肝硬化肌少症中医药诊治思路探讨

Discussion on the traditional Chinese medicine diagnosis and treatment of liver cirrhosis myopenia

肌少症是肝硬化患者营养不良的主要特征,也是肝硬化常见的并发症,严重影响着患者的生活质量和生存率。肝硬化肌少症可归属于中医学“痿证(病)”“虚劳”范畴,结合常占杰教授治疗肝硬化临床经验,将本病的病机概括为以下4个方面:脾胃虚弱、营精失养;湿浊浸淫、经脉失荣;血脉瘀滞、脉道壅塞;血亏髓枯、经脉痿弱。根据以上病机提出了四大治疗方法:健脾益胃、益气养血;祛湿化浊、荣养筋脉;化瘀通络、养血荣筋;补益肝肾、益精填髓,依据治法拟定方药,在临床应用中取得较好疗效。

Myopenia is the main feature of malnutrition in patients with liver cirrhosis,and is also a common complication of liver cirrhosis,which seriously affects the quality of life and survival rate of patients.Liver cirrhosis myopenia can be classified into the category of‘flaccidity syndrome(disease)and asthenic labor’in traditional Chinese medicine(TCM).In combination with the academic experience of the famous TCM expert in Shaanxi province and the academic experience of the national old TCM expert,professor CHANG Zhanjie,the clinical experience of treating liver cirrhosis,the pathogenesis of this disease is summarized into the following four aspects:weakness of the spleen and stomach,loss of nourishment of the essence,wet and turbid immersion,loss of glory of the meridians,blood stasis,blockage of the meridians,blood deficiency and marrow,and weakness of the meridians.According to the above pathogenesis,four treatment methods are proposed:invigorating the spleen and stomach,replenishing qi and blood,removing dampness and turbidity,nourishing muscles and veins,removing blood stasis and collaterals,nourishing blood and strengthen tendons,replenishing liver and kidney,replenishing essence and fill marrow.According to the treatment method,the prescription is formulated and has achieved good effect in clinical application.