杨叔禹教授应用泽泻汤加味治疗非酒精性脂肪肝临证经验  

Professor Yang Shuyu s Experience in Treating Non-alcoholic Fatty Liver with Zexie Decoction

作　　者：曾华蓉 柯志福 黄晓晴 杨叔禹(指导)[2] ZENG Huarong;KE Zhifu;HUANG Xiaoqing;YANG Shuyu(Xiamen Hospital Affiliated to Beijing University of Traditional Chinese Medicine,Xiamen 361000,China;The Fist Affiliated Hospital of Xiamen University,Xiamen 361000,China)

机构地区：[1]北京中医药大学附属厦门医院,福建厦门361000 [2]厦门大学附属第一医院,福建厦门361000

出　　处：《中国民族民间医药》2024年第13期76-79,107,共5页Chinese Journal of Ethnomedicine and Ethnopharmacy

基　　金：厦门市中医后备人才培养项目(编号:厦卫中医〔2022〕136号)。

摘　　要：结合现代社会“精神压抑、营养充溢、少动多逸”的普遍现象,杨叔禹教授认为非酒精性脂肪肝(NAFLD)的发生、发展与肝失疏泄、脾胃升清降浊功能失调、肾精不足有关。肝郁气滞,肝疏泄失常,导致脾失健运,津液、气血运化失司,日久肾精不足无以涵养肝血,痰湿、瘀血等病理产物留滞,积聚于肝而形成NAFLD。治疗上以泽泻汤为基础创制泽泻汤加味(院内制剂平堂5号胶囊)治疗NAFLD,方中以白术补脾,首乌补肝肾,大黄散瘀,山楂散积,泽泻散湿,有补有散,既能健脾渗湿,化痰活血,又可补肾养肝,可针对病机而治疗NAFLD,临床上取得良好的疗效。现代药理学亦证实泽泻汤加味可通过缓解NAFLD的“二次打击”治疗NAFLD。Combined with the modern society“mental depression,nutrition,less movement and more escape”common phenomenon,Professor Yang Shuyu believes that the occurrence and development of non-alcoholic fatty liver(NAFLD)is related to abnormal liver drainage,dysfunction of spleen and stomach in ascending and descending turbidity,and kidney essence deficiency.Liver stagnation of qi and abnormal liver drainage lead to dysfunction of the spleen in transport,body fluid,qi and blood transport transport disorder,the insufficiency of kidney essence over time can t nourish liver blood,and the stagnation of phlegm,blood stasis and other pathological products accumulate in the liver and form NAFLD.On the basis of Zexie Decoction to create Zexie Decoction Flavor(hospital preparation Pingtang No.5 Capsule)to treat NAFLD.In this prescription,Baizhu(Atractylodes)tonifying the spleen,Shouwu(Fleece-flower root)tonifying the liver and kidney,Dahuang(Rhubarb)dispersing blood stasis,Shanzha(Hawthorn)removing retention,Zexie(Rhizoma alismatis)purging and removing dampness.This prescription has the effect of supplementing and expelling,it can not only strengthen the spleen and exhalate dampness,relieve phlegm and promote blood circulation,but also tonify the kidney and liver,which can treat NAFLD according to the pathogenesis.Good clinical effect has been obtained.Modern pharmacology also confirmed that Zexie Decoction can treat NAFLD by alleviating the“two-hit”of NAFLD.

关 键 词：非酒精性脂肪肝 泽泻汤加味 名医经验 杨叔禹 

分 类 号：R249.2[医药卫生—中医临床基础] R249.7[医药卫生—中医学]