从“六郁”论代谢相关脂肪性肝病的理论与临床实践

Theoretical and clinical practice of metabolic associated fatty liver disease based on the theory of“six stagnation diseases”

代谢相关脂肪性肝病已成为全球第一大肝病,包括单纯性脂肪变性,脂肪性肝炎,纤维化/肝硬化与肝癌,常与代谢综合征相关。其病理复杂,国内尚无新药上市。既往中医认识或从食,或从痰湿,或从湿热,或从肝郁脾虚等论治,但细致分析其疾病的病理过程与中医“六郁”理论相吻合。本文简要介绍了六郁致病理论的源流、导致脂肪肝的“六郁”病变特点,辨治要点与临床实践等,以期通过对代谢相关脂肪肝中医病机的深入认识,促进临床治疗进展。

Metabolic associated fatty liver disease(MAFLD)has become the most common liver disease in the world,including simple hepatic steatosis,steatohepatitis,liver fibrosis/cirrhosis,and liver cancer,and it is often associated with metabolic syndrome.MAFLD has complex pathological manifestations,and there are still no new drugs on the market in China.In the past,traditional Chinese medicine often treated this disease from the perspective of food,phlegm-dampness,damp-heat,or liver depression and spleen deficiency,but a detailed analysis showed that the pathological process of the disease was consistent with the theory of“six stagnation diseases”in traditional Chinese medicine.This article briefly introduces the origin of the pathogenic theory of“six stagnation diseases”,the pathological features of the“six stagnation diseases”leading to fatty liver disease,the key points of syndrome differentiation and treatment,and clinical practice,so as to promote clinical treatment through an in-depth understanding of the traditional Chinese medicine pathogenesis of MAFLD.