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

Corresponding author: baoyang, 17800509@qq.com

DOI: 10.12201/bmr.202604.00153

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  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

  Submit time: 22 April 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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