| 引用本文: |
张德旭,蔡晓钧,李鹏,龚怡琳,李菁.基于“土壅木郁”探讨非酒精性脂肪性肝病的论治[J].湖南中医药大学学报,2023,43(10):1896-1901[点击复制] |
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| 基于“土壅木郁”探讨非酒精性脂肪性肝病的论治 |
| 张德旭,蔡晓钧,李鹏,龚怡琳,李菁 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| “土壅木郁”是脾病及肝的一种病理过程，为脾土壅滞，逆而侮木，使肝木郁滞，疏泄功能失常所致。非酒精性脂肪性肝病包括单纯性脂肪肝、非酒精性脂肪性肝炎、非酒精性脂肪性肝病相关肝硬化、肝细胞癌。“土壅木郁”在非酒精性脂肪性肝病发生发展中起到重要作用，与肝细胞脂质代谢紊乱具有一定关系。“土壅”反映在异常脂质蓄积于肝脏、肝细胞自噬功能受抑制以及发病诱因多为不良生活饮食习惯；“木郁”则体现在肝细胞因脂质代谢紊乱、自噬功能受抑制，造成的脂毒性肝细胞炎症、损伤以及肝脏相关临床表现。治疗上要时刻注重疏肝健脾以固本，贯穿始终，针对不同时期痰湿浊瘀程度施以相应治法以治标，并辅以生活方式、饮食习惯、情志疏导等手段。 |
| 关键词: 非酒精性脂肪性肝病 土壅木郁 脂质代谢 自噬 疏肝健脾 祛瘀化浊 |
| DOI：10.3969/j.issn.1674-070X.2023.10.023 |
| 投稿时间：2023-02-06 |
| 基金项目:湖南省中医肿瘤临床医学研究中心（2021SK4023）；湖南省临床医疗技术创新引导项目（2021SK51410）；湖南省卫生健康委科研重点项目（C202203108338）；湖南省教育厅优秀青年项目（21B0365）；长沙市自然科学基金项目（kq2202453）。 |
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| Treatment of non-alcoholic fatty liver disease based on "earth congestion and wood constraint" |
| ZHANG Dexu,CAI Xiaojun,LI Peng,GONG Yilin,LI Jing |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Earth congestion and wood constraint is a pathological process of spleen disease affecting the liver, which is due to the stagnant spleen (earth) counter-restraining the liver (wood), leading to its depression and thus the failure of governing the free flow of qi. As for Non-alcoholic fatty liver diseases, it includes simple fatty liver, non-alcoholic steatohepatitis, non-alcoholic fatty liver disease-related cirrhosis, and hepatocellular carcinoma. Actually, "earth congestion and wood constraint" plays an important role in the occurrence and development of non-alcoholic fatty liver diseases, and has a certain relationship with the disorder of lipid metabolism in hepatocytes. "Earth congestion" is reflected in abnormal lipid accumulation in the liver, inhibition of autophagy in hepatocytes, and the inducement of poor living and eating habits, while "wood constraint" is reflected in the lipid-toxic hepatocyte inflammation, injury, and liver-related clinical manifestations caused by lipid metabolism disorders and inhibition of autophagy in hepatocytes. Therefore, in the treatment, much attention should be paid to soothing the liver and strengthening the spleen to secure the root throughout the whole process, and corresponding therapeutic methods could be applied to treat the manifestations according to the degree of phlegm, dampness, turbidity, and blood stasis in different periods, supplemented by lifestyle, eating habits, emotional guidance and other means. |
| Key words: non-alcoholic fatty liver disease "earth congestion and wood constraint" lipid metabolism autophagy soothing the liver and strengthening the spleen eliminating stasis and transforming turbidity |
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