酒精性肝病严重危害国民的健康。现代医学认为肠黏膜屏障损伤和细菌移位是酒精性肝损伤的重要病理环节，在此基础上形成了“肠-肝轴”理论和“二次打击”学说。本文基于历代医家论点的文献检索和现代研究结果，提出“脾虚血瘀”是酒精性肝损伤的基本病机，“肠道是中药防治酒精性肝损伤的重要靶位”及“从脾论治”的理论假说。并结合研究团队近年来对经验复方健脾活血方的研究进展，说明具有健脾活血、清浊利湿功效的健脾活血方具有良好的临床疗效，其药理机制表现为修复小肠黏膜的机械屏障损伤，改善菌群结构，减少内毒素释放，进而减轻对肝脏的“二次打击”。该研究思路和研究结果体现了酒精性肝损伤“脾虚血瘀”的病机特点以及“从脾论治”的治疗法则，对传统理论进行了现代诠释，为中医药防治该病提供了参考。

Alcoholic liver disease(ALD),a critical illness in China,was believed that intestinal mucosal barrier injury and bacterial translocation were the significant basic pathology of alcoholic liver injury in the field of modern medicine and formed the "gut-liver axis" theory and the "two hit" hypothesis.We proposed that "spleen deficiency and blood stasis" was the basic pathogenesis of alcoholic liver injury diseases in Chinese medicine,and hypothesized that "intestinal was a crucial target for the prevention and treatment of alcoholic liver injury in traditional Chinese medicine" and "treatment based on spleen function" based on literature retrieving and modern researches.In this review,our findings of Jianpi Huoxue decoction verified that it repaired the injury of intestinal mucosal mechanical barrier,restructed the bacteria and inhibited endotoxin releasing and constrained the "second hit" in liver with favorable clinical efficacy.The pharmacological mechanism manifested its“ spleendeficiency and blood-stasis" pathogenesis and the theory of "treatment based on spleen function" in alcoholinduced liver injury deseases.We hope to modernize and comprehensively interprete its traditional theory with the provision of a reference for its prevention and treatment of the disease.

国家自然科学基金委面上项目（30371818），酒精性肝损伤与小肠通透性改变的关系及健脾中药的干预，负责人：胡义扬；国家自然科学基金委青年科学基金项目（30801536）：基于均匀设计的健脾活血方抗酒精性肝损伤不同作用途径的主效应中药研究，负责人：冯琴。