从“六经为川,肠胃为海”探讨代谢相关脂肪性肝病的辨治思路

Exploration of the Idea of Syndrome Differentiation and Treatment of Metabolic Related Fatty Liver Disease from“Six Meridians as the Rivers and Intestines and Stomach as the Sea”

代谢相关脂肪性肝病(MAFLD)作为临床上一种常见的慢性肝病,属于中医“肝癖”“积聚”等疾病范畴。文章以黄帝内经“六经为川,肠胃为海”理论为指导,深入阐释其理论钩玄,援物比类,据象而思,认为川海激活赖九窍注之气,海纳百川功在运抵肠胃,川海相通反映疾病传变,并结合现代医学相关研究辨析MAFLD的发病机制,指出临证应逆疾病形成的途径分层梳理辨治,采取“洁流”“复旧”“澄源”的治疗策略,着重缓和胃肠以祛瘀源,固本善后以复川海之功,疾病当愈,为中医辨证论治MAFLD拓宽治疗思路,并提供理论支持。

Metabolic fatty liver disease(MAFLD),as a common chronic liver disease in clinic,belongs to the category of“liver addiction”and“accumulation”in traditional Chinese medicine.Guided by the theory of“six meridians as the rivers and intestines and stomach as the sea”of Inner Canon of Huangdi,this paper deeply explains its theory,hooks the mystery and aids the comparison of things.According to the image,it is considered that the activation of the river and the sea depends on the Qi injected into the nine orifices,the sea contains all rivers,the power is transported to the intestines and stomach,the communication between the river and the sea,and reflects the transmission of diseases.Combined with the relevant research of modern medicine,this paper discriminates the pathogenesis of MAFLD,It is pointed out that the clinical syndrome should go against the way of disease formation,sort out the syndrome differentiation and treatment in layers,adopt the treatment strategies of“cleaning the flow”“restoring the old”and“clarifying the source”,focus on slowly gastrointestinal tract to eliminate the source of blood stasis,consolidate the essence and improve the function of restoring rivers and sea,and the disease should heal,so as to broaden the treatment ideas and provide theoretical support for the syndrome differentiation and treatment of MAFLD in traditional Chinese medicine.