从“肝与大肠相通”理论辨治代谢相关脂肪性肝病的应用与中医实践  

Application and TCM Practice of Differentiation and Treatment of Metabolism-related Fatty Liver Disease from the Theory of"Connection between Liver and Large intestine

作　　者：陶飞宝[1] 施维群 TAO Feibao;SHI Weiqun(Jinhua Central Hospital,Jinhua,Zhejiang 321000;National Famous Traditional Chinese Medicine Expert Inheritance Studio,Hangzhou,Zhejiang 310005)

机构地区：[1]金华市中心医院,浙江金华321000 [2]施维群全国名老中医药专家传承工作室,浙江杭州310005

出　　处：《内蒙古中医药》2024年第5期96-99,共4页Inner Mongolia Journal of Traditional Chinese Medicine

基　　金：施维群全国名老中医药专家传承工作室(国中医药人教函[2022]75号);浙江省中青年名中医培养项目(浙中医药[2021]22号);浙江省中医药科技计划项目(2024ZL1181)。

摘　　要：代谢相关脂肪性肝病(MAFLD)是一种除酒精或其他明确肝损伤因素导致的肝脏病理综合征,随着近年饮食及生活习惯的改变,MAFLD的流行率以前所未有的速度上升,已成为我国慢性肝病及肝酶异常的第一大原因。MAFLD具有起病隐匿、发病率高及肝外不良影响等特点,发病与胰岛素抵抗、脂质代谢紊乱等因素密切相关。中医学将MAFLD命名为“肝癖”,认为因肝体用失调、脾肾亏虚等,最终出现痰瘀互结,阻滞肝脏经络最终导致MAFLD。“肝与大肠相通”理论是目前治疗MAFLD的新思路,通畅肠腑、降浊升清,可协调肠腑、肝脏气机,从而辅助提高MAFLD治疗效果。遂从“肝与大肠相通”理论的内涵、应用及医案举例等入手,剖析“肝与大肠相通”理论,为临床治疗MAFLD提供一种新的治疗思路。Metabolic fatty liver disease(MAFLD)is a kind of liver pathological syndrome caused by alcohol or other definite liver injury factors.With the change of diet and living habits in recent years,the prevalence of MAFLD has increased at an unprecedented rate,and has become the first major cause of chronic liver disease and abnormal liver enzymes in China.MAFLD has the characteristics of concealed onset.high incidence and extrahepatic adverse effects,which is closely related to insulin resistance,lipid metabolism disorder and other factors.In traditional Chinese medicine,MAFLD is named"liver fetish".It is believed that due to the imbalance of liver body use,spleen and kidney deficiency and so on,phlegm and blood stasis eventually appear and block liver meridians and collaterals finally lead to MAFLD.The theory of"communication between liver and large intestine"is a new idea for the treatment of MAFLD at present,which can unobstruct intestinal viscera,decrease turbid and ascend clear,coordinate intestinal viscera and liver qi,thus assist to improve the therapeutic effect of MAFLD.Therefore,starting with the connotation,application and medical examples of the theory of"communication between liver and large intestine",this paper analyzes the theory of"communication between liver and large intestine",so as to provide a new treatment idea for clinical treatmentof MAFLD.

关 键 词：“肝与大肠相通”理论 辨治 代谢相关脂肪性肝病 应用 中医实践 

分 类 号：R229[医药卫生—中医基础理论]