基于“痰湿瘀”理论探讨代谢相关脂肪性肝病铁死亡机制的中医内涵*

作者：柯琼菲1，刘芳芳2，凌家生2，何钺珏1，曾国美1

单位：1.广州中医药大学，广东 广州 510000； 2.广州中医药大学惠州医院/惠州市中医医院，广东 惠州 516000

引用：引用：柯琼菲，刘芳芳，凌家生，何钺珏，曾国美.基于“痰湿瘀”理论探讨代谢相关脂肪性肝病铁死亡机制的中医内涵[J].中医药导报,2025,31(5):183-187,194.

DOI：10.13862/j.cn43-1446/r.2025.05.032

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摘要：

中医学认为“痰湿瘀”是代谢相关脂肪性肝病（MAFLD）的重要病理基础，这一理论与铁死亡在MAFLD中引发的脂质过氧化、胰岛素抵抗及其加速病情进展的机制相契合。通过论述痰湿瘀与铁死亡在生理病理上的紧密关系，同时探讨痰湿瘀、铁死亡与MAFLD的关系，在宏观及微观层面丰富从痰湿瘀角度治疗MAFLD的理论内涵，确立燥湿祛痰、活血化瘀、肝脾同治的治疗原则，为中西医结合治疗MAFLD的理论研究及临床实践提供参考。

关键词：代谢相关脂肪性肝病；铁死亡；痰湿；瘀

Abstract：

Traditional Chinese medicine (TCM) believes that "phlegm-dampness-stasis" is an important pathological basis for metabolic associated fatty liver disease (MAFLD). This theory aligns with the mechanisms of lipid peroxidation, insulin resistance, and disease progression acceleration caused by ferroptosis in MAFLD. By elaborating on the close relationship between phlegm, dampness, stasis and ferroptosis in physiology and pathology, and exploring the connections among phlegm, dampness, stasis, ferroptosis and MAFLD, this paper enriches the theoretical connotation of treating MAFLD from the perspective of phlegm, dampness and stasis at both macroscopic and microscopic levels. It establishes the therapeutic principles of drying dampness, eliminating phlegm, promoting blood circulation to remove stasis, and treating both the liver and the spleen simultaneously, providing beneficial references for the theoretical research and clinical practice of integrated traditional Chinese and Western medicine in the treatment of MAFLD.

Key words：metabolic associated fatty liver disease; ferroptosis; phlegm and dampness; stasis

发布时间：2026-01-03

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