从肝脾肾论治肝纤维化  

Treating Liver Fibrosis Based on Regulating the Liver and Spleen and Kidney

作　　者：胡晓萍[1] 罗伟生[1] 刘礼剑[2] 陈美琳 陈姗 黎妍 申秋艳 王亚飞 HU Xiao-ping;LUO Wei-sheng;LIU Li-jian;CHEN Mei-lin;CHEN Shan;LI Yan;SHEN Qiu-yan;WANG Ya-fei(Guangxi University of TCM,Nanning,Guangxi,China,530001;The First Affiliated Hospital of Guangxi University of TCM,Nanning,Guangxi,China,530023)

机构地区：[1]广西中医药大学,广西南宁530001 [2]广西中医药大学第一附属医院,广西南宁530023

出　　处：《河南中医》2020年第1期13-16,共4页Henan Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81660779);广西壮族自治区科技攻关计划项目(2017AA21041);广西中医药大学校级一般硕士研究生创新项目(YCSY2018024)。

摘　　要：肝纤维化病机为本虚标实,本虚为肝、脾、肾气血阴阳亏虚,标实为湿热、疫毒、痰浊、瘀血等互结,病位在肝、与脾、肾关系密切,治应扶正祛邪,标本兼治。脾胃为后天之本,肝纤维化的治疗当以顾护中焦脾胃为主,脾胃健旺,则肝脏安和。肝纤维化的治疗主要以恢复肝脏的生理特性为主,治疗宜疏肝解郁、行气导滞。血瘀证贯穿肝纤维化始终,且血瘀的程度与肝纤维化密切相关,治疗除疏肝理气外,还应采用活血化瘀通络之法,以改善肝内气滞血瘀的状态。肝肾同居下焦,乙癸同源,肝病日久可累及肾脏,导致肝肾阴津亏虚,肝肾同病,故治疗应肝肾同治,滋水以涵木。The pathogenesis of liver fibrosis is primary deficiency and secondary excess.Primary deficiency means qi,blood,yin and yang deficiency of the liver,spleen and kidney.Secondary excess refers to intermingled damp heat,pestilence,phlegm and blood stasis.The location of the disease lies in the liver,and is closely related to the spleen and kidney.It should be treated by strengthening healthy and removing pathogenic factors,treating the root and branch simultaneously.The spleen and stomach are the foundation of acquired constitution.The treatment of liver fibrosis should focus on protecting the spleen and stomach in the middle energizer.If the spleen and stomach are vigorous,the liver will work properly.The treatment of liver fibrosis is mainly to restore the physiological characteristics of the liver by soothing the liver and relieving depression,moving qi and removing food stagnation.Blood stasis syndrome runs through liver fibrosis all the time,and the degree of blood stasis is closely related to liver fibrosis.In addition to soothing the liver and regulating qi,we should also adopt the method of invigorating blood and dissolving stasis and unblocking the collaterals to improve the state of qi stagnation and blood stasis in the liver.Both Liver and kidney lie in lower energizer,and are from the same source.Chronic liver disease can affect kidney,leading to deficiency of yin and fluid of liver and kidney,attacking liver and kidney together,so liver and kidney should be treated together,by nourishing water to moisten wood.

关 键 词：肝纤维化 调理脾胃 疏肝解郁 行气导滞 活血化瘀通络 滋水涵木 

分 类 号：R259.752[医药卫生—中西医结合]