从“兰除陈气”探析肥胖辨治  

Syndrome Differentiation and Treatment of Obesity from "Orchids to Eliminate Stagnant Qi"

作　　者：周静鑫[1] 鲁轶臻 杨杰[1] 金健[1] 缪娟[1] 张岩[2] ZHOU Jingxin;LU Yizhen;YANG Jie;JIN Jian;MIAO Juan;ZHANG Yan(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 101121,China;Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]北京中医药大学东直门医院,北京101121 [2]首都医科大学附属北京友谊医院,北京100050

出　　处：《中国实验方剂学杂志》2023年第16期72-78,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(80804091);第六批北京市级中医药专家学术经验继承工作项目。

摘　　要：肥胖是由遗传、饮食结构、生活方式与行为、心理、环境及社会等多因素引起能量过剩致体内脂肪异常或过多堆积的一种慢性、易反复、进行性的代谢性疾病。肥胖作为主要危险因素,增加了2型糖尿病、高血压、心血管疾病、卒中、部分恶性肿瘤等多种慢性疾病的发病风险。全球肥胖发病率逐年上升,随着人民生活水平不断提高,我国已有超过半数以上的成年人存在超重及肥胖,严重危害人民健康,增加社会与经济负担,成为亟待解决的重大公共卫生问题。肥胖,最早见于《黄帝内经》,有“肥贵人,则高梁之疾也”之描述,并提出“肥者令人内热,甘者令人中满,故其气上溢,转为消渴。治之以兰,除陈气也”。膏粱酒食之积不化而成陈气,故肥胖为“陈气”之疾。肥胖是因嗜食膏粱酒酪,辛辣浓味,生冷寒凉,甜腻食物,或饱食安逸少动、久坐熬夜,或喜、怒、忧、思、恐等五志过及,或因先天禀赋异常,致脾胃受纳运化失常,小肠化物泌别吸收失调,陈气内生,堆积于脏腑与肌肤,而见形体肥满。食饮入口,离不开胃之受纳腐熟、小肠之受盛泌别清浊、脾之转输,其病位在脾、胃、小肠。兰者,兰泽香草也,狭义即佩兰、泽兰,芳香之品,能畅气机,除陈腐,涤垢腻;广义凡气味香辛,可醒脾升清,和胃降浊,助小肠化物泌别如常,逐退盈余者,皆谓之“兰”。因此,肥胖当治以“兰除陈气”,旨在运用辛香之品调整脾、胃、小肠之功能,逐退食湿痰浊郁热等盈余,以复中焦升降平衡,肥者不肥也。Obesity is a chronic,recurrent,and progressive metabolic disorder characterized by the abnormal or excessive accumulation of body fat caused by multiple factors such as genetics,dietary structure,lifestyle and behavior,psychology,environment,and society,leading to an energy surplus.Obesity is a major risk factor that increases the risk of developing various chronic diseases,including type 2 diabetes,hypertension,cardiovascular diseases,stroke,and certain malignancies.The global incidence of obesity is increasing year by year.With the continuous improvement of people's living standards,more than half of adults in China are now overweight or obese,posing a serious threat to people's health and increasing the social and economic burden.It has become a pressing major public health issue that needs to be addressed urgently.The concept of obesity can be traced back to the Huangdi’s Internal Classic(Huang Di Nei Jing),which describes it as"the problems in fat and affluent people are caused by excessive taking of rich food",and suggests that''frequent intake of rich and greasy foods can produce interior heat.Sweet flavor causes chest fullness.That is why its spleen-Qi flows upwards and changes into consumption-thirst disease.It can be treated by Eupatorii Herba which is used to remove stagnant Qi''.The stagnant qi is caused by the transformation failure of rich and greasy food and wine,so obesity is the disease of stagnant qi.Obesity is caused by indulging in rich and greasy food,wine,spicy and flavorful foods,raw and cold foods,and sweet and greasy foods,or overeating and leading a sedentary lifestyle,staying up late,or experiencing emotional imbalances such as excessive joy,anger,worry,pensiveness,and fear.It can also be caused by congenital abnormalities,leading to improper functioning of the spleen and stomach,dysregulation of the absorption and secretion of the small intestine,and the accumulation of stagnant Qi in the organs and muscles,resulting in a plump physique.The intake of food and drink depends on the fun

关 键 词：肥胖 “陈气”之疾 脾、胃、小肠 “兰除陈气” 

分 类 号：R2-0[医药卫生—中医学] R22R242R2-031R285.5