三焦气化理论在肥胖症中的临床运用  

Clinical application of Sanjiao Qi transformation theory in obesity

作　　者：李雅莉 郭晓霞[2] 李燕[2] LI Yali;GUO Xiaoxia;LI Yan

机构地区：[1]山西中医药大学,山西太原030024 [2]山西省中医院,山西太原030012

出　　处：《中医临床研究》2024年第24期127-131,共5页Clinical Journal Of Chinese Medicine

基　　金：山西省中医药管理局项目:基于病证结合探究单纯性肥胖湿证不同脏腑病位的代谢组学特征(2023ZYYA006);山西省中医药管理局项目:柴胡加龙骨牡蛎汤联合穴位埋线治疗单纯性肥胖的临床研究(2022ZYYZ005)。

摘　　要：随着人民生活水平的提高,肥胖症的患病人数逐年增多,中国肥胖总人数高居世界第一,如何有效治疗肥胖症已成为不可忽视的问题。肥胖症病因复杂,涉及人体多个脏腑。中医认为其发病不离痰、湿、瘀等病理因素,治疗上多从脾、从肝、从肾论治,或侧重于痰浊、水湿、瘀血等,但皆不够全面。三焦是人体上焦、中焦、下焦的合称,其贯通人体上下、内外,调控全身之气机,并总领五脏六腑发挥其生理功能,在输布水谷精微、调节水液方面起着协调平衡的作用,是气、血、津液正常运行的重要通道。三焦气化通利则能使气血调和,生化有源,水液代谢平衡,上通下达有序。若三焦气化不利,气、血、津液循行异常,水谷精微不能归于正途,则水液代谢紊乱,产生水湿、痰浊、瘀血等多种病理产物,最终导致肥胖症。因此,恢复三焦气化升降有序在本病的治疗中具有重要意义。而肝胆、三焦同属少阳,肝胆以疏泄为用,共为升降之枢。少阳枢转通畅,则肝胆疏泄正常,三焦气机升降相因,阴阳平衡,脏腑调和,三焦调畅。人体气机和正常输布津液都需在少阳为枢的协调下顺利进行,二者共调气机升降、水液代谢,以维持诸脏功能正常。柴胡加龙骨牡蛎汤是临床通利三焦,调畅少阳枢机的常用方剂,有助于调畅枢机,平衡气血,推动三焦气化,为肥胖症的整体治疗提供了新的思路。With the improvement of people’s living standards,the number of people suffering from obesity is increasing year by year,and the total number of obese people in China ranks first in the world.How to effectively treat obesity has become a problem that can not be ignored.The cause of obesity is complex,involving a number of organs in the human body.Chinese medicine believes that its pathogenesis is not separated from phlegm,dampness,blood stasis and other pathological factors,and treatment from the spleen,treatment from the liver,treatment from the kidneys,or treatment focuses on phlegm,water dampness,and blood stasis,are not comprehensive.Sanjiao(三焦)is the collective name of the body’s epiglottis,mesoglottis,hypoglottis,which passes through the body up and down,inside and outside,regulating the whole body’s Qi(气),leading the five viscera and six fu-organs to play its physiological functions in the transmission of water and grain essence,and regulating the water and fluid to play a coordinated and balanced role,and it is an important channel of the normal operation of Qi,blood and body fluid.Favorable Sanjiao gasification can bring the harmony of Qi and blood,sufficient source of the generation and transformation,water metabolism balance,orderly ascending and descending.If Sanjiao gasification is unfavorable,there will be abnormal Qi,blood and fluid circulation,water and grain essence can not be returned to the right way,the water metabolism is disordered,resulting in water-dampness,phlegm,blood stasis and other pathological products,ultimately leading to obesity.Therefore,restoring the orderly Sanjiao gasification is of great significance in the treatment of this disease.Liver,gallbladder and Sanjiao belong to the Shaoyang(少阳)meridian,liver and gallbladder are used for evacuation,and together they are the pivot of elevation.If Shaoyang pivot is smooth,the liver and gallbladder excretion will be normal,Sanjiao gasification is due to the balance of Yin(阴)and Yang(阳),and the harmony of viscera and

关 键 词：三焦气化 肥胖症 柴胡加龙骨牡蛎汤 

分 类 号：R277[医药卫生—中医学]