1.北京中医药大学东直门医院,北京100700
2.厦门医学院公共课教学部人文教研室,厦门361023
乔祎雨,女,25岁,硕士研究生。研究方向:名老中医经验传承。
李雁,E-mail:13011097949@126.com
收稿:2025-03-17,
纸质出版:2025-12-25
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乔祎雨,李雁,孙玲玲,等.秦伯未治疗肝硬化常用角药经验[J].北京中医药,2025,44(12):1590-1593.
QIAO Yiyu,LI Yan,SUN Lingling,et al.QIN Bowei's experience in treatment of liver cirrhosis using ternary combinations of herbal drugs[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(12):1590-1593.
乔祎雨,李雁,孙玲玲,等.秦伯未治疗肝硬化常用角药经验[J].北京中医药,2025,44(12):1590-1593. DOI: 10.16025/j.1674-1307.2025.12.016.
QIAO Yiyu,LI Yan,SUN Lingling,et al.QIN Bowei's experience in treatment of liver cirrhosis using ternary combinations of herbal drugs[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(12):1590-1593. DOI: 10.16025/j.1674-1307.2025.12.016.
秦伯未教授运用角药治疗肝硬化具有丰富的临床经验,其认为肝硬化的病性为本虚标实,针对肝硬化病程之不同阶段,总结其核心病机为“郁、瘀、水、虚”。郁为始(早期),治以理气解郁、和胃化滞,药用柴胡、枳壳、六神曲;瘀为枢(病进),注重活血化瘀、消癥散结,药用三棱、莪术、醋鳖甲;水为标(失代偿期),法遵行气健脾、利尿泻水,药用茯苓、泽泻、大腹皮;虚为本(晚期),强调顾护脾肾、扶正温阳,药用黄芪、肉桂、附子。临床紧扣病机,灵活施治,效果显著。
Professor QIN Bowei has extensive clinical experience in treating liver cirrhosis using ternary combinations of herbal drugs. He believes that the pathological nature of liver cirrhosis is characterized by deficiency in origin and excess in manifestation. According to the different stages of the disease course, he summarizes the core pathogenesis of liver cirrhosis as "stagnation, stasis, water retention, and deficiency". Stagnation represents the beginning (early stage) and is treated by regulating
qi
, relieving stagnation, harmonizing the stomach, and resolving food accumulation, with
Bupleuri Radix
,
Aurantii Fructus
, and
Massa Medicata Fermentata
. Stasis serves as the pivot (disease progression stage), with treatment focusing on activating blood circulation, resolving stasis, and dispersing masses, using
Sparganii Rhizoma
,
Curcumae Rhizoma
, and vinegar-processed
Pelodisci Carapax
. Water retention represents the manifestation (decompensated stage), and the therapeutic principle follows promoting
qi
movement, strengthening the spleen, and inducing diuresis to drain water, with
Poria
,
Alismatis Rhizoma
, and
Arecae Pericarpium
. Deficiency constitutes the root (late stage), emphasizing the protection of the spleen and kidneys and reinforcing vital
qi
with warming-
yang
therapy, using
Astragali Radix
,
Cinnamomi Cortex
, and
Aconiti Radix Lateralis Praeparata
. In clinical practice, treatment is closely aligned with the underlying pathogenesis and applied flexibly, achieving significant therapeutic effects.
PENG CY , CHIEN RN , LIAW YF . Hepatitis B virus-related decompensated liver cirrhosis:benefits of antiviral therapy [J ] . J Hepatol , 2012 , 57 ( 2 ): 442 - 450 .
LI H . Advances in anti hepatic fibrotic therapy with traditional Chinese medicine herbal formula [J ] . J Ethnopharmacol , 2020 , 251 : 112442 .
XIE Z , QIANG J , PI X , et al . Favorable outcome of adjunctive traditional Chinese medicine therapy in liver cirrhosis: A large cohort study in Southwest China [J ] . Complement Ther Med , 2020 , 51 : 102446 .
杨聪聪 , 司国民 . 浅析“角药”理论及其现代临床应用 [J ] . 中医药导报 , 2017 , 23 ( 7 ): 13 - 16 .
孙玲玲 , 李雁 , 陈一凡 , 等 . 秦伯未从“虚、郁、瘀、水”辨治肝硬化经验 [J ] . 北京中医药 , 2024 , 43 ( 12 ): 1396 - 1400 .
黄祎 , 夏莉 , 雷青松 , 等 . 柴胡皂苷D对大鼠免疫性肝纤维化的保护作用及其机制研究 [J ] . 陆军军医大学学报 , 2022 , 44 ( 14 ): 1410 - 1420 .
江继超 , 洪洲 , 潘光旭 , 等 . 柴胡皂苷D抑制肝星状细胞活化及PSME3表达的实验研究 [J ] . 福建中医药 , 2024 , 55 ( 6 ): 25 - 28 .
汪雯 , 蓝天 , 郑芳 , 等 . 衢枳壳提取物改善2型糖尿病小鼠胰岛素抵抗的作用研究 [J ] . 浙江中医药大学学报 , 2022 , 46 ( 9 ): 936 - 944 .
秦伯未 著. 秦伯未增补谦斋医学讲稿 [M ] . 北京 : 中国医药科技出版社 , 2014 : 122 ,128,148,150, 215 - 218 .
冯涛 . 秦伯未解《西溪书屋夜话录》“治肝卅法” [J ] . 山东中医药大学学报 , 2020 , 44 ( 5 ): 580 - 584 .
秦伯未 编著. 医学大家秦伯未方药论著选 [M ] . 北京 : 中国中医药出版社 , 2016 : 5 -7,23,36,49,51,58,59,100,169, 189 .
李娟 , 单长民 , 赵永德 . 三棱、莪术抗大鼠肝纤维化的作用机理探讨 [J ] . 山东医药 , 2010 , 50 ( 37 ): 25 - 27 .
向文 , 陈敏 , 张佳东 , 等 . 鳖甲加工方法的改进研究 [J ] . 中国药房 , 2016 , 27 ( 1 ): 82 - 85 .
戴湘一 , 蒋开平 . 蒋开平论治肝硬化难治性腹水经验 [J ] . 北京中医药 , 2024 , 43 ( 6 ): 667 - 670 .
秦伯未 . 秦伯未谦斋中医学全书 下 [M ] . 吴大真,王凤,岐辑.王雷,王雪,秦淼,等整理.郑州 : 河南科学技术出版社 , 2020 : 840 .
FENG YL , LEI P , TIAN T , et al . Diuretic activity of some fractions of the epidermis of Poria cocos [J ] . J Ethnopharmacol , 2013 , 150 ( 3 ): 1114 - 1118 .
CHEN DQ , FENG YL , TIAN T , et al . Diuretic and anti-diuretic activities of fractions of Alismatis rhizoma [J ] . J Ethnopharmacol , 2014 , 157 : 114 - 118 .
陈其城 , 曹立幸 , 庞凤舜 , 等 . 大腹皮对犬胃肠运动的影响 [J ] . 时珍国医国药 , 2015 , 26 ( 6 ): 1366 - 1368 .
吴晓明 , 何强 , 尤圣杰 , 等 . 中药复方抗肝纤维化作用机制研究概述 [J ] . 北京中医药 , 2021 , 40 ( 6 ): 675 - 680 .
DU Y , WAN H , HUANG P , et al . A critical review of Astragalus polysaccharides: From therapeutic mechanisms to pharmaceutics [J ] . Biomed Pharmacother , 2022 , 147 : 112654 .
秦伯未 . 中医入门 [M ] . 北京 : 人民卫生出版社 , 1959 : 119 .
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