从肝主疏泄论治肝豆状核变性
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摘要
以"肝主疏泄"理论为指导,基于其内涵、生理功能和肝气郁、肝气逆两种病机特征,结合肝豆状核变性(hepatolenticulardegeneration,HLD)的发病机制和临床表现,对HLD的病因病机及辨证论治进行探讨。HLD病因病机为先天肝肾不足,肝失疏泄。疏泄不及则气机郁滞,以致铜毒蓄积累及肝胆;或疏泄太过,气机四逆,以致铜毒乱布累及脑、肾。HLD治疗应以疏肝益肾、调畅气机为原则。
Guided by the theory of liver governing conveyance and dispersion, based on its connotation, physiological functions and pathological characteristics of liver-qi invasion syndrome and liver-qi depression syndrome, combined with hepatolenticular degeneration(HLD), in the pathogenesis and clinical presentation, etiology and pathogenesis of HLD and syndrome differentiation and treatment were discussed. HLD etiology and pathogenesis of congenital kidney deficiency and liver pathogenesis. Pathogenesis is not as good as, Qi activity stasis that copper poison accumulate involving the liver, or support too, down four inverse that copper toxic mess involving the brain. The treatment principle of HLD should with soothing the liver and tonifying the kidney and regulating-the movement of Qi.
Guided by the theory of liver governing conveyance and dispersion, based on its connotation, physiological functions and pathological characteristics of liver-qi invasion syndrome and liver-qi depression syndrome, combined with hepatolenticular degeneration(HLD), in the pathogenesis and clinical presentation, etiology and pathogenesis of HLD and syndrome differentiation and treatment were discussed. HLD etiology and pathogenesis of congenital kidney deficiency and liver pathogenesis. Pathogenesis is not as good as, Qi activity stasis that copper poison accumulate involving the liver, or support too, down four inverse that copper toxic mess involving the brain. The treatment principle of HLD should with soothing the liver and tonifying the kidney and regulating-the movement of Qi.
引文
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[4]樊文,李成卫,王庆国.疏泄的三种含义及其支撑理论[J].浙江中医药大学学报,2014,38(11):1261-1263.
[5]关徐涛,詹向红,王冰.情志失常-肝失疏泄致衰说[J].时珍国医国药,2015,26(9):2208-2209.
[6]马月香.论肝失疏泄是疾病发生之源[J].江西中医学院学报,2008,20(1):8-9.
[7]穆俊霞.肝主疏泄在五脏整体功能活动中的作用[J].山西中医学院学报,2003,4(3):6-7.
[8]杨任民.肝豆状核变性的中西医结合治疗[J].中国中西医结合杂志,2007,27(9):773-775.
[9]王殿华,陈金亮.中医论治肝豆状核变性的思路与方法[J].中医杂志,2010,51(2):171-173.
[10]杨文明,韩辉,鲍远程,等.中医对肝豆状核变性病因病机及辨证论治的探索[J].北京中医药大学学报,2012,19(4):6-9.
[11]张亮亮,程楠,王训.铜代谢机制及其对肝脏的毒性作用[J].胃肠病学,2016,21(12):762-764.
[12]王共强,叶群荣,马心锋.从络病理论探讨肝豆状核变性的发病机制[J].中西医结合肝病杂志,2011,21(4):218-220.
[13]王共强,马心锋,王伟,等.Wilson病中医证型与客观指标相关性研究[J].中国中西医结合杂志,2013,33(11):1489-1493.
[14]叶群荣,胡纪源,王共强,等.Wilson病临床症状特征和中医证型分析[J].安徽中医学院学报,2013,32(4):34-37.
[15]王共强,张杰,叶群荣,等.Wilson病“精准驱铜”与金属内稳态的调控[J].医学研究杂志,2016,45(10):162-164.
[16]史亚飞,郭丽丽,吴皓萌,等.青少期应激:肝主疏泄调畅情志中枢机制研究新角度[J].中国中医基础医学杂志,2014,20(8):1069-1072.