盛国光从“土壅木郁,痰瘀互结”分期论治代谢相关脂肪性肝病

Sheng Guoguang’s Stage Treatment of Metabolic Associated Fatty Liver Disease Based on“Earth-obstructing and Wood-stagnation,Phlegm and Blood Stasis”

代谢相关脂肪性肝病已成为我国第一大慢性肝病,其发生机制尚未完全明确。盛国光教授审证求因,从“土壅木郁,痰瘀互结”角度分期论治代谢相关脂肪性肝病,归纳其各阶段核心病机,针对病机遣方用药。该病早期以土壅木郁、痰瘀互结为主,治宜运脾开郁、化痰活血,常用四术汤合二陈汤加减;中期以痰瘀化热为主,治宜清肝泻火、化痰活血,常用小柴胡汤合二陈汤加减;晚期以脏腑虚损为主,治宜滋肝健脾、补肾固本,兼化痰活血,常用一贯煎合六君子汤加减,临床常效如桴鼓。

Metabolic associated fatty liver disease has become the most important chronic liver disease in China.Its mechanism is not completely clear.Professor Sheng Guoguang examines the symptoms and seek the cause,treats the disease by stages from the perspective of“earth-obstructing and wood-stagnation,phlegm and blood stasis”,summarizes the core pathogenesis of each stage,and prescribes drugs for the pathogenesis.In the early stage,the disease is mainly caused by earth-obstructing and wood-stagnation and phlegm and blood stasis and the corresponding treatment method should be activating spleen to eliminate depression,relieving phlegm and promoting blood circulation,with common use of modified Sizhu Decoction combined with Erchen Decoction.In the middle stage,phlegm and blood stasis transform into heat are the main pathogenesis,and the appropriate treatment is clearing liver and purging fire,and relieving phlegm and promoting blood circulation,with common use of modified Xiaochaihu Decoction combined with Erchen Decoction.In the late stage,weakness of the internal organs is the main pathogenesis,and it is appropriate to nourish liver and fortify the spleen,tonifying the kidney and consolidate the root,supplementing with reducing phlegm and activating blood circulation,with common use of modified Yiguan Decoction combined with Liujunzi Decoction in modification,which has achieved confirmed clinical efficacy.