脂肪肝中医证候学研究进展
DOI: 10.12449/JCH241001
利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:赛俊婷负责查阅文献,撰写论文;李秀惠负责拟定文章思路,修改并最终定稿。
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摘要: 脂肪肝根据病因可分为酒精性脂肪性肝病和非酒精性脂肪性肝病,已成为全球第一大肝病。由于脂肪肝病因与病理机制的不同,在不同病理阶段可以表现为不同的中医“证”。“证”又称“证候”,是以一定阶段病机为基础,是中医辨证治疗的基石。目前对脂肪肝的“证”研究,尚不统一,且比较杂乱,采用不同辨证方法得出不同的证型,影响了临床辨证治疗。本文简要介绍了历代医家与现代医家对脂肪肝证型的临床研究,进一步强调规范与准确的脂肪中医证型对辨证论治的意义。Abstract: Fatty liver disease can be classified into alcoholic fatty liver disease and nonalcoholic fatty liver disease based on etiology, and it has become the most important liver disease worldwide. Due to the differences in the etiology and pathological mechanism of fatty liver disease, it may manifest as different traditional Chinese medicine syndromes during different pathological stages. The syndrome is based on the pathogenesis in a certain stage and is the basis for syndrome differentiation in traditional Chinese medicine. At present, there is still a lack of unified studies on the syndrome of fatty liver disease, and different methods for syndrome differentiation have obtained different syndrome types, which affects the syndrome differentiation-based treatment in clinical practice. This article briefly introduces the clinical studies on the syndrome types of fatty liver disease conducted by doctors of all dynasties and modern doctors and further emphasizes the significance of standard and accurate determination of the traditional Chinese medicine syndrome types of fatty liver disease in syndrome differentiation-based treatment.
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[1] HENRY L, PAIK J, YOUNOSSI ZM. Review article: The epidemiologic burden of non-alcoholic fatty liver disease across the world[J]. Aliment Pharmacol Ther, 2022, 56( 6): 942- 956. DOI: 10.1111/apt.17158. [2] ZHU WF. TCM diagnostics[M]. Beijing: China Traditional Chinese Medicine Press, 2003.朱文锋. 中医诊断学[M]. 北京: 中国中医药出版社, 2003. [3] LIANG W. Study on TCM syndrome differentiation of alcoholic liver disease[D]. Nanjing: Nanjing University of Chinese Medicine, 2013.梁卫. 酒精性肝病的中医辨证规律研究[D]. 南京: 南京中医药大学, 2013. [4] LIANG W, WU CY. Treatment of alcoholic liver disease[J]. J Tradit Chin Med, 2013, 54( 5): 433- 434. DOI: 10.13288/j.11-2166/ r.2013.05.018.梁卫, 吴承玉. 酒精性肝病辨治心得[J]. 中医杂志, 2013, 54( 5): 433- 434. DOI: 10.13288/j.11-2166/r.2013.05.018. [5] Branch of Gastrointestinal Diseases, China Association of Chinese Medicine. Common understanding on Chinese medicine diagnosis and treatment of nonalcoholic fatty liver disease[J]. J Beijing Univ Tradit Chin Med, 2011, 30( 2): 83- 86.中华中医药学会脾胃病分会. 非酒精性脂肪性肝病中医诊疗共识意见[J]. 北京中医药, 2011, 30( 2): 83- 86. [6] Branch of Gastrointestinal Diseases, China Association of Chinese Medicine. Expert consensus on TCM diagnosis and treatment of nonalcoholic fatty liver disease(2017)[J]. J Clin Hepatol, 2017, 33( 12): 2270- 2274. DOI: 10.3969/j.issn.1001-5256.2017.12.002.中华中医药学会脾胃病分会. 非酒精性脂肪性肝病中医诊疗专家共识意见(2017)[J]. 临床肝胆病杂志, 2017, 33( 12): 2270- 2274. DOI: 10.3969/j.issn.1001-5256.2017.12.002. [7] Branch of Gastrointestinal Diseases, China Association of Chinese Medicine. Traditional Chinese Medicine diagnosis and treatment guidelines for nonalcoholic fatty liver disease(primary doctor edition)[J]. Chin J Integr Tradit West Med Liver Dis, 2019, 29( 5): Insert 3-Insert 6.中华中医药学会脾胃病分会. 非酒精性脂肪性肝病中医诊疗指南(基层医生版)[J]. 中西医结合肝病杂志, 2019, 29( 5): 后插3-后插6. [8] Diagnosis and Treatment Center of Hepatology of South China Alliance of TCM, National Administration of Traditional Chinese Medicine. Diagnosis and treatment scheme of Ganpi(non-alcoholic steatohepatitis)[J/CD]. Chin J Liver Dis Electron Version, 2021, 13( 1): 1- 9. DOI: 10.3969/j.issn.1674-7380.2021.01.001.国家中医药管理局华南区中医肝病诊疗中心联盟. 肝癖(非酒精性脂肪性肝炎)诊疗方案[J/CD]. 中国肝脏病杂志(电子版), 2021, 13( 1): 1- 9. DOI: 10.3969/j.issn.1674-7380.2021.01.001. [9] Branch of Hepatobiliary Diseases, China Association of Chinese Medicine. Diagnosis and treatment guideline for Chinese Medicine on non-alcoholic steatohepatitis[J]. J Clin Hepatol, 2023, 39( 5): 1041- 1048. DOI: 10.3969/j.issn.1001-5256.2023.05.007.中华中医药学会肝胆病分会. 非酒精性脂肪性肝炎中医诊疗指南[J]. 临床肝胆病杂志, 2023, 39( 5): 1041- 1048. DOI: 10.3969/j.issn.1001-5256.2023.05.007. [10] LIU XY, MA SP, ZHANG LH, et al. Professor Zhao Wenxia’s experience in treating non-alcoholic fatty liver disease with“four discriminations” and“four differentiations”[J]. Chin J Integr Tradit West Med Liver Dis, 2022, 32( 11): 964- 968. DOI: 10.3969/j.issn.1005-0264.2022.011.002.刘晓彦, 马素平, 张丽慧, 等. 赵文霞教授“四辨”“四分”论治非酒精性脂肪性肝病经验[J]. 中西医结合肝病杂志, 2022, 32( 11): 964- 968. DOI: 10.3969/j.issn.1005-0264.2022.011.002. [11] SUN YL, SUN JG, ZHANG Y, et al. YIN Changjian’s experience in treating nonalcoholic fatty liver disease by stages[J]. Shandong J Tradit Chin Med, 2022, 8( 5): 465- 469. DOI: 10.16295/j.cnki.0257-358x.2022.05.001.孙玉莉, 孙建光, 张永, 等. 尹常健分期辨治非酒精性脂肪性肝病经验[J]. 山东中医杂志, 2022, 8( 5): 465- 469. DOI: 10.16295/j.cnki.0257-358x.2022.05.001. [12] NIE ZY, FENG CL, PAN WY, et al. Feng Chonglian’s experience in the syndrome differentiation and treat-ment of non-alcoholic fatty liver disease[J]. China Med Her, 2021, 18( 22): 145- 148.聂钊源, 冯崇廉, 潘伟钰, 等. 冯崇廉辨治非酒精性脂肪性肝病经验探讨[J]. 中国医药导报, 2021, 18( 22): 145- 148. [13] LI XP, HAO JM, ZHAO J. Professor Yang Zhen’s experience in treating alcoholic liver disease from‘damp-heat fire’[J]. Hebei J Tradit Chin Med, 2021, 7( 2): 189- 192. DOI: 10.3969/j.issn.1002-2619.2021.02.003.李小平, 郝建梅, 赵晶. 杨震教授从“湿热相火”论治酒精性肝病经验[J]. 河北中医, 2021, 7( 2): 189- 192. DOI: 10.3969/j.issn.1002-2619.2021.02.003. [14] FANG LH, GUO ZL, ZHANG YF, et al. Prof.Tian Delu’s experience of three-phase three-Zang organ differentia-tion with the diagnosis and treatment of alcoholic liver disease[J]. Mod Chin Clin Med, 2021, 28( 5): 38- 42. DOI: 10.3969/j.issn.2095-6606.2021.05.009.方俐晖, 郭志玲, 张轶斐, 等. 田德禄教授三期三脏辨治酒精性肝病经验[J]. 现代中医临床, 2021, 28( 5): 38- 42. DOI: 10.3969/j.issn.2095-6606.2021.05.009. [15] LI XJ, ZHAO Y, FENG Q, et al. Traditional Chinese medicine syndrome types of nonalcoholic fatty liver disease based on literature data mining[J]. World Chin Med, 2023, 18( 2): 263- 268. DOI: 10.3969/j.issn.1673-7202.2023.02.020.李晓静, 赵瑜, 冯琴, 等. 基于文献分析的非酒精性脂肪肝中医证型分布特点[J]. 世界中医药, 2023, 18( 2): 263- 268. DOI: 10.3969/j.issn.1673-7202.2023.02.020. [16] SONG WX. Research on clinical experience of famous Traditional Chinese Medicine in treating fatty liver based on data mining[D]. Nanning: Guangxi University of Traditional Chinese Medicine, 2024.宋文选. 基于数据挖掘的名老中医治疗脂肪肝临床经验研究[D]. 南宁: 广西中医药大学, 2024. [17] ZHANG HZ. Analysis of TCM syndrome types based on TCM syndrome elements professor Lu Bingjiu’s essentials of treating alcoholic liver disease[D]. Shenyang: Liaoning University of Traditional Chinese Medicine, 2019.张慧珍. 基于中医证素证型研究探析卢秉久教授治疗酒精性肝病精要[D]. 沈阳: 辽宁中医药大学, 2019. [18] National Medical Products Administration(NMPA). Supplementary provisions on the administration of registration of Traditional Chinese Medicine[EB/OL].( 2008-01-07)[ 2023-10-06]. https://www.nmpa.gov.cn/xxgk/fgwj/gzwj/gzwjyp/20080107120001991.html. https://www.nmpa.gov.cn/xxgk/fgwj/gzwj/gzwjyp/20080107120001991.html国家药品监督管理局. 中药注册管理补充规定[EB/OL].( 2008-01-07)[ 2023-10-06]. https://www.nmpa.gov.cn/xxgk/fgwj/gzwj/gzwjyp/20080107120001991.html. https://www.nmpa.gov.cn/xxgk/fgwj/gzwj/gzwjyp/20080107120001991.html
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