从“伏毒”探析慢性肝炎病因病机
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摘要
慢性肝炎具有发病率高、病程长、后期易发生肝硬化和肝癌、预后差的特点。目前认为慢性肝炎的主要发病机制是"虚、湿(浊、痰)、瘀、热、毒"。而正虚是慢性肝炎发生的根本原因,这些病理产物的存在又耗伤人体的正气,加重正虚,加速慢性肝炎的进展。通过伏毒学说能更全面认识慢性肝炎病机,正虚是伏毒产生的始因,湿(浊、痰)、瘀、热、毒皆属于伏毒的范畴。从伏毒学说渊源、慢性肝炎危险因素与伏毒致病的关系、慢性肝炎病机与伏毒的关系以及从伏毒学说探析慢性肝炎的治疗思路等方面阐述慢性肝炎的病因病机。
Chronic hepatitis has the characteristics of high incidence,long course of disease,easy to develop liver cirrhosis and liver cancer,and poor prognosis. At present,it is believed that the main pathogenesis of chronic hepatitis is deficiency,dampness(turbidity,phlegm),blood stasis,heat,and toxin. Deficiency of vital-qi is the fundamental cause of chronic hepatitis. Dampness(turbidity,phlegm),stasis,heat,and toxin are pathological products formed on the basis of deficiency. The existence of these pathological products also consumed vital-qi of the body,exacerbates the deficiency and accelerates the progress of chronic hepatitis.The pathogenesis of chronic hepatitis can be fully understood by means of the theory of latent toxin,which is caused by deficiency,and dampness(turbidity,phlegm),blood stasis,heat and poison all belong to the category of latent toxin. The study fully discussed the contents of the theory origin of latent toxin,the relationship between the risk factors and the pathogenesis of chronic hepatitis,the relationship between the pathogenesis of chronic hepatitis and the latent toxin. The treatment ideas of chronic hepatitis was also analyzed based on the theory of latent toxin in the study to demonstrate etiology and pathogenesis of chronic hepatitis.
Chronic hepatitis has the characteristics of high incidence,long course of disease,easy to develop liver cirrhosis and liver cancer,and poor prognosis. At present,it is believed that the main pathogenesis of chronic hepatitis is deficiency,dampness(turbidity,phlegm),blood stasis,heat,and toxin. Deficiency of vital-qi is the fundamental cause of chronic hepatitis. Dampness(turbidity,phlegm),stasis,heat,and toxin are pathological products formed on the basis of deficiency. The existence of these pathological products also consumed vital-qi of the body,exacerbates the deficiency and accelerates the progress of chronic hepatitis.The pathogenesis of chronic hepatitis can be fully understood by means of the theory of latent toxin,which is caused by deficiency,and dampness(turbidity,phlegm),blood stasis,heat and poison all belong to the category of latent toxin. The study fully discussed the contents of the theory origin of latent toxin,the relationship between the risk factors and the pathogenesis of chronic hepatitis,the relationship between the pathogenesis of chronic hepatitis and the latent toxin. The treatment ideas of chronic hepatitis was also analyzed based on the theory of latent toxin in the study to demonstrate etiology and pathogenesis of chronic hepatitis.
引文
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[3]张继烈,鞠鲤亦.伏邪与伏毒[J].中国医药导报,2007,4(23):153.
[4]叶吉晃,周仲瑛.周仲瑛教授的“伏毒”学说[J].中国中医药现代远程教育,2005,3(12):36.
[5]周仲瑛.“伏毒”新识[J].世界中医药,2007,3(2):73-75.
[6]李晓良,汪承柏,贺江平.慢性乙型肝炎中医辨证与病理、病毒指标的关系:附117例分析[J].中西医结合肝病杂志,1996,6(2):4-5+23.
[7]郭明冬,李秋艳,翁维良.翁维良“百病皆瘀”学术思想探讨[J].中国中医基础医学杂志,2015,21(11):1363-1364+1369.
[8]彭汝琴,王绍展,王媛媛,等.丹参素通过MEK/ERK信号通路抑制肝纤维化[J].中南药学,2017,15(5):580-586.
[9]李丝冰.肝复康和丹参对肝纤维化wnt经典通路的影响[D].大连:大连医科大学,2015:3-10.
[10]张彩华,李骢,李华军,等.丹参酮ⅡA干预肝纤维化模型大鼠相关信号通路相关因子的表达[J].中国组织工程研究,2015,19(27):4345-4350.
[11]郭立中,吴勉华,周学平,等.周仲瑛教授学术思想简介(一)[J].南京中医药大学学报,2008,9(6):361-365.
[12]李志满.垂盆草介导Sirt1-AMPK-LXR信号通路改善二甲基亚硝胺所致肝纤维化作用机制的研究[D].延吉:延边大学,2017:3-10.
[13] LIAN L H,JIN X,WU Y L,et al. Hepatoprotective effects of Sedum sarmentosum on D-Galactosamine/Lipopoly-saccharide-Induced Murine Fulminant Hepatic Failure[J]. Journal of Pharmacological Sciences,2010,114(2):147-157.
[14] ADEI A,ZAITON Z,FAIZAH O,et al. Aqueous extract of Piper sarmentosum decreases atherosclerotic lesions in high cholesterolemic experimental rabbits[J]. Lipids Health Disease,2010:44.
[15]黄亚娟,蒋士生,王红梅,等.蒋士生教授从伏毒论治慢性萎缩性胃炎经验[J].中医药导报,2017,23(3):33-34+38.