2026 年第 5 期 第 21 卷

代谢相关脂肪性肝病合并幽门螺杆菌感染的中西医研究现状和展望

Research status and prospects of integrated traditional Chinese and western medicine on metabolic-associated fatty liver disease complicated with Helicobacter pylori infection

作者：刘云高娟黄雨晴周毅叶松

英文作者：Liu Yun Gao Juan Huang Yuqing Zhou Yi Ye Song

单位：湖北省中医院湖北中医药大学附属医院湖北中医药大学第一临床学院湖北时珍实验室中医肝肾研究及应用湖北省重点实验室，武汉430061

英文单位：Hubei Provincial Hospital of TCM the Affiliated Hospital of Hubei University of Chinese Medicine the First Clinical College of Hubei University of Chinese Medicine Hubei Shizhen Laboratory Hubei Key Laboratory of Research and Application of Liver and Kidney Diseases of Traditional Chinese Medicine Wuhan 430061 China

关键词：代谢相关脂肪性肝病；幽门螺杆菌；共病；中医体质

英文关键词：Metabolic-associatedfattyliverdisease;Helicobacterpylori;Comorbidity;TraditionalChinesemedicineconstitution

• 摘要：

• 代谢相关脂肪性肝病（MAFLD）是全球最常见的慢性肝病，幽门螺杆菌（Hp）为高感染率的胃内定植菌，二者共病的相关性已成研究热点。多项荟萃分析证实MAFLD与Hp感染呈正相关，基础和临床研究提示Hp可通过诱发炎症反应和胰岛素抵抗等途径加重MAFLD，早期根除Hp可改善MAFLD患者代谢及炎症状态，改善肝脏脂肪变性。中医体质研究证实湿热质、痰湿质为二者共同易感体质，共病患者脾失运化、湿热痰浊的核心病机与现代医学机制形成“病机-机制”双向印证。由此，Hp根除治疗有望成为延缓MAFLD进展的潜在干预策略，而共病患者的中医体质研究，也为制定个体化中西医结合诊疗方案、提升共病防治水平提供了新方向。

• Metabolic-associated fatty liver disease (MAFLD) is the most common chronic liver disease worldwide, and Helicobacter pylori (Hp) is a highly prevalent intragastric colonizing bacterium. The correlation between their comorbidity has become a research hotspot. Several meta-analyses have confirmed a positive correlation between MAFLD and Hp infection. Basic and clinical studies suggest that Hp can aggravate MAFLD by inducing inflammatory response and insulin resistance. Early eradication of Hp can improve metabolic and inflammatory status as well as hepatic steatosis in patients with MAFLD. Studies on traditional Chinese medicine (TCM) constitutions have confirmed that damp-heat constitution and phlegm-damp constitution are the common susceptible constitutions for both diseases. The core pathogenesis of spleen failing in transportation, damp-heat and phlegm-turbidity in comorbid patients provides a two-way confirmation of "pathogenesis-mechanism" with modern medical mechanisms. Therefore, Hp eradication therapy is expected to be a potential intervention strategy to delay the progression of MAFLD, and research on TCM constitutions of comorbid patients also provides a new direction for formulating individualized integrated TCM and western medicine diagnosis and treatment plans and improving the prevention and treatment level of comorbidity.