摘要
[目的]探讨陈永灿结合窠囊理论辨治代谢相关脂肪性肝病(metabolic-associated fatty liver disease,MAFLD)的经验。[方法]通过跟诊抄方、收集临床医案、查阅相关古籍和文献资料,阐述陈永灿对于窠囊理论及MAFLD病机的认识,总结其运用窠囊理论辨证治疗MAFLD的临证经验,并附医案以供佐证。[结果]陈永灿认为MAFLD病机为本虚标实,标实与窠囊理论相似,均以气滞、痰阻、瘀积互结为病理产物,本虚以脾气虚和肝阴亏为主。治疗上陈永灿提出健脾助运、养阴柔肝以培元固本,清热化痰、理气化瘀以破窠囊,标本兼顾。所附验案为肝癖,辨证为肝郁脾虚、湿热痰瘀,治以疏肝健脾解郁、清热利湿化痰、理气活血化瘀,并取得较好疗效。[结论]陈永灿结合窠囊理论辨治MAFLD经验丰富,切合实用,值得临床借鉴。
[Objective Objective]To explore CHEN Yongcan’s experience in the treatment of metabolic-associated fatty liver disease(MAFLD)combined with the cage theory.[Methods Methods]By following the prescription,collecting clinical medical records,consulting relevant ancient books and literature,this paper expounds CHEN Yongcan’s understanding of the cage theory and the MAFLD pathogenesis,summarizes his clinical experience in syndrome differentiation treatment of MAFLD combined with the cage theory and provides medical records for evidence.[Results Results]CHEN Yongcan believed that the pathogenesis of MAFLD was root deficiency and branch excess,which was similar to the cage theory.The primary deficiency of MAFLD was mainly caused by Qi stagnation,phlegm obstruction and stasis.On the treatment,CHEN Yongcan put forward invigorating spleen to help transportation,nourishing Yin and softening liver to raise origin and consolidate the root,clearing heat and eliminating phlegm,regulating Qi and removing blood stasis to break the cyst,and giving consideration to superficial.The attached test case was liver procomania,with syndrome differentiation of liver depression and spleen deficiency,dampness,heat and blood stasis,with treatment of relieving liver and spleen,clearing heat,dampness and phlegm,regulating Qi and blood circulation and removing blood stasis,and achieved good curative effect.[Conclusion Conclusion]CHEN Yongcan has rich experiences in differentiation and treatment of MAFLD combined with the cage theory,which is practical and worthy of clinical reference.
作者
余碧炯
吴黎艳
陈永灿
YU Bijiong;WU Liyan;CHEN Yongcan(Zhejiang Chinese Medical University,Hangzhou(310053),China;Tongde Hospital of Zhejiang Province)
出处
《浙江中医药大学学报》
2025年第1期115-118,共4页
Journal of Zhejiang Chinese Medical University
基金
2022年全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号)。
关键词
代谢相关脂肪性肝病
窠囊理论
辨证论治
陈永灿
医案
metabolic-associated fatty liver disease
cage theory
treatment based on syndrome differentiation
CHEN Yongcan
medical records
