基于“阳化气,阴成形”理论的肝硬化发病与治疗探讨

Discussion on the pathogenesis and treatment of cirrhosis based on the theory of Yang transforming Qi, Yin forming shape

“阳化气,阴成形”的理论源自《黄帝内经·素问》。“阳化气,阴成形”中的阳和阴是指物质的动与静、气化与凝聚、分化与合成等相对运动,进而说明物质和能量的存在形式是相互依存、相互转化的关系。中医认为,生命就是生物体的气化运动,气化运动的本质就是化气与成形相互作用。阳性热,可以化阴为气;阴性冷,阴性凝敛,所以可以凝聚而成形。肝硬化是由各种病因长期作用下对肝脏造成损害,导致肝组织纤维化、假小叶及再生结节形成的慢性进行性肝病,而进行性的肝纤维化是肝硬化的重要病理基础。肝硬化等病可引起腹部肿大,水肿,其原因是中焦阳虚,阳气不能化水,水湿泛滥成病。文章基于“阳化气,阴成形”理论探讨肝硬化的发病机制,探讨肝硬化“体阴而用阳”的辨证论治方法,以期为临床提供参考。

The theory of Yang(阳)transforming Qi(气),Yin(阴)forming shape originates from the Huangdi Neijing·Suwen(《黄帝内经·素问》).Yang and Yin in“Yang transforming Qi,Yin forming shape”refer to the relative movements of matter,such as movement and stillness,gasification and condensation,differentiation and synthesis,which further shows that the existing forms of matter and energy are interdependent and transformed.TCM believes that life is the interaction between gasification and formation of organisms.Yang,hot in nature,can transform Yin into Qi.Yin,cold in nature,has the effect of coagulation and shaping.Cirrhosis is a chronic progressive liver disease caused by long-term damage to the liver by various etiologies,resulting in liver tissue fibrosis,pseudolobules and regenerated nodules,and progressive liver fibrosis is an important pathological basis for cirrhosis.Cirrhosis and other diseases can cause abdominal swelling and edema,which is caused by the deficiency of Yang in the middle Jiao(中焦),the inability of Yang Qi to transform into water,and the flooding of water dampness leading to diseases.This paper discusses the pathogenesis of cirrhosis based on the theory of Yang transforming Qi,Yin forming shape,and discusses the treatment method of cirrhosis based on syndrome differentiation of Warming yang and nourishing Yin,with a view to providing reference for clinical practice.