基于脾虚痰瘀探讨代谢相关脂肪性肝病的辨治

Differentiation and Treatment of Metabolic Associated Fatty Liver Disease Based on Spleen Deficiency and Phlegm Stasis

“脾主运化”是脾的重要生理功能之一,脾运功能正常则水谷精微得以布散、濡养全身,水液得以正常输布。代谢相关脂肪性肝病患者因过食肥甘厚腻、情志不畅等原因致脾失健运,痰瘀内阻,脂代谢失常,促进肝脂肪变性,食肥则胆碱等物质生成增多,过食则致肠道菌群失调,导致代谢相关脂肪性肝病的发生发展。脾虚痰瘀是代谢相关脂肪性肝病的核心病机,健脾化瘀活血法可通过调节肠道微生态以及TMAO代谢治疗该病,中医药治疗的整体观亦从中得到体现。

"Spleen governing transportation and transformation"is one of the important physiological functions of Spleen.With the normal function of the spleen transportation,the essence of grain and water can be dispersed and nourished throughout the body,and the body fluid can be distributed normally.Patients with metabolic associated fatty liver disease(MAFLD)suffer from Spleen transport dysfunction,the internal resistance of phlegm and Stasis,abnormal lipid metabolism,and promotion of liver steatosis due to overeating sweet,fat,and greasy food and emotional disturbance and other reasons.Eating fat increases the production of choline and other substances,while overeating leads to the occurrence and development of MAFLD.Spleen deficiency and phlegm Blood stasis is the core pathogenesis of MAFLD.The method of strengthening the Spleen and removing Blood stasis and promoting Blood circulation can treat the disease by regulating the intestinal microecology and TMAO metabolism.The overall view of traditional Chinese medicine treatment is also reflected in it.