不同临床表型代谢相关脂肪性肝病的发病机制及中西医结合治疗策略

赵文霞; 高磊; 陈欣菊; 郑瑗瑗; 刘素彤; 张丽慧; 赵晴; 赵晨露

doi:10.12449/JCH260423

不同临床表型代谢相关脂肪性肝病的发病机制及中西医结合治疗策略

DOI: 10.12449/JCH260423

赵文霞^{1, 2, 3, , ,},
高磊^4, , ,,
陈欣菊¹,
郑瑗瑗¹,
刘素彤^{1, 2, 3},
张丽慧^{1, 2, 3},
赵晴^{1, 2, 3},
赵晨露^{1, 2, 3}

1.
河南中医药大学第一附属医院脾胃肝胆科，郑州 450000
2.
河南省中医科学院全国名中医赵文霞研究所，郑州 450000
3.
中西医防治重大疾病河南省协同创新中心，郑州 450000
4.
广州中医药大学基础医学院，广州 510006

基金项目:

国家自然科学基金项目 (82205086);

全国名中医传承工作室建设项目 (National Medical Affairs Office, Renjiaohan ［2022］ No.245);

国家科技重大专项自主项目 (2018ZX1030502)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：赵文霞负责拟定写作思路并撰写论文；高磊、陈欣菊负责设计论文框架；郑瑗瑗负责整理资料；刘素彤、张丽慧、赵晴、赵晨露负责文献检索与整理。

详细信息

通信作者:
赵文霞， zhao-wenxia@163.com （ORCID： 0000-0002-0592-3504）

高磊， raygaolei@smu.edu.cn （ORCID： 0000-0001-9030-390X）

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出版历程
- 收稿日期: 2025-12-31
- 录用日期: 2026-01-19
- 出版日期: 2026-04-25

Metabolic dysfunction-associated fatty liver disease with different clinical phenotypes： Pathogenesis and strategies for integrated traditional Chinese and Western medicine treatment

Wenxia ZHAO^{1, 2, 3
, ,
,},
Lei GAO^{4
, ,
,},
Xinju CHEN¹,
Yuanyuan ZHENG¹,
Sutong LIU^{1, 2, 3},
Lihui ZHANG^{1, 2, 3},
Qing ZHAO^{1, 2, 3},
Chenlu ZHAO^{1, 2, 3}

1.
Spleen，Stomach and Hepatobiliary Department，The First Affiliated Hospital of Henan University of Chinese Medicine，Zhengzhou 450000，China
2.
Research Institute of National Famous Traditional Chinese Medicine Expert Zhao Wenxia，Henan Academy of Chinese Medicine Sciences，Zhengzhou 450000，China
3.
Henan Province Collaborative Innovation Center for Prevention and Treatment of Major Diseases by Chinese and Western Medicine，Zhengzhou 450000，China
4.
School of Basic Medical Sciences，Guangzhou University of Chinese Medicine，Guangzhou 510006，China

Research funding:

National Natural Science Foundation of China (82205086);

National Famous Traditional Chinese Medicine Inheritance Studio Construction Project (National Medical Affairs Office, Renjiaohan ［2022］ No.245);

Independent Project of National Science and Technology Major Project (2018ZX1030502)

More Information

Corresponding author: ZHAO Wenxia， zhao-wenxia@163.com （ORCID： 0000-0002-0592-3504）; GAO Lei， raygaolei@smu.edu.cn （ORCID： 0000-0001-9030-390X）

摘要

摘要: 代谢相关脂肪性肝病（MAFLD）是一种病因复杂的慢性代谢性肝病。不同临床表型如肥胖、高脂血症、2型糖尿病、绝经后以及慢性乙型肝炎在MAFLD发生发展中的作用机制各异，导致该病在临床进程及预后方面存在高度异质性。本文旨在系统总结肥胖、高脂血症、2型糖尿病、绝经后、慢性乙型肝炎等5种不同临床表型MAFLD的发病机制及临床特征，并据此阐述相应的个体化中西医诊疗方案，以期为临床实践提供参考并提高临床诊疗水平。
- 代谢相关脂肪性肝病 /
- 肥胖症 /
- 高脂血症 /
- 糖尿病， 2型 /
- 绝经后期 /
- 乙型肝炎，慢性
Abstract: Metabolic dysfunction-associated fatty liver disease （MAFLD） is a chronic metabolic liver disorder with complex etiologies. Different clinical phenotypes of MAFLD （such as obesity， hyperlipidemia， type 2 diabetes mellitus， the postmenopausal state， and chronic hepatitis B） have different mechanisms of action in the development and progression of MAFLD， leading to high heterogeneity in its clinical progression and prognosis. This article systematically reviews the pathogeneses and clinical features of the above five clinical phenotypes of MAFLD and elaborates on the corresponding individualized diagnosis and treatment regimens integrating traditional Chinese medicine and Western medicine， in order to provide a reference for clinical practice and improve clinical diagnosis and treatment.
- Metabolic Dysfunction-Associated Fatty Liver Disease /
- Obesity /
- Hyperlipidemias /
- Diabetes Mellitus， Type 2 /
- Postmenopause /
- Hepatitis B， Chronic

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注： IR，胰岛素抵抗。

图 1 代谢相关脂肪性肝病不同临床表型的发病机制及中西医结合治疗

Figure 1. Pathogenesis and integrated traditional Chinese and western medicine treatment of different clinical phenotypes of MAFLD

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不同临床表型代谢相关脂肪性肝病的发病机制及中西医结合治疗策略

DOI: 10.12449/JCH260423

通信作者:
赵文霞， zhao-wenxia@163.com （ORCID： 0000-0002-0592-3504）

高磊， raygaolei@smu.edu.cn （ORCID： 0000-0001-9030-390X）

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Metabolic dysfunction-associated fatty liver disease with different clinical phenotypes： Pathogenesis and strategies for integrated traditional Chinese and Western medicine treatment

Corresponding author: ZHAO Wenxia， zhao-wenxia@163.com （ORCID： 0000-0002-0592-3504）; GAO Lei， raygaolei@smu.edu.cn （ORCID： 0000-0001-9030-390X）

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不同临床表型代谢相关脂肪性肝病的发病机制及中西医结合治疗策略

DOI: 10.12449/JCH260423

通信作者: 赵文霞， zhao-wenxia@163.com （ORCID： 0000-0002-0592-3504） 高磊， raygaolei@smu.edu.cn （ORCID： 0000-0001-9030-390X）

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Metabolic dysfunction-associated fatty liver disease with different clinical phenotypes： Pathogenesis and strategies for integrated traditional Chinese and Western medicine treatment

Corresponding author: ZHAO Wenxia， zhao-wenxia@163.com （ORCID： 0000-0002-0592-3504）; GAO Lei， raygaolei@smu.edu.cn （ORCID： 0000-0001-9030-390X）

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通信作者:
赵文霞， zhao-wenxia@163.com （ORCID： 0000-0002-0592-3504）

高磊， raygaolei@smu.edu.cn （ORCID： 0000-0001-9030-390X）