基于络病理论探讨肝纤维化病机与治疗

Discussion on pathogenesis and treatment of hepatic fibrosis based on collateral disease theory

肝纤维化是多种慢性肝病发展为肝硬化甚至肝癌的关键病理过程。中医药在抗肝纤维化过程中发挥了重要的作用。文章基于对络病理论的认识,认为肝纤维化病机是经络气虚为本,脉络瘀滞为标。治疗当以通为用,予辛味虫蚁通络与补虚通络相结合,标本并治,可使气血通畅,肝积得消。此外,络病理论与其他肝纤维化病机理论如“虚损生积”论、“主客交”论亦有着密切的联系,综合各论,总以通络补虚结合,疗效可观,以资为鉴。

Hepatic fibrosis is the key pathological process in the development of cirrhosis and hepatocellular carcinoma.Traditional Chinese medicine has played an important role in the antifibrotic therapy.Based on the understanding of collateral disease theory,this paper holds that the pathogenesis of hepatic fibrosis is deficiency of meridians on root cause and stagnation of collaterals on manifestation.The treatment should be based on dredging,combining acrid drug and insect drug and tonifying deficiency to dredge collaterals.Treatment both manifestation and root cause can make qi and blood unobstructed and liver accumulation disappear.In addition,the theory of collateral disease is closely related to other pathogenesis theories of hepatic fibrosis,such as the theory of‘asthenia and deficiency cause accumulation’,and the theory of‘zhukejiao’.Based on the above theories,the combination of dredging collaterals and tonifying deficiency is effective,which can be used for reference.