余江毅辨治肥胖经验

Yu Jiang-yi′s Experience of Treating Obesity

余江毅教授认为,肥胖的发生与过食肥甘、先天禀赋、情志异常、地域等多种因素有关,胃火亢盛、肝气郁结、脾虚生痰为主要病机,且虚实夹杂贯穿始终。余教授临证时,将辨病位、辨病理因素、辨体质等多种方法相结合,主张从中焦论治,以清胃泻热、疏肝解郁、行气健脾、化痰利湿清热、祛瘀泻浊为基本治法。余教授认为,肥胖日久,患者脾肾两虚,浊邪为患,容易导致临床诸多变证,方用温肾方加减,以补虚削实,益火补土。此外,余教授还注重三因制宜,以患者为中心的理念。

Professor Yu Jiang-yi believes that the occurrence of obesity is related to many factors,such as overeating fat and sweet food,congenital endowment,abnormal emotions,geography and so on.Hyperactivity of stomach fire,stagnation of liver qi,spleen deficiency generating phlegm are the main pathogenesis,and deficiency and excess are mixed throughout the whole process.In clinical practice,Professor Yu advocates the combination of many therapies,such as differentiation of disease location,differentiation of pathological factors and differentiation of physical constitution.He suggests treatment from the middle energizer,adopts the basic treating principle of clearing stomach and purging heat,soothing liver and relieving depression,moving qi and strengthening spleen,resolving phlegm and removing dampness,clearing heat,removing blood stasis and purging turbidity.Professor Yu believes that if obesity lasts for a long time,the patients will suffer from deficiency of both spleen and kidney and turbidity,which is easy to lead to many clinical deteriorated syndromes.So Modified Kidney-Warming Decoction can be used to supplement deficiency,reduce excess,and replenish fire and nourish earth.In addition,Professor Yu also pays attention to adjusting measures according to conditions of three categories of disease cause and emphasizes the concept of comprehensive treatment,overall consideration and patient-centered idea.