基于“升清降浊”理论探索代谢相关脂肪性肝病的辨证策略

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【关键词】代谢相关脂肪性肝病；清浊理论；升清降浊；气机

【中图分类号】R259 【文献标志码】A 【文章编号】1007－8517（2025）21-0005-05

DOI：10. 3969/j. issn. 1007 -8517. 2025.21. zgmzmjyyzz202521002

Abstract：Metabolicasociatedfattliverdiseasehasbecomethemaincauseofchronic liverdiseaseglobally.Thediseaselocates intheliver，wherestoresblodandperformsdispersingandrelieving.Thefunctionshouldbeinharmonyandcreatingadynamic balance.MAFLDdisrupts thisbalane，leading toabnormaldrainageandimpaireddigestion，causingthesplen tofailtoproperly processfoodndelivertofailtoreceivenourishment，furtheraeleratingtheprogessonofthediseaseandformngavicousccle. ThisarticleexploresthetheoreticalbasisandclinicalapplicationofteQing-ZuteoryireatingMAFLDbasedonteoigiand connotation of the Qing - Zhu theory. By analyzing the pathogenesis of MAFLD from the perspective of the Qing Zhu theory，it is believedthathefundamentalpathogenesislesinthedsfunctionofliverchannelsndthelossoftsdspersingandrelievngfuction， aswellastheimpairmentofthespleen’sfunctionandqideficiency.ByanalyzingthetreatmentofMAFLDfromtheperspectiveofthe Qing Π-Π Zhutheory，itisbelievedthatthemainapproachisto“strengthenqi，regulatethesplen，andunblockliverchannels，remove dampnessandtoxins，anddisslvebloodstasis.”Thisapproachaims toasistthespleenandlivercancoordinatingandrestoringthe physiological functions of the internal organs，providing a new perspective for clinical treatment of MAFLD.

KeyWords：Metabolic AssociatedFatyLiver Disease；The Qing-Zhu Theory；Rising Qiand Lowering Turbidity；Qi Movement

代谢相关脂肪性肝病（metabolicassociated fat-tyliverdisease，MAFLD）是指与全身代谢功能障碍相关的肝脂肪变性疾病，目前关于MAFLD的发病机制不明确，多数学者比较认可的是“多重打击”学说，认为是在高脂饮食、肥胖、胰岛素抵抗的第一重打击下，慢性炎症、氧化应激反应、肠道菌群改变及遗传易感因素等共同作用下，主要由于代谢和炎症应激（主要是脂肪组织功能障碍和胰岛素抵抗的结果）和脂肪性肝病的防御和修复机制之间的不平衡造成MAFLD的发生发展[1]。（剩余9410字）