吴又可“主客交”学说对中医肝纤维化证治的启示  

Inspiration of Wu Youke's Theory "Intercourse between Host and Guest" for TCM Syndrome Differentiaotion and Treatment for Liver Fibrosis

作　　者：袁建[1] 杨宇[1] 

机构地区：[1]成都中医药大学,四川成都610075

出　　处：《河南中医》2010年第5期428-430,共3页Henan Traditional Chinese Medicine

基　　金：四川省中医药管理局科研专项资助(编号:2007xs16)

摘　　要："主客交"学说是中医重要理论之一,长期以来有效地指导着临床。将"主客交"应用到肝纤维化有望为肝纤维化研究提供新的思路:①肝纤维化与"主客交"的病理相似。"主""客"混处血脉导致了络病阴伤,阴伤促成了络病,络病加重了阴伤,二者互为因果,形成痼疾。肝纤维化过程中的ECM沉积、微循环障碍、血流变异常等与络病密切相关,"主客交"形成络病阴伤过程中的气血阻滞、络脉凝瘀的本质是血循环障碍。据此,肝纤维化与"主客交"可以络病为结合点,用"主客交"理论阐释肝纤维化的病因病理。②肝纤维化治疗贵在"通"。"主客交"代表方三甲散通中有补、补中寓通、以通为主、以通透邪、以通扶正,从而分解"主""客",去除痼疾。肝纤维化与"主客交"二者病机类似,故其治疗异中有同。Theory of ＂intercourse between host and guest＂, one of the important TCM theory, has been used for long time to guide the clinical practice effectively. The applieaton of the theory to the treatment for liver fibrosis is expected to provide a new way for liver fibrosis： （1） hepatic fibrosis and ＂intercourse between host and guest＂ have similar pathology. Host and guest mixed in the blood vessel may lead to yin injuries and collateral diseases, while yin injuries may lead to collateral diseases and collateral diseases deteriorate yin injuries. Deposition of ECM, microcirculation disorder and abnormal blood rheology in liver fibrosis are closely associated with collateral diseases. The essenece. of block of qi and blood, collateral stagnation and stasis during the formaton of collateral diseases and yin injuries is the blood circulation disorder. Accordingly, liver fibrosis and ＂intercourse between host and guest＂ can be combined with the point of collateral disease, theory. ＂intercourse between host and guest＂ can explain the etiology and pathology of liver fibrosis. （2）The treatment for liver fibrosis should be stressed on purgation. The representative prescription Sanjia Powder can seperate the host and guest, remove the confined disease. Since liver fibrosis and ＂intercourse between host and guest＂ have similar pathogenesis, differences between their treatment have similarities.

关 键 词：“主客交” 肝纤维化 络病 三甲散 吴又可 

分 类 号：R22[医药卫生—中医基础理论]