罗伟生以“化瘀四法”辨治慢性肝病  

Luo Weisheng Treating Chronic Liver Disease withFour Methods in Dispersing Blood Stasis

作　　者：甘雨晴 谢家诚 魏文悦 韦沅汛 罗伟生 GAN Yuqing;XIE Jiacheng;WEI Wenyue;WEI Yuanxun;LUO Weisheng(Guangxi University of Chinese Medicine,Nanning Guangxi China 530001;Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning Guangxi China 530000)

机构地区：[1]广西中医药大学,广西南宁530001 [2]广西中医药大学附属瑞康医院,广西南宁530000

出　　处：《中医学报》2024年第4期782-786,共5页Acta Chinese Medicine

基　　金：全国名老中医药专家传承工作室建设项目{国中医药人教函[20212]75号};广西名中医传承工作室建设项目{桂中医药科教发[2021]6号}。

摘　　要：肝郁是慢性肝病发病的始动因素,脾胃虚弱是慢性肝病发展的根本原因,气虚血瘀,痰瘀阻络是慢性肝病的重要病理过程。辨治慢性肝病要遵循健脾益气、补气生血、补血活血的法则,同时不忘疏肝利胆、利湿祛痰。故基于“因虚致瘀”理论提出化瘀四法,即补气健脾、活血散瘀法适用于慢性肝病之气虚血瘀证;疏肝行气、祛痰通络法适用于气滞血瘀、痰瘀阻络证;养血活血化瘀法适用于慢性肝病之气血不足、瘀血阻络证;软坚消癥化瘀法主要用于重度肝纤维化、肝硬化结节、肝脾肿大、肝内胆汁淤积、肝癌等慢性肝病患者。临证根据慢性肝病的症状体征及病因病机,随症加减药物,创立八珍荔核抗纤方。Chronic Liver disease has a hidden onset,a long course,being lingering and difficult to be cure.Liver Qi depression is the initiating factor of the onset of chronic Liver disease,and Spleen and Stomach weakness is the fundamental cause of the development of chronic Liver disease.Qi deficiency,blood stasis,Phlegm and blood stasis blocking the meridian are important pathological processes of chronic Liver disease.The differentiation and treatment of chronic Liver disease should follow the principles of invigorating the Spleen and Qi,supplementing Qi and blood as well as promoting blood circulation.At the same time,we should not forget to soothe the Liver Qi,promote gallbladder function as well as relieve Dampness and Phlegm.Therefore,based on the theory of blood stasis due to deficiency",the four methods in resolving blood stasis are proposed.Specifically,the methods of tonifying Qi and strengthening Spleen,promoting blood circulation and dispersing blood stasis are suitable for the Qi deficiency and blood stasis syndrome of chronic Liver disease.The method of soothing the Liver and promoting Qi as well as dispelling Phlegm and unblocking collateral are suitable for Qi stagnation and blood stasis as well as Phlegm stasis obstructing collateral.The method of nourishing blood,promoting blood circulation and removing blood stasis are applicable to the syndrome of insufficient Qi and blood as well as stasis and obstruction of collateral in chronic Liver disease;The method of softening and eliminating lump and removing blood stasis are mainly used in patients with chronic Liver diseases of severe liver fibrosis,liver cirrhosis nodules,hepatosplenomegaly,intrahepatic cholestasis,and liver cancer.According to the symptoms,signs,etiology,and pathogenesis of chronic Liver disease,modified Bazhen Lihe Kangxian Formula is applied.

关 键 词：慢性肝病 “化瘀四法” 八珍荔核抗纤方 罗伟生 

分 类 号：R249.27[医药卫生—中医临床基础]