痰湿理论的源流及其在非酒精性脂肪性肝病中的应用研究进展  

Origin of phlegm-damp theory and application research progress of phlegm-damp theory in the treatment of non-alcoholic fatty liver disease

作　　者：尹艺晓 胡义扬[1,2,3,4] 彭景华 YIN Yi-xiao;HU Yi-yang;PENG Jing-hua(Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Institute of Liver Diseases Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Ministry of Education Key Laboratory of Liver and Kidney Diseases,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Shanghai Key Laboratory of Traditional Chinese Clinical Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院,上海201203 [2]上海中医药大学肝病研究所,上海201203 [3]上海中医药大学教育部肝肾疾病重点实验室,上海201203 [4]上海市中医临床重点实验室,上海201203

出　　处：《中华中医药杂志》2023年第4期1689-1692,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金面上项目(No.81673750);上海申康三年行动计划项目(No.SHD2020CR2049B)。

摘　　要：非酒精性脂肪性肝病(NAFLD)属于中医“肝癖”“胁痛”及“积聚”范畴,痰湿是其核心致病因素,贯穿NAFLD病理进展的始终。文章梳理了中医痰湿理论的历史沿革,结合研究进展归纳了NAFLD中痰湿的形成与过食肥甘、过劳伤气、肝脾失调、肾精不足、痰湿体质密切相关,综述了NAFLD痰湿证在肝脏影像学、血清脂质和炎症因子、肠道菌群及胆汁酸代谢等方面不同于其他证型的特点,以及针对NAFLD中“痰湿”的祛湿化痰、疏肝健脾、补肾化痰的治法方药与针刺,以期为中医药治疗NAFLD提供科学支撑。Non-alcoholic fatty liver disease(NAFLD)is recognized as‘hepatomania'‘hypochondriac pain'or abdominal mass'in traditional Chinese medicine,of which the core pathogenic factor is phlegm damp.The original understanding of theory of phlegm-damp is summarized in this review paper,as well as the research progress in the etiology and pathogenesis such as overeating fat and sweet,overwork,liver and spleen disorder,kidney essence deficiency,phlegm and damp constitution.This paper summarizes the characteristics of phlegm damp syndrome of NAFLD diferent from other syndrome types in liver imaging,serum lipids and inflammatory factors,intestinal flora and bile acid metabolism,etc.,and the treatment methods and prescriptions and acupuncture for eliminating damp and eliminating phlegm,soothing liver and strengthening spleen,and tonifying kidney and eliminating phlegm aiming at‘phlegm-damp'in NAFLD,in order to provide scientific support for the treatment of NAFLD with traditional Chinese medicine.

关 键 词：非酒精性脂肪性肝病 痰湿 祛湿化痰 疏肝健脾 补肾化痰 

分 类 号：R259[医药卫生—中西医结合]