张进军运用调肝化痰法治疗肥胖经验

Zhang Jinjun's Experience of Treating Obesity by Regulating the Liver and Resolving Phlegm

张进军主任医师认为,肥胖的发病多以“肝”为始发因素,以“肝郁”为本,“痰湿”为标,“痰湿”为主要病理因素。张老师治疗肥胖以“调肝化痰”为治则,针对不同证型,以条达木郁、调和气血、运枢扶阳等治法辨证施治,以求从气治痰,气顺痰消。饮食不节是单纯性肥胖的首要病因,单纯性肥胖病机多为肝气郁滞,胃强脾弱,常用黄连温胆汤合泻心汤加减治疗;多囊卵巢综合征性肥胖病机多为肝郁血瘀,脾肾亏虚,常用苍附导痰丸合益母胜金丹加减治疗;甲状腺功能减退性肥胖病机多为木郁遏阳,阳衰阴盛,常用洗心汤及附子理中汤加减治疗。

Chief physician Zhang Jinjun believes that the occurrence of obesity is mostly based on"the liver",with"liver depression"as the root cause,and"phlegm dampness"as the manifestation as well as the main pathological factor.Professor Zhang treats obesity with"regulating the liver and resolving phlegm"as the principle.For different syndromes,he uses syndrome differentiation and treat-ment,such as dispersing wood depression,regulating qi and blood,moving axis and strengthening yang,etc.in order to treat phlegm from qi,and make qi smooth and phlegm disappear.For simple obesity,irregular diet is the primary cause,its pathogenesis is liver-qi stagna-tion,strong stomach and weak spleen,thus Modified Coptis Gallbladder-Warming Decoction is often adopted.For polycystic ovary syn-drome obesity mostly caused by liver depression and blood stasis,spleen and kidney deficiency,Modified Rhizoma Atractylodis and Aco-nite Phlegm-Expelling Decoction combined with Yimu Shengjin Elixir can be used.For hypothyroidism obesity mostly caused by stagna-ted wood blocking yang,yang deficiency and yin excess,Modified Heart-Washing Decoction and Aconite Middle-Regulating Decoction is commonly used.