基于膏浊致病理论从三焦疏泄与淋巴管关系论治肥胖

Treating Obesity from Relationship between Sanjiao Discharge and Lymphatic Vessels Based on Gaozhuo Inducing Disease Theory

"膏浊"由摄入人体内的水谷精微所化生,三焦通利,气机顺畅,津液输布正常时,"膏浊"是维持人体正常生理活动所必需物质。若三焦疏泄失常,气血津液失司,生理之"膏浊"则变为"膏邪"(即体内过剩脂肪)与"浊邪"(即血糖、血脂、尿酸等异常)而产生肥胖,因此临床治疗肥胖常采用通利三焦之药,通过消膏化浊之法将"膏邪""浊邪"转化与排泄,并能取得良好效果。现代医学研究证实淋巴管功能障碍同样会导致肥胖的发生,并且现代医学中淋巴管系统与中医学中的"三焦"在解剖位置以及生理功能方面都密切相关。然而通利三焦之药是如何使脂肪转化与分解、是否与恢复淋巴管功能密切相关至今未见报道。研究"通利三焦之药"对人体的作用机制及作用途径,可为膏浊病的生理病理基础及理论内涵赋予新的含义,并为中医药治疗单纯性肥胖症的靶点研究提供新的理论依据。

"Gaozhuo"is derived from the ingestion of the water and food.The function of Sanjiao is normal and so the Qi movement is normal.When the body fluid is transported normally,"Gaozhuo"is a necessary substance for maintaining normal physiological activities of the human body.If Sanjiao function is abnormal,the Qi and blood fluids are lost,and the physiological"Gaozhuo"becomes"Gaoxie"(that is,excess fat in the body)and"Zhuoxie"(ie,abnormal blood sugar,blood lipids,and uric acid),resulting in obesity.Clinical treatment of obesity often uses drugs for dredging Sanjiao,which can transform and excrete"Gaoxie"and"Zhuoxie"and can achieve good results.Modern medical research has confirmed that lymphatic dysfunction also leads to obesity,and in modern medicine,the lymphatic system and Sanjiao in traditional Chinese medicine are closely related in anatomical location and physiological function.However,how the drugs for dredging Sanjiao is closely related to how to convert and decompose fat and restore lymphatic function has not been reported so far.Studying the mechanism and action pathway of drugs for dredging Sanjiao on the human body can give new meaning to the physiological and pathological basis and theoretical connotation of ointment,and provide new research for the target research of traditional Chinese medicine for treating simple obesity.