从脂质蓄积与“痰浊”论治非酒精性脂肪性肝病  

Treatment of Non-alcoholic Fatty Liver Disease from Perspective of Lipid Accumulation and"Phlegm and Turbidity"

作　　者：赵洁[1] 丁睿哲 丁婧 肖准[2] 张振强[1] 张效威 谢治深 徐江雁[1] ZHAO Jie;DING Ruizhe;DING Jing;XIAO Zhun;ZHANG zhenqiang;ZHANG Xiaowei;XIE Zhishen;XU Jiangyan(Henan University of Chinese Medicine,Zhengzhou Henan China 450046;The First Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450046)

机构地区：[1]河南中医药大学,河南郑州450046 [2]河南中医药大学第一附属医院,河南郑州450000

出　　处：《中医学报》2024年第10期2076-2080,共5页Acta Chinese Medicine

基　　金：国家自然科学基金项目(82174267);河南省中医药科学研究专项课题-重大项目(2023ZYZD15);河南省高校科技创新人才支持计划项目(22HASTIT048)。

摘　　要：中医学认为“肝失疏泄,脾失健运,痰浊聚积于肝”为非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)的核心病机,“痰浊”是NAFLD关键的病理因素。现代医学认为“肝内脂质沉积”为NAFLD病理关键,也是促进疾病进展的重要因素。“痰浊”与脂质蓄积常见于痰湿体质者,二者均具有黏滞、易聚集的特性,同时作为病理产物又加剧了NAFLD疾病发展,故脂质蓄积可能是“痰浊”的现代生物学基础之一。NAFLD病机复杂,虚实并存,临证需注重病机走向,谨防兼证、变证出现,治以虚实同调,以健脾祛湿化痰为要,临证选用泽泻汤加味以健脾祛湿,化痰散瘀。In traditional Chinese medicine,it is believed that"Liver Qi dispersing dysfunction and Spleen weakness induced Turbidity accumulating in the Liver"is the core pathogenesis of nonalcoholic fatty liver disease(NAFLD),in which"Phlegm and Turbidity"is the key pathological factor of NAFLD.In modern medicine it is believed that"intrahepatic lipid deposition"is the key to the pathology of NAFLD and an important factor in promoting disease progression."Phlegm and Turbidity"and lipid accumulation are common in patients with Phlegm and Dampness constitution,both of which have the characteristics of stickiness and easy aggregation,and at the same time,as pathological products,they aggravate the development of NAFLD disease,so lipid accumulation may be one of the modern biological bases of"Phlegm and Turbidity".The pathogenesis of NAFLD is complex with deficiency and excess syndromes.Therefore,in clinical practice,the pathogenesis trend should be paid attention to and the appearance of concurrent syndrome and changed syndrome should be guarded against.By regulating the conditions of deficiency and excess at the same time,the Spleen should be strengthened,the Dampness should be dispelled,and the Phlegm should be dissolved.Modified Zexie Decoction can achieve the clinical efficacy.

关 键 词：非酒精性脂肪性肝病 痰浊 脂质蓄积 健脾祛湿化痰 泽泻汤加味 痰湿体质 

分 类 号：R259.75[医药卫生—中西医结合]