicine,so as to provide new ideas for clinical nutrition intervention and guidance.