桂枝茯苓丸开玄通络化瘀拮抗肝脏微循环障碍防治肝纤维化理论探析

Guizhi Fuling Wan Improve Hepatic Microcirculation by Opening Xuanfu and Unblocking Collaterals to Prevent and Treat Hepatic Fibrosis

肝脏微循环障碍是肝纤维化关键病机之一,细胞外基质过度沉积及肝窦毛细血管化为肝纤维化主要病理改变。中医学中肝具有气血并调的生理功能,“体阴用阳”的生理特性,以“肝玄府-肝络脉”为结构基础。中医学“肝玄府闭郁-肝络脉阻滞”致气滞血瘀为癥积,与西医学肝窦内皮细胞失窗孔致肝窦毛细血管化,从而障碍肝脏微循环,终致肝纤维化的病机认识内涵一致。活血祛湿、缓消癥块的桂枝茯苓丸可缓解“玄府闭郁-络脉阻滞”以防治肝纤维化。

In western medicine(WM),hepatic microcirculation disorder is one of the key pathogenesis of hepatic fibrosis,which mainly pathologically featured as excessive deposition of extracellular matrix and hepatic sinusoidal capillarization.In Traditional Chinese medicine(TCM),liver,with xuanfu and collaterals as one of the structural bases,functions to regulate qi and blood and has the physiological characteristics of‘yin in form but yang in function'.If xuanfu and collaterals of liver were stagnated and blocked,the movement of qi and circulation of blood would be disturbed to cause accumulation even concretions,which is consistent with the WM in understanding the pathogenesis of hepatic fibrosis.In WM,liver sinusoidal endothelial cells(LSECs)lose fenestrae and undergo capillarization to disturb hepatic microcirculation and eventually lead to hepatic fibrosis.Guizhi Fuling Wan,acting to promote blood circulation,dispel dampness and resolve masses,could open xuanfu,unblock collaterals and dissolve stasis to prevent and treat hepatic fibrosis.