| 余臣祖1，张朝宁1▲，张燕2.“脾主运化”与铁死亡在代谢相关脂肪性肝病中的关系探讨[J].中国医药科学,2023,(15):78-81 基金项目:甘肃省自然科学基金（21JR7RA567） |
| “脾主运化”与铁死亡在代谢相关脂肪性肝病中的关系探讨 |
| Exploration of the relationship between "spleen governing transportation and transformation" and ferroptosis in metabolic-associated fatty liver diseases |
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| DOI： |
| 中文关键词: 脾主运化；脾运失常；代谢相关脂肪性肝病；铁死亡 |
| 英文关键词:Spleen governing transportation and transformation; Dysfunction of the spleen in transport; Metabolic-associated fatty liver disease; Ferroptosis |
| 作者 | 单位 | | 余臣祖1，张朝宁1▲，张燕2 | 1.甘肃中医药大学内科学教研室 中医内科学教研室，甘肃兰州 730000；
2.兰州大学第二医院体检中心，甘肃兰州 730030 |
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| 中文摘要: |
| [摘要] 代谢相关脂肪性肝病（MAFLD）又名非酒精性脂肪肝病（NAFLD），是一组常见慢性肝病的总称，包括单纯性脂肪肝、非酒精性脂肪性肝炎（NASH）、肝纤维化、肝硬化及肝癌。铁死亡是细胞内铁过载导致毒性脂质过氧化物累积引起细胞氧化损伤的新型细胞死亡方式，研究显示铁死亡参与MAFLD的发生发展。脾主运化是脾将饮食水谷转化为水谷精微，并把水谷精微吸收、转输至全身各脏腑组织的生理功能，脾失健运则聚湿生痰，痰浊壅滞于肝，膏脂转输障碍，引起肝脏脂肪变性，痰阻气滞，气滞血瘀，痰浊与瘀血互结成毒，浊毒久郁化热，导致脂肪性肝炎，促进病情进展，这与肝细胞铁死亡引起肝脏脂质代谢紊乱导致细胞氧化损伤及炎症反应具有一定的关联，脾主运化在肝细胞铁死亡中起着主导作用。本文通过介绍铁死亡和“脾运失常”在MAFLD发病中的作用，探讨“脾主运化”与铁死亡在MAFLD脂质代谢紊乱中的相关性，为中西医结合治疗MAFLD提供参考。 |
| 英文摘要: |
| [Abstract] Metabolic-associated fatty liver disease (MAFLD), also known as non-alcoholic fatty liver disease (NAFLD), is a general term for a group of common chronic liver diseases, including nonalcoholic fatty liver, non-alcoholic steatohepatitis (NASH), liver fibrosis, cirrhosis, and liver cancer. Ferroptosis is a new type of cell death caused by intracellular iron overload that results in oxidative cellular damage due to the accumulation of toxic lipid peroxides. Studies have shown that ferroptosis is involved in the occurrence and development of MAFLD. The "spleen governing transportation and transformation" is the physiological function of the spleen to transform dietary water and grain into the essence of water and grain and absorb and transfer the essence of water and grain to all internal organs and tissues of the whole body. If there is dysfunction of the spleen in transport, it will accumulate dampness and produce phlegm. The phlegm stagnates in the liver, and the grease transfer will be blocked, causing steatosis of the liver. Phlegm blocking will cause qi stagnation, leading to blood stasis, and then turbid phlegm and static blood will combine to form poison. Then turbid poison will become heat after a long period of stagnation, leading to steatohepatitis and promoting the progress of the disease, which is related to the disorder of liver lipid metabolism caused by liver cell ferroptosis, leading to oxidative cellular damage and inflammatory response. The "spleen governing transportation and transformation" plays a leading role in liver cell ferroptosis. This article introduces the role of ferroptosis and "dysfunction of the spleen in transport" in the pathogenesis of MAFLD and explores the correlation between "spleen governing transportation and transformation" and ferroptosis in the disorder of lipid metabolism in MAFLD, providing a reference for the treatment of MAFLD by combining traditional Chinese medicine and Western medicine. |
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