脂肪肝病机的“六郁”观

“Six-type stagnation”in the pathogenesis of fatty liver

脂肪肝的发生与中医肝脾肾密切相关,主要因肝失疏泄、脾失健运、肾失气化,致使湿、痰、瘀等多重病理因素相互搏结而成。六郁学说奠基于《黄帝内经》五郁之论,源始于《丹溪心法》六郁之称,发展于献可《医贯》相因为病。"气郁""食郁""湿郁""火郁""痰郁""血郁"之六郁,始以"气郁"为先导,交错贯穿于脂肪肝发病始终,在治疗上应以"调畅气机"为要,"顾护脾胃"为本。文章以"六郁学说"为出发点,对脂肪肝的病机进行深入探讨,从而为临证治疗本病提供理论依据。

The occurrence of fatty liver is closely related to the liver,spleen and kidney in TCM.The liver dys-function in maintaining the free flow of qi,the spleen dysfunction in transportation and transformation and the kidney dys-function in qi activity result in the interaction of many pathological factors such as damp,phlegm and stasis.The six-type stagnation is based on the five-type stagnation in Huangdi neijing,originated from Danxi xinfa and developed in Yiguan.Qi stagnation,food retention,damp retention,fire accumulation and phlegm accumulation are the six types of stagnation,of which,qi stagnation is predominated and exists in the development of fatty liver.In treatment,the key principle is regulating qi activity and the root is protecting the spleen and stomach.In the paper,focusing on the doctrine of six types of stagna-tion,the pathogenesis of fatty liver was explored so as to provide the theoretic evidence for the clinical treatment.