通讯作者: 包扬, 17800509@qq.com

DOI：10.12201/bmr.202604.00153

Exploring the Prevention and Treatment of Obesity-related Type 2 Diabetes Based on the Theory of “Earth Stagnation and Wood Depression”

• 摘要：本文基于“土壅木郁”理论探讨肥胖型2型糖尿病（type 2 diabetes mellitus，T2DM）的防治机制与策略。该理论认为，脾失运化（土壅）与肝失疏泄（木郁）是核心病机。现代研究证实，“土壅”对应肠道菌群紊乱引发的代谢性炎症，“木郁”关联下丘脑-垂体-肾上腺（hypothalamic-pituitary-adrenal，HPA）轴功能失调，二者与“痰热互结”（脂肪组织炎症）构成恶性循环，共同导致胰岛素抵抗。据此，提出“运脾疏肝，清热化痰”的治则，其通过调节肠道微生态、抑制HPA轴亢进、阻断NF-κB/MAPK炎症通路等多靶点途径发挥治疗作用，代表方剂如葛根芩连汤、逍遥散、茵陈蒿汤等。本研究为肥胖型T2DM诊疗提供融合经典理论与现代医学的新范式，需进一步开展机制探索与高质量临床研究。未来需借助多组学技术深化系统机制研究，推动诊疗的精准化。

  关键词： 土壅木郁；肥胖型T2DM；肠道菌群；HPA轴；脂肪组织炎症

   

  Abstract: Type 2 diabetes mellitus (T2DM) is a global chronic metabolic disease often characterized by the complex pathological feature of obesity. This clinical phenotype plays a critical role in disease progression and has increasingly become a significant focus of medical research. Based on the theory of “Earth Stagnation and Wood Depression,”this paper systematically elaborates on the pathogenesis, prevention, and treatment strategies of obesity-related T2DM. The study indicates that “Earth Stagnation”(spleen-stomach stagnation) and “Wood Depression”(liver qi stagnation) interact as both cause and effect: endogenous phlegm-dampness leads to spleen-stomach stagnation and impaired transportation, which in turn causes liver qi stagnation and dysfunction in free flow, ultimately contributing to insulin resistance and metabolic disorders. This reveals the central role of middle jiao qi stagnation in the onset and progression of the disease.At the theoretical level, this paper integrates the pathological mechanism of “Earth overwhelming Wood”from the Five Elements theory and relevant discussions by physicians throughout history, clarifying that spleen-stomach stagnation is a key pathogenesis leading to liver qi stagnation. At the clinical level, patients with obesity-related T2DM often suffer from spleen deficiency and dampness accumulation due to dietary irregularities and sedentary lifestyles, with damp-turbidity suppressing liver wood, further exacerbating metabolic dysregulation. Modern research also confirms that the “Earth Stagnation”state is closely associated with chronic low-grade inflammation, elevated free fatty acids, and abnormalities in insulin signaling pathways.Regarding prevention and treatment strategies, this paper proposes a core therapeutic principle of “activating the spleen, resolving dampness, promoting qi flow, and alleviating depression,” with specific recommendations provided from both preventive and interventional perspectives. Clinical practice has shown that formulas based on this theory, such as Dachaihu Decoction and Yinchenhao Decoction, help improve insulin resistance and related metabolic indicators. This study offers a new paradigm for the diagnosis and treatment of obesity-related T2DM by integrating classical theories with modern medicine. Future efforts should focus on further exploring the underlying mechanisms and conducting high-quality clinical research to deepen its scientific connotation and validate its application value.

  Key words: Obesity-related Type 2 Diabetes；Earth Stagnation and Wood Depression；Insulin Resistance；Theoretical Analysis

  提交时间：2026-04-22

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
• html

• 图表

• 邱美洁, 周 杰, 肖 玮. 从气血津液理论探讨COPD合并2型糖尿病氧化应激与代谢失衡的关联机制. 2025. doi: 10.12201/bmr.202506.00039

  徐宿珍, 陈进. 小檗碱调控血糖的多靶点作用机制及其在2型糖尿病防治中的研究进展. 2025. doi: 10.12201/bmr.202510.00049

  王涛. 门诊老年2型糖尿病患者低血糖的危险因素分析. 2024. doi: 10.12201/bmr.202412.00069

  成路平, 吴思扬, 路波. 基于机器学习的2型糖尿病发病因素分析与预测. 2025. doi: 10.12201/bmr.202509.00003

  钱徐选弘, 龚文波. 基于“土得木而达”从肝脾论治慢性下肢静脉性水肿. 2026. doi: 10.12201/bmr.202603.00014

  李瑞瑶, 许婧怡, 戴浩宇, 孙慧文, 鲍瀛, 华履春, 吴天星. 基于深度置信网络的2型糖尿病微血管并发症预测. 2024. doi: 10.12201/bmr.202404.00021

  芮晨, 陈玥琪, 李金斌, 张胜发. 人工智能在基层2型糖尿病健康管理中的应用进展与趋势. 2025. doi: 10.12201/bmr.202506.00072

  芮晨. 基于机器学习的2型糖尿病合并高血压影响因素模型对比与解释性分析. 2025. doi: 10.12201/bmr.202511.00058

  刘红萍, 杨杰, 庞国明, 邢颖, 李鹏辉, 吴敏, 温宵宵, 李洪皎, 文天才. 基于改进关联规则与Logistic回归算法集成的2型糖尿病中医证型鉴别研究. 2024. doi: 10.12201/bmr.202404.00034

  陈家祈, 王丽, 朴春丽. 玉液汤联合二甲双胍治疗2型糖尿病Meta分析. 2024. doi: 10.12201/bmr.202407.00066

• 序号	提交日期	编号	操作
  1	2026-03-13	10.12201/bmr.202604.00153V1	下载

• 公开评论  匿名评论  仅发给作者 提交评论