Abstract：Recent modern medical studies have shown that the enteric- hepatic axis is involved in the pathogenesis of fatty liver. Prof. HU Shiping combined the enteric-hepatic axis with the theory of strengthening the spleen in liver diseases to explore the pathogenesis and treatment of fatty liver in Chinese medicine. It was pointed out that the main cause of fatty liver is the co- occurrence of liver and spleen diseases；fatty liver is originated from the abnormal regulation of lipid metabolism due to spleen deficiency；the imbalance of intestinal flora is the microscopic manifestation of spleen deficiency；and that the enteric- hepatic axis may be the pathological basis of co- occurrence of liver and spleen diseases. The core of the theory of strengthening the spleen in liver diseases to guide the treatment of fatty liver lies in regulating the spleen， which may promote the recovery of intestinal flora homeostasis and liver function by regulating the enteric-hepatic axis，so as to delay and prevent the development of the disease.