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1.上海中医药大学附属龙华医院,上海市徐汇区宛平南路725号,200032
2.上海中医药大学脾胃病研究所
3.首都医科大学附属北京地坛医院
4.中国中医科学院西苑医院脾胃病研究所
Received:03 December 2025,
Revised:2025-12-25,
Published:17 February 2026
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戴亮,季光,王宪波等.代谢相关脂肪性肝病的中医诊疗研究现状及展望[J].中医杂志,2026,67(04):386-391.
DAI Liang,JI Guang,WANG Xianbo,et al.Research Advances of Traditional Chinese Medicine Diagnosis and Treatment of Metabolic Dysfunction-Associated Steatotic Liver Disease:Overview and Prospects[J].Journal of Traditional Chinese Medicine,2026,67(04):386-391.
戴亮,季光,王宪波等.代谢相关脂肪性肝病的中医诊疗研究现状及展望[J].中医杂志,2026,67(04):386-391. DOI: 10.13288/j.11-2166/r.2026.04.008.
DAI Liang,JI Guang,WANG Xianbo,et al.Research Advances of Traditional Chinese Medicine Diagnosis and Treatment of Metabolic Dysfunction-Associated Steatotic Liver Disease:Overview and Prospects[J].Journal of Traditional Chinese Medicine,2026,67(04):386-391. DOI: 10.13288/j.11-2166/r.2026.04.008.
代谢相关脂肪性肝病(MASLD)病机以脾虚为本,与痰浊、湿热、血瘀密切相关,临床以肝郁脾虚、湿浊内停为主要证型。研究表明,MASLD不同证型与肠道菌群、代谢物谱等生物学指标存在内在联系。在治疗上,经典名方、现代验方及中药新药可调节糖脂代谢,改善胰岛素抵抗和代谢性炎症,作用机制呈现多靶点特征,针刺等外治法亦具辅助价值。然而,当前研究仍存在临床证据质量有待提高、机制阐释系统性不足等局限。未来需开展以肝脏组织学等硬终点为目标的高质量临床试验,并运用多组学等现代技术深入阐释中医药作用机制,以推动中医药成为MASLD的一线治疗方案。
The pathogenesis of metabolic dysfunction-associated steatotic liver disease (MASLD) is fundamentally rooted in spleen deficiency and is closely associated with phlegm turbidity, damp-heat and blood stasis. Clinically, liver constraint with spleen deficiency and internal retention of damp turbidity represent the predominant traditional Chinese medicine (TCM) syndrome patterns. Researches have indicated intrinsic connections between the syndrome patterns and biological indicators such as gut microbiota and metabolic profiles. Regarding treatment, classical famous formulas, modern empirical formulas, and newly developed TCM drugs show positive effects in regulating glucose and lipid metabolism, improving insulin resistance, and alleviating metabolic inflammation, exhibiting multi-target mechanisms of action; acupuncture and other external therapies also provide adjunctive value. Nevertheless, current researches still have limitations such as the lack of high-quality clinical evidence and insufficient systematic elucidation of the uncerlying mechanisms. Future efforts should focus on conducting high-quality TCM clinical trials with hard endpoint outcomes such as hepatic histology outcomes, and utilizing modern technologies like multi-omics to elucidate TCM's mechanisms of action, thereby advancing the position of TCM as a first-line therapeutic strategy for MASLD.
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