田德禄基于“肝为刚脏必柔以济之”分期辨治肝纤维化的用药经验
Professor TIAN Delu's medication experience in differentiating and treating liver fibrosis by stages based on the principle of "the liver, serving as a firm organ, being tempered by softness"
- 北京中医药 2026年45卷第2期 页码：217-221
- 作者机构：
北京中医药大学东直门医院中内教研室，北京 101121
- 作者简介：
周静鑫，女，39岁，博士，主任医师。研究方向：中医药防治内分泌代谢病的临床与基础研究。
孙慧怡，E-mail：bjshy06@163.com
- 基金信息：第六批北京市级中医药专家学术经验继承工作项目;中华中医药学会雏鹰计划中医临床青年人才研修项目;北京市通州区科技创新人才资助项目(JCQN2024022);北京中医药大学东直门医院临床研究和成果转化能力试点项目(DZMG-MLZY-23009);田德禄“三名”传承工作室项目(2023-SZ-F-1)
DOI：10.16025/j.1674-1307.2026.02.012
中图分类号：收稿：2025-03-03，
纸质出版：2026-02-25
- 稿件说明：
移动端阅览
周静鑫，孙慧怡，张雯，等.田德禄基于“肝为刚脏必柔以济之”分期辨治肝纤维化的用药经验［J］.北京中医药，2026，45（2）：217-221.
ZHOU Jingxin,SUN Huiyi,ZHANG Wen,et al.Professor TIAN Delu's medication experience in differentiating and treating liver fibrosis by stages based on the principle of "the liver, serving as a firm organ, being tempered by softness"[J]. Beijing Journal of Traditional Chinese Medicine,2026,45(02):217-221.
周静鑫，孙慧怡，张雯，等.田德禄基于“肝为刚脏必柔以济之”分期辨治肝纤维化的用药经验［J］.北京中医药，2026，45（2）：217-221. DOI： 10.16025/j.1674-1307.2026.02.012.
ZHOU Jingxin,SUN Huiyi,ZHANG Wen,et al.Professor TIAN Delu's medication experience in differentiating and treating liver fibrosis by stages based on the principle of "the liver, serving as a firm organ, being tempered by softness"[J]. Beijing Journal of Traditional Chinese Medicine,2026,45(02):217-221. DOI： 10.16025/j.1674-1307.2026.02.012.
摘要
肝纤维化归属于中医学“胁痛”“黄疸”“积聚”范畴。田德禄教授基于“肝为刚脏必柔以济之”的生理特性，认为肝纤维化是过食肥甘厚味、酒酪之品或病毒之外邪侵袭，致肝体用及气血失和，脏腑功能失调，湿、热、毒、郁、瘀等病理产物稽留胶结，凝滞肝络，肝体受损而发。初病多实，久则虚实夹杂，后期则正虚邪留。治疗当谨守病机，以“祛其邪，补其虚，调其气血”为治疗原则，分三阶段辨治，早期治以疏肝理气、活血化瘀、清利湿热，中期祛邪同时治以调肝理脾，后期治以扶正固本、补益肝脾肾，并将调血通络贯穿始终，复肝之刚柔相济的生理功能以逆转肝纤维化。
Abstract
Liver fibrosis falls within the categories of "hypochondriac pain"， "jaundice"， and "abdominal mass" in traditional Chinese medicine （TCM）. Based on the physiological characteristic that "the liver， serving as a firm organ， being tempered by softn
ess"， Professor TIAN Delu considers liver fibrosis to result from excessive consumption of rich， greasy， and alcoholic foods， or invasion by external pathogens such as viruses. These factors lead to disharmony of the liver's substance and function， as well as
qi
and blood， resulting in dysfunction of the
Zang-fu
organs. Consequently， pathological products such as dampness， heat， toxin， stagnation， and blood stasis accumulate， congeal， and obstruct the liver collaterals， causing damage to the liver. In the early stage， the disease is predominantly characterized by excess； over time， it develops into a pattern of mixed deficiency and excess， and in the late stage， it is marked by deficiency of healthy
qi
with persistence of pathogenic factors. Treatment should adhere to the pathogenesis， following the principle of "eliminating pathogenic factors， tonifying deficiency， and regulating
qi
and blood"， with stage-based differentiation and management. In the early stage， treatment focuses on soothing the liver and regulating
qi
， activating blood and resolving stasis， and clearing damp-heat. In the middle stage， while eliminating pathogenic factors， treatment also emphasizes regulating the liver and strengthening the spleen. In the late stage， therapy focuses on reinforcing healthy
qi
and consolidating the root， tonifying the liver， spleen， and kidney. Throughout all stages， regulation of blood and unblocking of the collaterals are consistently applied to restore the physiological state of balance between firmness and softness of the liver， thereby reversing liver fibrosis.
关键词
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references
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