摘要
肝与脑的关系密切,肝主神志,脑主神明,肝经通于脑,二者共同维系人体精神思维活动。从西医的角度讲,肝脏生理功能受大脑调控,肝脏也能通过代谢、内分泌、激素、炎症反应等途径影响大脑功能。而肝失疏泄是导致阿尔茨海默病(Alzheimer's Disease,AD)发生发展的核心病因,贯穿AD发生发展始末。在AD前期,肝失疏泄,则脾胃升降失调,清阳不升,浊阴不降,水谷精微及营养物质的输布难以维系,痰浊滋生,气血生化乏源,后天不补先天,肾精化髓不足,元神失养;在AD中期,肝失疏泄,肝郁化火生风,痰浊内生,痰浊乘风上扰神明,或气滞血瘀,瘀阻脑络,或痰瘀互结郁而化火,躁扰清阳;在AD末期,肝失疏泄,血行不畅留瘀,痰湿日久成浊,痰瘀结于脑内,一方面进一步阻滞气机,加重“脑浊”积聚;另一方面蕴积日久则酿浊成毒,毒损脑络,最终髓减脑消,神机失用。而肝主疏泄核心功能为调畅气机,调肝气能畅情志,情志畅达则神明清爽;调肝气,肝疏泄有度,是“肾主骨生髓,上通于脑”的前提条件,故调肝气可养髓益智。调肝气既能阻断痰瘀生成的途径,又能促使痰、瘀代谢吸收,有效减少痰、瘀等有害物质在脑内堆积而损伤脑络。通过调理肝之气机保证肝疏泄功能的正常以防治AD是“脑病肝治”的具体体现。本研究将通过探讨肝与脑在AD发生发展过程中的内在联系,从“肝主疏泄”的角度分析防治AD的可行性。
The liver and the brain have a close relationship,the liver is the master of spirituality,the brain is the master of godliness,the liver meridian is connected to the brain,and both of them jointly maintain the human body’s mental thinking activities.From the perspective of Western medicine,the physiological function of the liver is regulated by the brain,and the liver can also affect the brain function through metabolism,endocrine,hormone,inflammation and other pathways.Liver dysfunction is the core cause of AD,and it runs through the whole process of AD development.In the early stage of AD,when the liver loses its detachment and excretion,the elevation of the spleen and stomach will be out of order,the clear Yang(阳)will not rise,the turbid Yin(阴)will not descend,and it will be difficult to maintain the transmission of water and grain essence and nutrients,so phlegm and turbidity will grow,and there will be a lack of source of Qi(气)and blood production and transformation,and acquired substances cannot nourish congenital foundation,with a shortage of renal essence,and the marrow will be insufficient,so that the first spirit is lost.In the middle stage of AD,when the liver loses its detachment and excretion functions,liver depression will generate wind and fire,and phlegm and turbidity will be generated internally.At the end of AD,when the liver loses its detachment and excretion functions,the blood does not flow well and stagnation is retained,phlegm and dampness become turbid over time,and phlegm stagnates in the brain,which on the one hand further blocks the Qi and aggravates the accumulation of‘brain turbidity’;on the other hand,it becomes poisonous when accumulated for a long period of time,which damages the cerebral channels and ultimately reduces the medulla oblongata and the brain and disables the divine organism.The core function of the liver is to regulate and smooth the Qi,which can smooth the sentiment,the sentiment is unimpeded,then the god is bright and refreshing;regulating the liver Qi and making proper dredging function of the liver is the prerequisite of‘kidney masters bone,produces pulp,and is connected to the brain upward’,so regulate the liver Qi can nourish the marrow and benefit the wisdom,block the pathway of the phlegm and stagnation generation,promote the metabolic absorption of phlegm and blood stasis,and effectively reduce the phlegm and stagnation and other harmful substances in the brain.This can effectively reduce the accumulation of phlegm and stasis and other harmful substances in the brain and damage the brain complex.The prevention and treatment of AD by regulating the Qi of the liver to ensure the normal function of liver excretion is a concrete embodiment of‘cerebral disease and liver treatment’.In this paper,we will explore the intrinsic connection between liver and brain in the process of AD,and analyse the feasibility of preventing and treating AD from the perspective of‘the liver is the main regulator of excretion’.
作者
程炜
何章欣
谭爱华
CHENG Wei;HE Zhangxin;TAN Aihua
出处
《中医临床研究》
2024年第33期25-28,共4页
Clinical Journal Of Chinese Medicine
基金
湖北省自然科学基金(2022CFB962)
湖北省中医药管理局中医药科研项目(ZY2023Q025)。
关键词
阿尔茨海默病
肝主疏泄
脑病肝治
Alzheimer’s disease
Liver governing conveyance and dispersion
Treating brain diseases from the liver
