Academic regimen for management of chronic liver disease based on TCM Zang Xiang and combination of disease and syndrome pattern
-
摘要: 通过复习中医藏象经典论述,结合近现代医家关于肝病诊治的研究进展,归纳刘成海教授中西医结合诊治肝病的学术经验。提出以中医肝藏象指导西医肝疾病诊治,原则上注意内调肝之体用阴阳平衡,外调肝与其他脏腑的生克和谐。在当今病证结合临床实践背景下,需赋予传统藏象以现代疾病要素,重视疾病的基本证候病机,并结合疾病分期、或风险因素以分辨其主要证型。最后提出肝络瘀阻在慢性肝病发生发展中的关键作用,需根据瘀血程度、疾病分期及其正邪盛衰合理应用活血化瘀方药及其治法配伍。Abstract: Professor LIU Chenghai's academic experience was raised about management of chronic liver disease after reviewing the classical literature of Zang Xiang theory of traditional Chinese medicine (TCM) and recent advancements in research studies. Initially, he proposed that the Zang Xiang theory could be adapted for the diagnosis and treatment of contemporary liver ailments, emphasizing the importance of maintaining yin-yang balance within the liver and harmony between the liver and other organs. Under the current practice regimen of integrative medicine, the factors of modern diseases should be included in Zang Xiang, such as analyzing basic TCM pattern of specific liver disease and main patterns at different stages or sub-categories of a disease. Lastly, highlighted the pivotal role of blood stasis in the liver collaterals in the pathogenesis of chronic liver disease, advocating for the practice of activating blood circulation and removing stasis, tailored to the degree of blood stasis and vital deficiency present at different stages of the liver disease.
-
-
[1] 张介宾. 类经[M]. 北京: 中医古籍出版社, 2016: 56-56.
[2] 刘成海. 中医肝藏象理论与现代肝病诊治[J]. 中西医结合肝病杂志, 2022, 32(9): 780-783.
[3] 郝娟, 刘成海. 肝硬化辨病与辨证的临床诊断进展[J]. 中国中西医结合消化杂志, 2016, 24(12): 967-970. doi: 10.3969/j.issn.1671-038X.2016.12.21
[4] 刘成海, 吕靖, 周扬. 肝硬化的中西医结合临床治疗[J]. 内科理论与实践, 2015, 10(4): 259-262.
[5] 齐婧姝, 王宇, 刘成海. 活血化瘀法在肝硬化中医药治疗中的实践应用与发展[J]. 上海中医药杂志, 2023, 57(8): 27-32.
[6] 徐大椿. 兰台轨范[M]. 北京: 人民卫生出版社, 2007: 18-18.
[7] 刘成海. 重视肝硬化的中西医结合诊治研究[J]. 中国中西医结合消化杂志, 2023, 31(2): 77-78. doi: 10.3969/j.issn.1671-038X.2023.02.01
[8] 潘凯, 雷阳, 赵强, 等. 熊去氧胆酸联合加味健脾补肾方治疗原发性胆汁性肝硬化的疗效观察[J]. 中国中医药科技, 2016, 23(4): 441-442, 447.
[9] 刘成海. 病证结合中药为主治疗脂肪肝[J]. 药品评价, 2009, 6(2): 77-78, 44.
[10] 刘成海, 季光, 胡义扬. 脂肪肝的中西医结合诊疗[M]. 上海: 上海中医药大学出版社, 2024: 181-181.
[11] 孙晶晶, 陶艳艳, 王清兰, 等. 滋阴清热方治疗绝经后女性非酒精性脂肪性肝病的临床疗效观察[J]. 临床肝胆病杂志, 2012, 28(3): 179-182.
[12] 陈可冀. 陈可冀学术思想与医疗经验选集[M]. 北京: 北京科学技术出版社, 2016: 147-160.
[13] 陈园, 刘成海. 络病理论在慢性肝病中的应用[J]. 中华中医药学刊, 2007, 25(9): 1860-1862.
[14] 叶天士. 临证指南医案[M]. 北京: 人民卫生出版社, 2006: 52-52.
[15] 聂广, 张赤志, 唐智敏, 等. 拓展王伯祥教授"肝络瘀阻"学说构建中医肝病分期辨证体系[J]. 中西医结合肝病杂志, 2022, 32(9): 773-779, 786.
[16] 刘燕玲, 李志更, 郭朋. 以活血化瘀法为核心治疗肝纤维化的思路[J]. 中医杂志, 2009, 50(1): 76-78, 81.
[17] 郭亚楠, 顾宏图, 赵长青, 等. 中医药对肝硬化门静脉血栓的干预作用及用药特点分析[J]. 临床肝胆病杂志, 2023, 39(2): 345-351.
-