基于“肝病实脾”理论探讨代谢相关脂肪性肝病继发2型糖尿病的生物学内涵
Exploring the Biological Connotation of Treating T2DM Secondary to MASLD Based on the Theory of “Treating Liver Disease by Nourishing Spleen”
DOI: 10.12677/tcm.2025.147477, PDF,    科研立项经费支持
作者: 刘祎凡, 贾佳龙：成都中医药大学临床医学院，四川 成都；刘 桠*：成都中医药大学附属医院内分泌科，四川 成都
关键词: 代谢相关脂肪性肝病；2型糖尿病；肝病实脾；治未病；Metabolic Dysfunction-Associated Steatotic Liver Disease； Type 2 Diabetes Mellitus； Treating Liver Disease by Nourishing Spleen； Preventive Treatment of Diseases
摘要: 全球代谢相关脂肪性肝病(MASLD)的患病率逐年增高，且与2型糖尿病(T2DM)发病关系密切。流行病学证据表明，MASLD患者发生T2DM的风险是健康人的2倍以上，MASLD是T2DM的驱动因素，可作为T2DM的“预警窗口期”。本文基于“见肝之病，知肝传脾，当先实脾”理论，结合现代医学研究进展，从肝胰循环、肝与线粒体氧化应激、肝与肠道菌群和肝与胆汁酸代谢四个层面，论述MASLD继发T2DM的病机及发病机制，从“脾”论治以发挥中医“治未病”的优势，对MASLD的治疗及T2DM的预防具有重要意义。
Abstract: The global prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing year by year, and it is closely related to the onset of type 2 diabetes mellitus (T2DM). Epidemiological evidence shows that the risk of T2DM in patients with MASLD is more than 2 times that of healthy people, and that MASLD is a driver of T2DM and serves as an “early warning window” for T2DM. Based on the theory of “Knowing the liver disease will be transmitted to the spleen, strengthening the spleen”, combined with the progress of modern medical research, this paper discusses the pathogenesis of T2DM secondary to MASLD from four aspects: liver-pancreas circulation, oxidative stress between liver and mitochondria, liver and intestinal flora, and liver and bile acid metabolism, so as to give full play to the advantages of TCM in “preventive treatment of diseases” from the perspective of the “spleen”. It is of great significance for the treatment of MASLD and the prevention of T2DM.
文章引用：刘祎凡, 贾佳龙, 刘桠. 基于“肝病实脾”理论探讨代谢相关脂肪性肝病继发2型糖尿病的生物学内涵[J]. 中医学, 2025, 14(7): 3225-3232. https://doi.org/10.12677/tcm.2025.147477

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