| 徐俊超,于澜,于佳妮,等.基于“川海理论”辨治MAFLD刍论[J].浙江中医药大学学报,2023,47(6):602-607. |
| 基于“川海理论”辨治MAFLD刍论 |
| Humble Opinion on the Differentiation and Treatment of MAFLD Based on “Chuanhai Theory” |
| DOI：10.16466/j.issn1005-5509.2023.06.004 |
| 中文关键词: 代谢相关脂肪性肝病 川海理论 取类比象 整体观念 病机认识 论述 |
| 英文关键词: metabolic associated fatty liver disease Chuanhai Theory analogy holistic concept pathology cognition review |
| 基金项目:全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号)；辽宁省科技厅省自然基金项目(2019-MS-231) |
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| 中文摘要: |
| [目的] 探究“川海理论”，丰富代谢相关脂肪性肝病的中医病机理论及临床治疗方法，以期指导临床。[方法] 运用取类比象和整体观念，结合卢秉久教授四十载临床经验，阐述“川海理论”的内涵、“川海理论”与代谢相关脂肪性肝病病机的联系以及在辨治中的应用。[结果] “川海理论”的内涵可概括为“六经为川，终日乾乾，以通为用；肠胃为海，众川所归，泽利万物”；与代谢相关脂肪性肝病的联系主要体现在饮食水谷的运化，气血津液的生化、运行和输布，以及“湿”“痰”“浊”“瘀”等病邪的化生与传变等生理病理活动，其病理表现包括“气机不利，生痰聚湿化浊”“滞浊成瘀，成积伤脏损脉”“肾阳亏虚，无以温煦气化”三个方面；基于此，提出以“澄源”“洁流”“复旧”三法管理及治疗代谢相关脂肪性肝病，具体包括饮食与运动管理、利湿通阳、通腑泄浊、活血化瘀、健脾益气、疏肝解郁及温肾助阳等中医治法。经典验案中，面对“湿”“痰”“浊”“瘀”等诸邪皆备的患者，基于“川海理论”如法施治，收效显著。[结论] “川海理论”内涵丰富，是对代谢相关脂肪性肝病中医病机理论及治法的创新，值得重视并广泛应用于临床。 |
| 英文摘要: |
| [Objective] To explore the “Chuanhai Theory”， enrich the traditional Chinese medicine(TCM) pathogenesis theory and clinical treatment methods of metabolic associated fatty liver disease， in order to guide clinical practice. [Methods] Using analogies and holistic concepts， combined with Professor LU Bingjiu’s 40 years of clinical experience， the connotation of “Chuanhai Theory”， the relationship between “Chuanhai Theory” and the pathogenesis of metabolic associated fatty liver disease， and the diagnosis and treatment of this disease were expounded. [Results] The connotation of “Chuanhai Theory” can be summarized as “the six channels act like the rivers， work all day long， and use generality for use; stomach and intestines are the sea， where all rivers return， and all things benefit”; the connection with metabolic associated fatty liver disease is mainly reflected in the transportation and transformation of food， water and grains， the operation and distribution of Qi， blood and body fluids， as well as physiological and pathological activities such as the transformation and transmission of pathogenic pathogens such as “dampness” “phlegm” “turbidity” and “stasis”. Pathological manifestations include three aspects of unfavorable Qi mechanism， producing phlegm， accumulating dampness and dissolving turbidity; stagnation of turbidity and stasis， which accumulates and damages the viscera and damages the veins; deficiency of kidney Yang， inability to warm and transform Qi. Management and treatment of metabolic associated fatty liver disease with three methods of “cleansing flow” and “rejuvenation”， including diet and exercise management， removing damp and activating Yang， promoting blood circulation and removing blood stasis， invigorating the spleen and replenishing Qi， soothing the liver and relieving stagnation and warming the kidney and activate Yang and other TCM treatment methods. In the classic case， in the face of patients with various pathogenic factors such as “dampness” “phlegm” “turbidity”. and “blood stasis”， treatment was according to the “Chuanhai Theory” and achieved remarkable results， which supported the foregoing. [Conclusion] The “Chuanhai Theory” has rich connotations， and it is an innovation of TCM pathogenesis theory and treatment method for metabolic associated fatty liver disease， which is worthy of attention and widely used in clinical practice. |
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