高脂血症从脾论治探幽  

Discussion of the Treatment of Hyperlipidemia on the Basis of Spleen Theory

作　　者：李维娜[1] 冯玲[1] 

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《世界中西医结合杂志》2017年第4期577-580,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(81470184);"十二五"国家科技支撑计划"名老中医临床经验;学术思想传承研究(一)"项目(2013BAI13B041);2012年国家中医药管理局行业专项(201207001)

摘　　要：高脂血症是缺血性心脑血管疾病的主要且独立的危险因素,血脂水平与脾虚证有直接且密切的关系,脾气虚致使脾的运化和转输功能失司,痰浊内生,形成脂浊。目前中医药降脂的方法种类繁多,治疗角度各有差异,如疏肝除湿,泻肝活血、补肾降脂、利胆泄浊、涤痰化瘀,通腑降气等。不可否认,在实际应用中,这些方法都取得了一定的临床效果。但由于未抓住高脂血症发生及发展的关键——脾虚,仅针对某个病因或某个病机发展阶段论治,不能透过现象看本质,舍本求末,故临床疗效稍有不佳。笔者认为治疗高脂血症必须紧紧抓住脾失健运,痰浊内生这一病机关键,健运后天以治本,化痰祛浊以治标,脾健痰化,膏脂自消。因此理脾化痰为治疗高脂血症重要法则。以治脾为本,并不意味着排斥其他治法,而是根据患者伴随症状,在健脾的同时,伍以相应的治法,共奏降脂之效。Hyperlipidemia is the main and independent risk factor of ischemic cardiocerebrovascular disease.The level of blood lipid is directly and closely related to spleen deficiency.Spleen deficiency leads to dysfunction in transformation and transportation,and phlegm production.At present,there are various of methods for reducing lipid in TCM,such as removing liver qi stagnation and damp,reducing liver fire and activating blood circulation,tonifying kidney and reducing lipid,benefiting gallbladder and removing turbidity,resolving phlegm and removing stasis and reducing qi of fu organs.A certain of clinical effects has been surely achieved in practice.But,the clinical therapeutic effects were not good enough because of limited understanding on the importance of spleen deficiency in the occurrence and development of hyperlipidemia,which is the root of treatment rather than just focusing on some etiology or a stage in pathogenesis.The writers believed that the dysfunction of spleen in transportation and phlegm production are the keys of the pathogenesis of the disease.Strengthening the spleen in transportation is the primary,resolving phlegm is the secondary in the treatment,which is the essential rule in the treatment of hyperlipidemia.However,the other therapeutic methods are also applicable in combination in terms of the symptoms so that the better effects can be achieved for reducing lipid.

关 键 词：高脂血症 脾虚 痰浊 以脾为本 

分 类 号：R589.2[医药卫生—内分泌]