肥胖症与脂肪性肝病协同诊疗模式的思考与探索

Consideration and exploration of collaborative diagnosis and treatment model of obesity and steatotic liver disease

脂肪性肝病的两次更名均强调了代谢功能障碍在疾病发展中的潜在驱动作用,反映了脂肪性肝病的高度异质性。在“态靶理论”与“膏浊理论”指导下,该研究认为肥胖是脂肪性肝病发病及病程发展的关键因素,从肥胖症与脂肪性肝病的共病现状、共病机制、共治趋势等方面出发,进行肥胖症与脂肪性肝病共同防治的探讨。以减轻体重为中心,通过中药内服与中医外治结合、中医综合治疗与外科代谢手术结合、院内诊治与院外生活方式管理结合的系统性干预策略,实现脂肪性肝病与肥胖症的共同防治、共同管理,将脂肪性肝病及其并发症的防控关口前移,以此提高临床诊疗效果。

The redefinition of steatotic liver disease highlights the potential driving role of metabolic dysfunction in disease development,reflecting the high heterogeneity of steatotic liver disease.Under the guidance of"state target theory"and"paste turbid"theory,obesity was deemed to a key factor in the onset and progression of steatotic liver disease in this study.This study discussed the co-prevention and treatment of steatotic liver disease and obesity from the aspects of the present situation,mechanism and co-treatment trend of steatotic liver disease and obesity.With weight management as the center,through systematic intervention strategies which is combination of oral administration and external treatment of traditional Chinese medicine,integration of traditional Chinese medicine syndrome differentiation treatment and metabolic surgery,and unity of in-hospital diagnosis and out-of-hospital lifestyle management,to achieve"co-management of steatotic liver disease and obesity",improve clinical diagnosis and treatment effects,and move the prevention and control of steatotic liver disease and its complications forward.