[1]李倩,王石中,刘昊奇,等.名中医孙克伟从“阳化气不足，阴成形过度”辨治非酒精性脂肪性肝病[J].陕西中医,2025,46(6):826-830.[doi:DOI:10.3969/j.issn.1000-7369.2025.06.022]
　LI Qian,WANG Shizhong,LIU Haoqi,et al.Distinguished TCM expert SUN Kewei’s treatment of nonalcoholic fatty liver disease based on theory of “insufficient yang qi transformation and excessive yin manifestation”[J].,2025,46(6):826-830.[doi:DOI:10.3969/j.issn.1000-7369.2025.06.022]
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名中医孙克伟从“阳化气不足，阴成形过度”辨治非酒精性脂肪性肝病
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年6期
页码:
826-830
栏目:
名中医经验
出版日期:
2025-06-05

文章信息/Info

Title:
Distinguished TCM expert SUN Kewei’s treatment of nonalcoholic fatty liver disease based on theory of “insufficient yang qi transformation and excessive yin manifestation”
作者:
李倩1; 王石中1; 刘昊奇1; 孙克伟2
（1.湖南中医药大学第一中医临床学院，湖南 长沙 410007;2.湖南中医药大学第一附属医院，湖南 长沙 410007)
Author(s):
LI Qian1; WANG Shizhong1; LIU Haoqi1; SUN Kewei2
(1.First Clinical College,Hunan University of Traditional Chinese Medicine,Changsha 410007,China;2.First Affiliated Hospital,Hunan University of Traditional Chinese Medicine,Changsha 410007,China)
关键词:
非酒精性脂肪性肝病; 阳化气不足; 阴成形过度; 辨证论治; 苓桂术甘汤
Keywords:
Nonalcoholic fatty liver disease; Insufficient yang qi transformation and excessive yin manifestation; Syndrome differentiation and treatment; Linggui Zhugan decoction
分类号:
R 575.5
DOI:
DOI:10.3969/j.issn.1000-7369.2025.06.022
文献标志码:
A
摘要:
非酒精性脂肪性肝病（NAFLD）的发病与代谢紊乱密切相关，名中医孙克伟以“阳化气不足，阴成形过度”理论阐释其病机，认为阳气虚衰致气化无力，阴邪壅滞则痰瘀互结。阳气失于温煦推动，水谷精微难以化生为气，反聚为脂浊沉积肝络；阴成形过盛则痰湿、瘀血等病理产物堆积，形成肝脂蓄积、纤维化的有形之变。治疗上以温阳健脾、调和阴阳为本，辅以燥湿、清热、化痰、祛瘀之法，主方选用苓桂术甘汤、二陈汤等温阳化饮之剂，强调温药和之以助脾运、消阴邪。临床验案中，针对中焦湿热证予黄连温胆汤清热利湿，痰瘀互结证则转用苓桂术甘汤加活血化瘀药，并灵活配伍荷叶、丹参等化浊通络，配合生活方式干预，取得显著疗效。孙教授通过病证结合、标本兼治的诊疗思路，体现了中医整体观与辨证论治的特色，为NAFLD的中医治疗提供了理论与实践依据。
Abstract:
The pathogenesis of nonalcoholic fatty liver disease (NAFLD) is closely associated with metabolic disorders.Distinguished TCM expert SUN Kewei elucidates its disease mechanism through the theory of “insufficient yang qi transformation and excessive yin manifestation” He posits that yang qi deficiency leads to impaired qi transformation,while stagnation of pathogenic yin results in phlegm-blood stasis interaction.When yang qi fails to warm and transport,nutrients from food and water cannot be transformed into qi,instead accumulating as lipid turbidity deposited in the liver collaterals.Excessive yin manifestation promotes pathological accumulations such as phlegm-dampness and blood stasis,ultimately leading to fatty liver infiltration and fibrosis.Therapeutic principles focus on warming yang,strengthening the spleen,and harmonizing yin-yang,supplemented by drying dampness,clearing heat,resolving phlegm,and removing stasis.Core formulas include Linggui Zhugan decoction and Erchen decoction to warm yang and transform retained fluids,emphasizing warming medicinals to restore spleen transportation and dispel pathogenic yin.In clinical practice,Huanglian Wendan decoction was prescribed for damp-heat syndrome of the middle energizer to clear heat and drain dampness,while Linggui Zhugan decoction combined with blood-activating and stasis-resolving herbs addressed phlegm-stasis interaction.Adjunctive herbs such as lotus leaf and Salvia miltiorrhiza were flexibly incorporated to resolve turbidity and unblock collaterals,alongside lifestyle interventions,achieving marked efficacy.Through the combination of disease and syndrome and the treatment of both symptoms and root causes,Professor Sun embodies the characteristics of holistic view and syndrome differentiation and treatment of traditional Chinese medicine,and provides theoretical and practical basis for the treatment of NAFLD in traditional Chinese medicine.

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备注/Memo

备注/Memo:
国家自然科学基金资助项目（82104809）；湖南中医药大学双一流学科建设项目[2018（03）]
更新日期/Last Update: 2025-06-09