Practical application and development of activating blood and resolving stasis treatment method for liver cirrhosis

QI Jingshu; WANG Yu; LIU Chenghai

doi:10.16305/j.1007-1334.2023.2305030

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Practical application and development of activating blood and resolving stasis treatment method for liver cirrhosis

更新时间：2023-08-05

- Practical application and development of activating blood and resolving stasis treatment method for liver cirrhosis
- Shanghai Journal of Traditional Chinese Medicine Vol. 57, Issue 8, Pages: 27-32(2023)
- 作者机构：
  
  1.上海中医药大学附属曙光医院肝病研究所（上海 201203）
  2.上海市宝山区中西医结合医院消化科（上海 201999）
- 作者简介：
- 基金信息：
- DOI：10.16305/j.1007-1334.2023.2305030
  CLC：
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齐婧姝,王宇,刘成海.活血化瘀法在肝硬化中医药治疗中的实践应用与发展[J].上海中医药杂志,2023,57(8):27-32.

QI Jingshu,WANG Yu,LIU Chenghai.Practical application and development of activating blood and resolving stasis treatment method for liver cirrhosis[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(8):27-32.
齐婧姝,王宇,刘成海.活血化瘀法在肝硬化中医药治疗中的实践应用与发展[J].上海中医药杂志,2023,57(8):27-32. DOI： 10.16305/j.1007-1334.2023.2305030.

QI Jingshu,WANG Yu,LIU Chenghai.Practical application and development of activating blood and resolving stasis treatment method for liver cirrhosis[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(8):27-32. DOI： 10.16305/j.1007-1334.2023.2305030.

摘要

从中西医结合角度阐释肝硬化的血瘀病机及其活血化瘀治法的理论基础与实践应用。围绕肝硬化的中医病机证治，首先分析了中西医肝脏的概念异同，认为肝脏微循环系统即是中医“肝络”，其在维持肝脏生理稳态中发挥重要作用，而微循环障碍（或“肝络”瘀阻）则是肝硬化的核心病理（病机）；继而，从中医经典文献、近代名医经验、现代循证医学评价方面论证了活血化瘀是肝硬化的重要中医药治法，在具体实践时需根据活血化瘀中药的不同功效、疾病不同阶段等灵活应用，并注重与其他治法合理配合；最后，提出改善肝脏微循环是活血化瘀中药祛瘀生新治疗肝硬化的重要药理基础与治疗策略。

Abstract

This article states that blood stasis is the pathogenesis of liver cirrhosis， and explains the theoretical basis and practical application of the blood-activating and stasis-resolving method in the treatment of liver cirrhosis from the perspective of integrated traditional Chinese and Western medicine. Focusing on the traditional Chinese medicine （TCM） pathogenesis as well as syndromes and treatment of liver cirrhosis， we first compare the similarities and differences in the concepts of liver between the two medical systems， and hold that the liver microcirculatory system is termed as “Gan Luo” （liver collaterals） in TCM， which help to maintain the physiological homeostasis of the liver； and that the microcirculatory disorder （or stasis and obstruction in “liver collaterals”） is the core pathology（pathogenesis） of liver cirrhosis. As has been proved in TCM classical literature， experience of famous TCM doctors in modern times and contemporary evidence-based medical evaluation， blood-activating and stasis-removing method is an important TCM treatment method for liver cirrhosis. However， it should be applied flexibly according to the different effects of herbs for activating blood and resolving stasis and different stages of the disease， and attention should also be paid to appropriate coordination with other treatment methods in the real practice. Finally， we propose that improving liver microcirculation is a pivot pharmacological basis and therapeutic strategy for the treatment of liver cirrhosis with blood-activating and stasis-resolving herbs to eliminate stasis and generate new blood.

关键词

肝硬化活血化瘀法肝络肝脏微循环中药中西医结合

Keywords

liver cirrhosisactivating blood and resolving stasis methodliver collateralhepatic microcirculationtraditional Chinese herbal medicineintegrated traditional Chinese and Western medicine

references

刘成海.中医肝藏象理论与现代肝病诊治［J］.中西医结合肝病杂志，2022， 32（9）： 780-783.

陈园，刘成海.络病理论在慢性肝病中的应用［J］.中华中医药学刊，2007， 25（9）： 1860-1862.

HERNANDEZ-GEA V， FRIEDMAN S L. Pathogenesis of liver fibrosis［J］. Annu Rev Pathol， 2011，6： 425-456.

HYTIROGLOU P， THEISE N D. Regression of human cirrhosis： an update， 18 years after the pioneering article by Wanlesset al.［J］. Virchows Arch， 2018， 473（1）： 15-22.

史宇广，单书健. 当代名医临证精华［M］.北京：中医古籍出版社，1988： 325， 332， 336， 348.

杨世兴，孙塑伦，张学文. 碥石集（第四集）：著名中医学家经验传薪［M］.西安：陕西科学技术出版社，2003： 6-13.

齐婧姝，邢枫，刘成海.布加综合征9例临床分析及诊治经验［J］.肝脏，2022， 27（4）： 486-490.

DE GOTTARDI A， SEMPOUX C， BERZIGOTTI A. Porto-sinusoidal vascular disorder［J］. J Hepatology， 2022， 77（4）： 1124-1135.

INTAGLIATA N M， MAITLAND H， CALDWELL S H. Direct oral anticoagulants in cirrhosis［J］. Curr Treat Options Gastroenterol，2016， 14（2）： 247-256.

刘成海.论张仲景对黄疸病辨治法的贡献［J］.上海中医药大学学报，2004， 18（4）： 5-7.

Anon. WANG Cheng-bai（汪承柏）—A prominent hepatologist of integrative medicine［J］. Chin J Integrat Tradit West Med， 2004， 10（4）： 308-309.

姜申元. 血府逐瘀汤治疗高黄疸临床体会［J］. 辽宁中医药大学学报，2015， 17（3）： 170-171.

阮清发，林立，康旻睿，等. 康良石治疗乙肝肝硬化腹水经验［J］. 世界中西医结合杂志，2014， 9（9）： 923-926.

聂广. 王伯祥教授论治乙型肝炎的经验［J］. 新中医，1995， 24（5）： 3-4.

关伟. 钱英教授滋肾柔肝法治疗肝硬化腹水的经验［J］. 中西医结合肝病杂志，2015， 25（2）： 102-103.

ZHAO Z M， ZHU C W， HUANG J Q， et al. Efficacy and safety of Fuzheng Huayu tablet on persistent advanced liver fibrosis following 2 years entecavir treatment： A single arm clinical objective performance criteria trial［J］. J Ethnopharmacol， 2022， 298： 115599.

邓丽宁，侯宏波，李纯平，等.大黄䗪虫丸联合恩替卡韦治疗乙型肝炎肝纤维化的临床研究［J］. 天津医药，2008， 26（4）： 292-294.

赵治友，姚真敏，钟庆平，等.鳖甲煎丸对慢性肝病肝纤维化治疗作用的临床研究［J］. 新中医，2005， 37（4）： 29-30.

LIU P， HU Y Y， LIU C， et al. Multicenter clinical study on Fuzhenghuayu capsule against liver fibrosis due to chronic hepatitis B［J］. World J Gastroenterol， 2005， 11（19）： 2892-2899.

RONG G， CHEN Y， YU Z， et al. Synergistic effect of Biejia-Ruangan on fibrosis regression in patients with chronic hepatitis B treated with Entecavir： A multicenter， randomized， double-blind， placebo-controlled trial［J］. J Infect Dis， 2022， 225（6）： 1091-1099.

施梅姐，萧焕明，谢玉宝，等. 慢性乙型病毒性肝炎免疫耐受期患者应否治疗：一项临床随机对照试验的分层分析结果［J］. 中药药理与临床，2023， 39（1）： 62-66.

尹珊珊，王宝恩，王泰龄，等.复方861治疗慢性乙型肝炎肝纤维化与早期肝硬化的临床研究［J］. 中华肝脏病杂志，2004， 12（8）： 467-470.

YE Z， HUANG Q， SHE Y， et al . A meritorious integrated medical regimen for hepatic fibrosis and its complications via the systematic review and meta-analysis for Dahuang Zhechong pill-based therapy［J］. Front Med（Lausanne）， 2022， 9： 920062.

ZHANG T， YANG Y， WANG B， et al . Meta-analysis of influences of Biejiajian Pill combined with entecavir on serum liver fibrosis markers of compensatory period of hepatitis b cirrhosis： protocol of systematic review and meta-analysis［J］. Medicine（Baltimore）， 2019， 98（51）： e18458.

刘燕玲，李志更，郭朋. 以活血化瘀法为核心治疗肝纤维化的思路［J］. 中医杂志，2009， 50（1）： 76-78，81.

郭亚楠，顾宏图，赵长青，等. 中医药对肝硬化门静脉血栓的干预作用及用药特点分析［J］. 临床肝胆病杂志，2023， 39（2）： 345-351.

聂广，张赤志，唐智敏，等. 拓展王伯祥教授“肝络瘀阻”学说构建中医肝病分期辨证体系［J］. 中西医结合肝病杂志，2022， 32（9）： 773-779， 786.

LIU H L， LV J， ZHAO Z M， et al. Fuzhenghuayu Decoction ameliorates hepatic fibrosis by attenuating experimental sinusoidal capillarization and liver angiogenesis［J］. Sci Rep， 2019， 9（1）： 18719.

陈可冀. 陈可冀学术思想与医疗经验选集［M］.北京：北京科学技术出版社，2018： 154-155.

刘泽，秘智彤，刘伟，等.经典名方中应用下瘀血法方剂探析［J］.上海中医药杂志，2023， 57（5）： 46-50.

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