从“阳化气,阴成形”论治代谢相关脂肪性肝病

Treatment of Metabolic Fatty Liver Disease from Theory of"Yang Transforming Qi and Yin Constituting Form"

代谢相关脂肪性肝病(MAFLD)发病率居慢性肝脏疾病首位,其起病隐匿易被忽视,且无特效性干预药物,中医药现有治疗手段也有一定的局限性。基于《黄帝内经》“阳化气,阴成形”理论,结合临证实践经验,认为“阳化气不足,阴成形太过”是本病关键病机。阳虚则致气化无力,温养不足,脏腑机能下降,故气虚、气滞并见;日久酿生膏脂、痰浊、瘀血等病理产物,壅于脉管,滞于肝脏,发为本病,甚者可成积聚癥瘕,或累及他脏,变生他病。温阳消阴是本病的基本治法,当贯穿于MAFLD防治始终。根据疾病分期不同,温阳与消阴可各有侧重,结合生活调摄,临证可获满意疗效。

The incidence rate of metabolism associated fatty liver disease(MAFLD)ranks first in chronic liver disease.Its onset is hidden and easy to be ignored,and there is no specific intervention drug.The existing treatment methods of traditional Chinese medicine also have some limitations.Based on the theory of"yang transforming qi and yin constituting form"in Huangdi Neijing(the Yellow Emperor's Internal Classic),combined with clinical practice experience,it is believed that"insufficient yang transforming qi and excessive yin constituting form"is the key pathogenesis of the disease.Yang deficiency leads to weakness of qi;insufficient warming and nourishment,and decline of viscera function lead to qi deficiency and qi stagnation;the pathological products,such as cream,phlegm,blood stasis,etc.,will grow over time and block in the vessels and stagnate in the liver,and so occur the disease,and it can even become abdominal mass or other visceral diseases.Warming yang and eliminating yin is the basic treatment of this disease,which should run through the prevention and treatment of MAFLD.According to the different stages,warming yang and eliminating yin can have different emphasis.Combined with life regulation,clinical treatment can achieve satisfactory results.