非酒精性脂肪性肝病从脑论治刍议

Brain-Oriented Treatment of Non-alcoholic Fatty Liver Disease

随着我国经济水平提高,非酒精性脂肪性肝病(脂肪肝)已经成为我国最重要公共卫生问题之一。目前,脂肪肝的中西医治疗均缺乏安全高效的药物。新的治疗实践提示我们应该注意脑神在脂肪肝形成过程中的重要作用。中医学认为脑神为生命主宰,可统摄五脏。现代医学也发现脑肠轴的重要作用。无论是传统服食辟谷的实践还是针对食欲中枢调控的现代研究,均支持从脑调肝的可行性。基于前期实践,我们提出脂肪肝的治疗不应局限于五脏系统,更应重视中医脑神的调控。脑神为本,肝脾为标,痰热瘀血为末。通过调神,达到抑食欲、促运动和最终治愈脂肪肝的目标。脑肝同治理论或许是未来破解脂肪肝治疗困局的关键思路。

With the improvement of economic level,non-alcoholic fatty liver disease(NAFLD)has become one of the most important public health problems in China.At present,there is a lack of safe and efficient drugs for the treatment of NAFLD.According to the new treatment method,how crucial a role the brain plays in the development of NAFLD should be aware.In traditional Chinese medicine(TCM),brain is the master of life and can control the five internal organs.Modern medicine has also discovered the important role of the brain-gut axis.Both the traditional practice of fasting and the modern research on the regulation of appetite center support the feasibility of brain-oriented regulation of the liver.Based on previous practice,this study proposed that the treatment of NAFLD should not be limited to the five internal organs,but more attention should be paid to the regulation of the brain in TCM.Brain serves as the origin,liver and spleen as superficiality,and phlegm,heat,and blood stasis as the manifestations.The regulation of mind can suppress appetite and promote exercise,thereby treating NAFLD.The theory of brain-liver therapy may be the key idea to solve the dilemma of NAFLD treatment in the future.