从脾脏与三焦腑论治单纯性肥胖症

Treatment of Simple Obesity from Spleen and Sanjiao Fu

目的阐明单纯性肥胖症的治疗应以脾脏与“三焦腑”为核心,为临床治疗单纯性肥胖症提供理论依据。方法以临床实践为基础,结合古代文献对肥胖、脾脏、“三焦腑”的论述分析单纯性肥胖症的病因病机,进而阐明其理论基础。结果单纯性肥胖症虽然具有遗传易感性(即先天禀赋),但现代社会生活方式的特点决定了发生肥胖的病因应主要为饮食不节,过度安逸,情志失调。病位在脾与“三焦腑”,证属本虚标实,虚实夹杂。脾气亏虚为其始动因素,脾失健运,“三焦腑道”不畅,气化失常为其中心环节。其中脾失健运包括脾气亏虚和痰湿困脾所致之健运失常;“三焦腑道”不畅,气化失常是指:①三焦为六腑之一,具有传化物而不藏,实而不能满的特点;②三焦为水液运行的通道;③三焦为精微布散的通道;④三焦为原气运行的通道,主持诸气;⑤三焦为水液气化的场所等一系列的生理功能失常。痰湿、气滞、瘀血、郁热为脾与“三焦腑”失常的主要病理产物。脾与“三焦腑”又互相影响,终致痰湿困脾,水停三焦,气机郁滞,气郁化火,精微不布,化为脂膏为其病理改变,贯穿着单纯性肥胖症发病的始终。结论单纯性肥胖症从脾脏与“三焦腑”论治有坚实的理论基础。

Objective To clarify to spleen and the sanjiao fu as the core, and to provide a theoretical basis for the clinical treatment of simple obesity.Methods Based on clinical practice, the combination of ancient literature on obesity, spleen, sanjiao fu discusses the etiology and pathogenesis of simple obesity, and to clarify the theoretical basis.Results Simple obesity has genetic susceptibility (i.e.congenital), but the characteristics of modern social life determines the cause of obesity should be mainly for improper diet, excessive comfort, emotional disorders.The disease of the spleen and the sanjiao fu, this standard is false, false is mixed.As the key factor of spleen deficiency, spleen, sanjiao fu can not be free, as the central link in gasification.The splenism including spleen deficiency and phlegm dampness caused by spleen health movement disorders,"the road is not smooth, the sanjiao fu" refers to the disorder of qi jiao is one of the six fu organs, with no hidden objects and not full biography, the characteristics of the liquid water;jiao is running for the triple channel;all the micro channel, the original triple as the running channel, the host gas;physiological function of the triple energizer arrhythmia a series of liquid water gasification places etc..Phlegm, qi stagnation, blood stasis, heat is the main pathological product of spleen and sanjiao fu.The sanjiao fu spleen and influence each other, finally trapped spleen phlegm, water stop triple burner, qi stagnation, qi fire, subtle not cloth of grease for its pathological changes, always runs through the incidence of simple obesity.Conclusion Simple obesity from the spleen and the sanjiao fu of governance, there is a solid theoretical basis.