从“谷气过旺”到“热郁痰瘀”论非酒精性脂肪性肝炎的病机演变  

Discussion on Pathogenesis of Non-Alcoholic Fatty Hepatitis Based on Theories of Excess Food Energy And Heat Depression With Phlegm And Stasis

作　　者：纪云西[1,2] 郑超伟[1] 林穗玲[1] 陈冠林[1] 韩棉梅[1] 刘佳[1] 季幸姝[1] 周福生[1] 

机构地区：[1]广州中医药大学,广东广州510405 [2]广西中医学院第一附属医院,广西南宁530023

出　　处：《中华中医药学刊》2012年第1期57-59,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：中国博士后科学基金资助项目(20100470897);广西壮族自治区教育厅重点项目(J11051);广州中医药大学创新基金资助项目(09CX008);广州中医药大学博士后科研基金资助项目

摘　　要：从血脂代谢紊乱起始到非酒精性脂肪性肝炎的进展中存在着一定的病机演变规律,即谷气过旺,消耗不足,是血脂增高及脂质代谢紊乱形成的始动病机环节;气化失司,膏脂凝结,是胰岛素抵抗、高脂血症及单纯性非酒精性脂肪肝形成的病理基础;脂浊壅滞,聚结肝胞,是高脂血症及单纯性非酒精性脂肪肝形成主要病机;脾运失健,痰瘀互结,是非酒精性脂肪性肝炎形成的病理基础和病机关键;痰瘀郁热,积损肝络,是非酒精性脂肪性肝炎形成病理关键及其预后转折点。其中脾失运化是非酒精性脂肪肝病程进展的关键因素,而气化失司则贯穿与整个疾病过程。There are some certain pathogenesis changes of non-alcoholic fatty hepatitis caused by blood fat metabolic disturbance.Excess food energy and underconsumption,are the beginning cause of blood fat increase and metabolic disturbance;dysfunction of Qi and coagulation of fat are the pathological basis of insulin resistance,hyperlipemia and simplex non-alcoholic fatty hepatitis;fat and turbid stagnation in liver cells is the main pathogenesis of hyperlipemia and simplex non-alcoholic fatty hepatitis;spleen failing to transport and transform and obstructions of phlegm and stasis are the pathological basis and the key to pathogenesis;heat due to phlegm and stasis stagnation which can damage the liver collaterals is the pathological key to non-alcoholic fatty hepatitis and the turning point of its prognosis.Spleen failing to transform and transport is the important pathological factor of the disease development and dysfunction of Qi is throughout all the progress of the disease.

关 键 词：高脂血症 胰岛素抵抗 非酒精性脂肪性肝炎 气化失司 脾运失健 痰瘀互结 

分 类 号：R575.5[医药卫生—消化系统]