基于态靶辨治探讨代谢相关脂肪性肝病诊治策略

Strategy of Traditional Chinese Medicine to metabolic associated fatty liver disease based on“state-target strategy”

2020年国际专家共识将非酒精性脂肪性肝病更名为代谢相关性脂肪性肝病,强调该病是多器官代谢紊乱累及肝脏的表现,在临床特征、病理表现和治疗结局等方面存在异质性。仝小林院士创新性提出态靶结合的现代中医辨治思想,总结出“慢病十态”的辨病体系,结合现代中药药理学研究成果的临床回归进行疾病靶的选择和运用。我们结合中西医对代谢相关性脂肪性肝病的认识,提出疾病态势发展规律为“郁壅态—湿热态—瘀虚态”,综合相关文献和临床诊疗经验,初步探讨代谢相关性脂肪性肝病各态势阶段相应的调态方药和主要“靶药”(症靶、标靶),基于仝小林院士的态靶辨治理论探讨代谢相关脂肪性肝病的诊治策略。

In 2020,the international expert consensus changed the name of non-alcoholic fatty liver disease to metabolic-associated fatty liver disease(MAFLD),emphasizing that the disease is a manifestation of multi-organ metabolic disorder involving the liver,with heterogeneity in clinical features,pathological manifestations and treatment outcomes.In combination with the‘state-target strategy’,Prof.TONG Xiao-lin proposed the treatment strategy of‘ten states of chronic diseases’,holding that the general rule of the development of MAFLD is‘constraint and congestion state’,wet and hot state,stasis and deficiency state",and state-modulating formula and symptom-target and indicator-target drugs were given for each compound situation.