从脾虚论治肝硬化腹水的经验介绍

Experience in Treating Ascites Due to Cirrhosis from Spleen Deficiency

腹水是肝硬化失代偿期主要的临床表现之一,水湿泛滥多与肝脾肺肾脏腑功能失调,气机逆乱有关,其中肝郁脾虚是发病的基础,肝郁则疏运失常,脾虚则运化失司,进而导致气滞,血瘀,水湿蕴结于腹中,久之累及肾脏,肝肾阴虚是最终的结局,但在疾病发生发展的各个阶段,肝郁脾虚都持续存在,故应将疏肝健脾利水贯穿治疗的始终。本文所述病例从病因病机出发,结合患者的病史及症状体征,以肝郁脾虚为立足点,介绍从脾虚论治肝硬化腹水的治疗思路及遣方用药特点。

Ascites is one of the main clinical manifestations of decompensated cirrhosis.Excessive water and dampness is mainly related to the dysfunction of liver,spleen,lung,and kidney and qi movement disorder.The condition is rooted in liver depression and spleen deficiency.Liver depression leads to abnormal transportation,and spleen deficiency leads to the failure of the spleen in governing transportation and transformation.Then,qi stagnation,blood stasis,and water dampness occur in the abdomen,the long-term accumulation of which involves the kidney.Since liver stagnation and spleen deficiency exists throughout the disease course,the method of soothing the liver,invigorating the spleen,and promoting urination should be adopted throughout the treatment process.Considering the etiology,pathogenesis,and the patient's disease history,symptoms,and signs,this paper introduced the treatment principles and medication rules for ascites due to cirrhosis from liver stagnation and spleen deficiency.