代谢相关脂肪性肝病的中医认识及辨治  

TCM recognition and treatment of metabolic associated fatty liver disease

作　　者：周强[1] 陶琳[1] 张声生[1] ZHOU Qiang;TAO Lin;ZHANG Sheng-sheng(Digestive Center,Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院消化中心,北京100010

出　　处：《中华中医药杂志》2021年第11期6380-6384,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京市国家中医重点专科辐射工程(1+X+N)脾胃病专科项目(No.01070238);首都医科大学附属北京中医医院院级课题项目(No.YJ-201732);北京市医管局“培育计划”项目(No.PZ2018010)。

摘　　要：国际脂肪肝命名小组将"非酒精性脂肪性肝病"更名为"代谢相关脂肪性肝病"(MAFLD),并明确提出了其诊断标准,使得本病的诊断更加明确化、具体化。张声生教授根据"瘅"和"肝瘅"在古籍中的意义,以及"瘅"与代谢相关性疾病的关系,建议将MAFLD命名为中医的"肝瘅",并提出饮食不节、安逸过度、情志失调、痰湿体质、年老体衰是本病的主要病因,而其病位在肝,与脾、肾关系密切。"郁""膏""热""虚""瘀"是其核心病机;"疏""消""清""散""补"是其主要治法;肝郁气滞证、膏浊壅肝证、肝胃郁热证、肝络瘀阻证、肝肾阴虚证是本病的主要证型,可选择四逆散、茵陈蒿汤、大柴胡汤、膈下逐瘀汤、一贯煎等为主要方药加减论治。The international fatty liver nomenclature group renamed ‘nonalcoholic fatty liver disease’ as ‘metabolism associated fatty liver disease(MAFLD)’, and clearly put forward its diagnostic criteria, making the diagnosis of the disease clearer and more specific. According to the significance of ‘dan’ and ‘liver dan’ in ancient books, and the relationship between ‘dan’and metabolic related diseases, professor ZHANG Sheng-sheng proposed to name metabolic related fatty liver disease as ‘liver dan’ in traditional Chinese medicine, and proposed that improper diet, excessive comfort, emotional disorder, phlegm dampness constitution, aging and physical failure are the main causes of the disease, and the disease is located in the liver, which is closely related to the spleen and kidney. ‘Depression’ ‘plaster’ ‘heat’ ‘deficiency’ and ‘stasis’ are the core pathogenesis of metabolism associated fatty liver disease. The main treatment methods are ‘dredge’ ‘eliminate’ ‘clear’ ‘disperse’ and ‘tonify’;The main syndrome types of the disease are stagnation of liver qi, stagnation of liver due to plaster turbidity, stagnation of heat in liver and stomach, stagnation of liver collaterals and yin deficiency of liver and kidney, Sini powder, Yinchenhao Decoction, Dachaihu Decoction, Gexia Zhuyu Decoction and Yiguanjian Decoction can be selected as the main prescriptions.

关 键 词：代谢相关脂肪性肝病 肝瘅 病名 病因 辨治 

分 类 号：R259[医药卫生—中西医结合]