基于“脾升胃降”理论辨治脂浊病  

Differentiation and Treatment of Lipid Turbidity Disease Based on Theory of"Spleen Ascending and Stomach Descending"

作　　者：黄韵 朱文宇 宋玮 张小波 周昕[2] 杨乐乐 沈涛[2] HUANG Yun;ZHU Wenyu;SONG Wei;ZHANG Xiaobo;ZHOU Xin;YANG Lele;SHEN Tao(Hospital of Chengdu University of Traditional Chinese Medicine(TCM),Chengdu 610072,China;Chengdu University of TCM,Chengdu 610075,China)

机构地区：[1]成都中医药大学附属医院,成都610072 [2]成都中医药大学,成都610075

出　　处：《中国实验方剂学杂志》2025年第3期244-252,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金面上项目(81973743,82374331);四川省科技厅重点研发项目(2022YFS0381)。

摘　　要：脂浊病是由社会环境、饮食、生活方式等多因素引起脂质代谢紊乱的一种代谢性疾病,与现代医学中的多种疾病,如高脂血症、肥胖症、脂肪肝、动脉粥样硬化、代谢综合征、心脑血管疾病密切相关,影响范围大,危害深远。通过《黄帝内经》可知,脂浊病是人体生理性膏脂的病理改变。膏脂是津液中质地偏于稠厚的部分,具有滋润濡养的作用,是脑、髓、精、血等人体重要物质的初始状态与来源。一旦人体的膏脂发生异常,就会形成脂浊病。《黄帝内经》又指出人体津液运化转输与脾胃升降的生理性联系,可以推导出脂浊病的产生与脾胃功能升降失常之间的病理关系。脂浊病是过食肥甘厚味或脾胃禀赋不足,导致脾胃升清降浊失职,引起人体津液中偏稠厚的膏脂异化为脂浊,滞留于人体经络血脉、皮肤腠理及脏腑之中,形成表现形式多样的代谢性疾病。课题组认为“脾升胃降失常,膏脂转输障碍”是脂浊病的病理基础,根据脂浊停留部位不同,分为“清浊相干,浊滞营血”“脾不升清,浊伏脉道”“脾失运化,脂留腠理”“脾失转输,膏聚肝脏”4种常见病机类型。根据病机特点分为浊滞营血型、浊伏脉道型、脂溢腠理型、膏脂聚肝型4种常见证候分型,并给予相应方药辨证论治,以期对临床辨治脂浊病有一定的指导价值。Lipid turbidity disease is a metabolic disease featuring lipid metabolism disorders caused by many factors such as social environment,diet,and lifestyle,which is closely related to many diseases in modern medicine,such as hyperlipidemia,obesity,fatty liver,atherosclerosis,metabolic syndrome,and cardiovascular and cerebrovascular diseases,with a wide range of influence and far-reaching harm.According to the Huangdi Neijing,lipid turbidity disease reflects the pathological change of the body's physiologic grease.Grease is the thick part of body fluids,which has the function of nourishing,and it is the initial state and source of important substances in the human body such as brain,marrow,essence,and blood.Once the grease of the human body is abnormal,it can lead to lipid turbidity disease.The Huangdi Neijing also points out the physiological relationship between the transportation and transformation of body fluids and the rise and fall of the spleen and stomach,which can deduce the pathological relationship between the occurrence of lipid turbidity disease and the abnormal rise and fall of the spleen and stomach functions.Lipid turbidity disease is caused by overconsumption of fatty and sweet foods or insufficient spleen and stomach endowments,leading to disorders of the function of promoting clear and reducing turbidity in the spleen and stomach.This leads to the transformation of thick grease in body fluids into lipid turbidity,which accumulates in the body's meridians,blood vessels,skin pores,and organs,forming various forms of metabolic diseases.The research team believed that the pathological basis of lipid turbidity disease was the abnormal rise and fall of the spleen and stomach and the obstruction of the transfer of grease.According to the different locations where lipid turbidity stays,it was divided into four common pathogenesis types:"inability to distinguish between the clear and turbid,turbid stagnation in the Ying blood","spleen not rising clear,turbid accumulation in the vessels","spleen dysfunction,

关 键 词：脂浊病 脾升胃降 病理生理 病因病机 辨证分型 

分 类 号：R256[医药卫生—中医内科学] R287[医药卫生—中医学] R589