尹常健分期辨治非酒精性脂肪性肝病经验

YIN Changjian’s Experience in Treating Nonalcoholic Fatty Liver Disease by Stages

介绍尹常健教授分期辨治非酒精性脂肪性肝病的临床经验。尹常健教授认为,该病当分期辨治,首辨分期,次辨脏腑,再辨虚实。初期多属实,以痰湿、气滞多见,治宜化痰祛湿或行气导滞;中期邪气渐盛,邪正相争,以湿热蕴结、痰浊壅盛为主,治宜清热祛湿或芳香化浊;晚期正气已虚,邪气仍盛,以肝肾不足、痰瘀互结多见,治宜调补脾肾、化痰散结、活血通络。

Experience by Professor YIN Changjian in treating nonalcoholic fatty liver disease(NAFLD)was introduced in the paper.Professor YIN Changjian holds that NAFLD should be treated by stages.The first step is differentiating stage,the second step is differentiating viscera,and the third step is differentiating deficiency and excess.NAFLD at early stage is usually excessive,manifesting as phlegm and dampness,and qi stagnation,and therefore it should be treated by resolving phlegm and removing dampness,and promoting qi circulation and removing stagnation;at middle stage,the evil qi becomes strong,and there is the struggle between healthy qi and evil qi,manifesting as accumulation of damp heat and excessive phlegm and turbidity,and therefore should be treated by clearing heat and removing dampness or resolving turbidity with aromatic medicinals;at late stage,healthy qi is deficient and evil qi is still strong,manifesting as deficiency of liver and kidney,intermingled phlegm and stasis,and therefore it should be treated by regulating and tonifying spleen and kidney,resolving phlegm and dispersing nodules,and invigorating blood and dredging collaterals.