中医学和民族医学中肝热与肝病的辨析及证治  

Differentiation and Syndrome-treatment of Liver Heat and Liver Disease in Traditional Chinese Medicine and Ethnomedicine

作　　者：陈江凤 郭敏 魏赛雪[1] 杨焕 李晓东 CHEN Jiangfeng;GUO Min;WEI Saixue;YANG Huan;LI Xiaodong(School of Pharmacy,Gansu University of Chinese Medicine,Lanzhou 730010,China;Institute of Chinese Materia Medica,Gansu Provincial Hospital of Traditional Chinese Medicine(TCM),Lanzhou 730050,China;Professional Technical Center for Secondary Exploitation and Clinical Evaluation ofLongyao Large Varieties,Gansu Academy of TCM,Lanzhou 730050,China)

机构地区：[1]甘肃中医药大学药学院,兰州730010 [2]甘肃省中医院中药研究所,兰州730050 [3]甘肃省中医药研究院陇药大品种二次开发及临床疗效评价行业技术中心,兰州730050

出　　处：《中国实验方剂学杂志》2025年第8期218-227,共10页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(82160818);甘肃省自然科学基金项目(22JR5RA622)。

摘　　要：“肝热”作为中国各传统医学治疗阶段的核心病机之一,贯穿肝病不同阶段,但在各医学(中医学、藏族医学、蒙医学、维吾尔族医学、傣族医学、瑶族医学等)中对肝热的认识都未有统一的定论,对其的含义阐释存在同名异义、混淆挪用现象,严重制约着中医药和民族医药的传承创新和临床应用。通过对“肝热”的溯源和辨析,中医学之“肝热”因作息无序、饮食失常、内伤七情等因素致使肝失疏泄,气机郁结,肝经郁热化火;藏族医学之“肝热”因肝本性为热,内藏邪热,激发赤巴热毒,日久而成;蒙医学之“肝热”因饮食作息失常致希拉偏盛蕴结于肝而病;此三者病因上均与饮食、作息、外邪、情志等因素相关,病机上均与体内气机失调、脏腑代谢功能紊乱有关,临床症状上均有肝区疼痛、目黄身黄、发热口苦、纳呆食少等症状,治则治法和方药配伍上以清热为主,解毒为辅。其他民族医学,如维吾尔族医学、傣族医学、瑶族医学、苗族医学、畲族医学等均未有明确“肝热”论述,其病因病机、治则治法、方药诊治不成体系,多以单药或验方为主。该文从对我国现有文献信息数据库“肝热”文献的系统追溯、挖掘归纳及分析整理,以证为纲,以病为目,厘清了我国传统医学对“肝热”的病机异同,明晰了肝热与肝病的证病关联和证治现状,为肝病临床防治和药物开发提供证据和参考。As one of the core pathogenesis during treatment with traditional Chinese medicine,liver heat runs through different stages of liver disease.The interpretation of its meaning in different medicine categories(traditional Chinese medicine,Tibetan medicine,Mongolian medicine,Uygur medicine,Dai medicine,Yao medicine,etc.)is not unified,and the phenomena of the same name with different meanings,confusion,and misappropriation emerge.This seriously restricts the inheritance,innovation,and clinical application of traditional Chinese medicine and ethnomedicine.By tracing and analyzing liver heat,it is found that liver heat in traditional Chinese medicine is caused by disordered rest and diet,as well as internal injury due to emotional disorder,which leads to liver dysfunction,Qi stagnation,and heat turning to fire in the liver meridian.The liver heat in Tibetan medicine is caused by the accumulated heat of the liver nature and the evil heat in the liver,which stimulates the toxin of Chiba fever.The liver heat in Mongolian medicine derives from the abnormal diet and rest,making excessive Sheila accumulate in the liver and causing disease.The above etiologies are all related to diet,rest,exogenous evil,emotion,and so on,and the pathogenesis is related to the imbalance of Qi and the metabolic disorder of organs.The clinical symptoms are pain in the liver region,yellow eyes,bitter mouth,fever,digestion,and loss of appetite.The principle of treatment and compatibility of prescription are heat based,with auxiliary detoxification.Other ethnomedicine,such as Uygur medicine,Dai medicine,Yao Medicine,Miao medicine,and She medicine do not have a clear discussion on liver heat,and their etiology,pathogenesis,treatment,and prescription are not systematic,mostly based on a single drug or proven prescriptions.Through the systematic tracing,mining,induction,analysis,and arrangement of the liver heat based on existing literature information database in China,this paper regarded syndrome as the outline and disease as the goal,clarified the

关 键 词：肝热 肝病 中医学 民族医学 证病辨析 

分 类 号：R259[医药卫生—中西医结合] R287[医药卫生—中医内科学] R575[医药卫生—中医学]