基于“虚气留滞”理论探讨女性绝经后非酒精性脂肪性肝病的病机及治疗  

Discussion on the pathogenesis and treatment of non-alcoholic fatty liver disease in postmenopausal women based on the theory of"deficient qi and stagnation"

作　　者：徐铭窈 苏文渊 吴静 贺佳文 张皓薇 李金娟 岳嘉 张艳 XU Mingyao;SU Wenyuan;WU Jing;HE Jiawen;ZHANG Haowei;LI Jinjuan;YUE Jia;ZHANG Yan(Basic College of Gansu University of Chinese Medicine,Lanzhou 730000,China;School of Public Health of Gansu University of Chinese Medicine,Lanzhou 730000,China;Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]甘肃中医药大学基础医学院,兰州730000 [2]甘肃中医药大学公共卫生学院 [3]南京中医药大学附属医院

出　　处：《北京中医药大学学报》2024年第12期1745-1752,共8页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(No.82160831);中医学一级学科开放基金项目(No.301/3016190123)。

摘　　要：非酒精性脂肪性肝病是临床上常见的慢性肝病,近年来,随着社会对女性和老年群体健康的关注增加,女性绝经后非酒精性脂肪性肝病的防治日益成为代谢性疾病的研究热点。本文基于“虚气留滞”理论,结合女性绝经后生理病理特点和对非酒精性脂肪性肝病的西医学认识,探讨女性绝经后非酒精性脂肪性肝病的病机和治疗方法。本团队认为,女性绝经后非酒精性脂肪性肝病的病机以肝肾精血亏虚的“虚气”为本,以“虚气”所致的肝体用失衡为要,以痰瘀内积的“留滞”为标,同时,“虚气”与“留滞”互为因果,由虚而滞,因滞更虚,进而加速病情发展。治疗当采用补虚通滞、标本兼顾之法,针对女性“以肝为先天”的特点和女性绝经后“肾精渐衰”的生理状态,在行气化痰、活血化瘀的同时,注重滋补肝肾,养肝体以疏肝用,从而减少肝脏的脂质蓄积,为中医药治疗女性绝经后非酒精性脂肪性肝病提供新的视角与思路。Non-alcoholic fatty liver disease is a common chronic liver disease in clinical practice.In recent years,with increasing social attention to the health of women and the elderly,the prevention and treatment of non-alcoholic fatty liver disease after menopause has increasingly become a research hotspot in metabolic diseases.This study explores the pathogenesis and treatment method of non-alcoholic fatty liver disease in postmenopausal women based on the theory of"deficient qi and stagnation"and combined with the physiological and pathological characteristics of postmenopausal women and the Western medicine understanding of non-alcoholic fatty liver disease.We believe that the pathogenesis of nonalcoholic fatty liver disease in postmenopausal women is rooted in the"deficient qi"caused by depletion of liver and kidney essence and blood.The imbalance between the physical and functional aspects of the liver due to this"deficient qi"is the primary factor,while the"stagnation"of phlegm and blood stasis is the manifestation.Furthermore,the"deficient qi"and"stagnation"reinforce each other,with the deficiency leading to stagnation and stagnation exacerbating the deficiency,thus accelerating the progression of the disease.The treatment approach should be one that combines nourishing deficiency and resolving stagnation,addressing both root cause and maifestations.Given the female characteristic of"the liver as the innate organ"and the post-menopausal physiological state of"gradual decline of kidney essence",it is important to focus on nourishing the liver and kidneys,nurturing the liver′s physical body while maintaining its function,and also promoting the circulation of qi,resolving phlegm,and invigorating blood circulation to remove blood stasis.This approach aims to reduce the accumulation of lipids in the liver,offering a new perspective and approach for the treatment of non-alcoholic fatty liver disease in post-menopausal women with traditional Chinese medicine.

关 键 词：非酒精性脂肪性肝病 虚气留滞 女性 绝经后 补虚通滞 

分 类 号：R259[医药卫生—中西医结合]