基于“肝脾同调”阐析慢性肝病的中医治疗  

TCM Treatment of Chronic Liver Diseases Based on the Principle of Simultaneous Regulation of Liver and Spleen

作　　者：叶永安[1,2] 靳茜 李小科[1,2] 杜宏波[1,2] YE Yong′an;JIN Qian;LI Xiaoke;DU Hongbo(Department of Digestive Diseases,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Liver Diseases Academy of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院脾胃病科,北京100700 [2]北京中医药大学中医肝病研究院,北京100700

出　　处：《世界中医药》2024年第5期652-655,共4页World Chinese Medicine

基　　金：国家科技攻关计划项目(2004BA721A03);国家科技重大专项(2012ZX10005004,2008ZX10005006)。

摘　　要：慢性肝病是临床常见疾病,“郁、虚、湿、毒、瘀”是其核心病机,在疾病的不同阶段各有侧重,其中,以“郁、虚”为核心的肝脾失调是慢性肝病发生发展的关键。“肝脾同调”是治疗慢性肝病的基本治法,在慢性肝病不同阶段,其“肝脾同调”内涵同中有异。根据肝、脾生理病理特性,治脾明辨虚实,厘清轻重,活用运脾、健脾、温脾、醒脾、补脾等法;调肝体用并重,精准辨证,活用疏肝、缓肝、散肝、柔肝等法。临床上,治脾与调肝相辅相成,治调并举,常获良效。Chronic liver diseases are common in clinical practice,with depression,deficiency,dampness,toxin,and stasis as the core pathogenesis,which are presented at different disease stages.The liver and spleen disorder with depression and deficiency as the core is the key to the occurrence and development of chronic liver diseases.Accordingly,the simultaneous regulation of liver and spleen is the basic principle of treating chronic liver diseases.The connotation of this principle is different at different disease stages.According to the physiological and pathological characteristics of the liver and spleen,the treatment of the spleen should be based on the differentiation between deficiency and excess,and methods of activating,invigorating,warming,enlivening,and tonifying should be adopted flexibly.Similarly,the treatment of the liver should also be based on syndrome differentiation with emphasis on both liver property and function,with flexible adoption of soothing,relaxing,dispersing,and emolliating methods.In the clinical practice,the treatments of spleen and liver are not isolated but complementary to each other.The principle of simultaneously regulating the spleen and liver has been proven effective in treating chronic liver diseases.

关 键 词：慢性肝病 核心病机 郁 虚 肝脾同病 肝脾同调 治脾调肝 中医治疗 

分 类 号：R256.4[医药卫生—中医内科学]