摘要
《黄帝内经》中的“阳化气,阴成形”理论以化、成之用、变、动、衡衍生万物,高度凝练彰显道之含义本真,指导自然万物包括疾病的发生变化进展。故万千实体病状的表象皆是阴阳气化的应象。玄府由阴阳气化形成所涵养司调,其为枢纽、通道,佐助气之出入变化,实现与外界物质、能量、信息的交换。以玄府为转枢,基于阳化气,阴成形的宏观调控、整体思想下探析慢性肝病的微观机制,结合线粒体、外泌体、超微肝筛结构在慢性肝病形成进展中的作用机制,阐释在该理论指导下慢性肝病的本始之质、症状标象与其生理病理功能的密切内在关联性。现代研究表明,细胞自噬、肠道菌群失调、糖脂代谢紊乱、炎症因子激活、铁死亡等相关微观病理机制参与慢性肝病的发生发展,深刻剖析祖国医学的阴阳理念与现代医学的病理机制的共同内涵,总结出相关微观病理机制与“阳化气,阴成形-玄府”理论对慢性肝病发挥的指导统调作用的对应性。风药升生,透转玄府;辛甘合化,振阳散阴,具风药之性和辛甘合化之义的方药契合“阳化气,阴成形-玄府”理法之机。本文将辨宏观—辨微观相结合,旨在基于“阳化气,阴成形-玄府”理论解释慢性肝病的科学内涵和微观病理机制,并探索出辛甘合化、振阳启玄散阴之理法方药对慢性肝病的防治作用,为慢性肝病的临床治疗提供新思路与借鉴参考。
The theory of"Yang transforming Qi while Yin constituting form"in the Huangdi's Internal Classic is derived from the application,transformation,movement,and balance of Tao.It is highly condensed,revealing the true meaning of Tao and guiding the changes and progress of all natural things,including diseases.Therefore,the appearance of various physical diseases is the manifestation of Yin-Yang Qi transformation.Sweat pore,formed by the Qi transformation of Yin and Yang,is the nourishing and regulating system.It serves as the hub and channel,assisting in the flow and transformation of Qi,facilitating the exchange of material,energy,and information with the outside world.With sweat pore as the hub and based on the macro-control and holistic thinking of"Yang transforming Qi while Yin constituting form",this paper explores the microscopic mechanisms underlying chronic liver disease.In combination with the roles of mitochondria,exosomes,and the ultraliver sieve structure in the formation and progression of chronic liver disease,this paper elucidates the close internal relationship between the disease's initial quality,symptom signs,and its physiological and pathological functions under the guidance of this theory.Modern studies have shown that autophagy,intestinal flora disorders,glucose and lipid metabolism disturbances,activation of inflammatory factors,ferroptosis,and other microscopic pathological mechanisms are involved in the occurrence and development of chronic liver disease.The common connotation of the Yin-Yang concept in traditional Chinese medicine(TCM)and the pathological mechanisms in modern medicine is deeply analyzed.The corresponding relevant microscopic mechanisms and the guiding role of the theory of"Yang transforming Qi while Yin constituting form-sweat pore"in the management of chronic liver disease are summarized.Wind medicine promotes growth and transformation through sweat pore.The combination of pungent and sweet medicines facilitates Yang and disperse Yin.The formulas,combining the characteristics of wind medicine and pungent and sweet medicines,fit the principle of"Yang transforming Qi while Yin constituting form-sweat pore".This paper combines both macro and micro perspectives to explain the scientific connotation and microscopic mechanisms of chronic liver disease based on the theory of"Yang transforming Qi while Yin constituting form-sweat pore",and explore the prevention and treatment of chronic liver disease through the principles,methods,prescriptions,and medicines featured by combination of pungent and sweet medicines,facilitating Yang,activating sweat pore,and dispersing Yin,providing new ideas and reference for the clinical treatment of chronic liver disease.
作者
许钰颖
赵长普
李荣枝
张雨
王菲
郝晨源
束光杰
XU Yuying;ZHAO Changpu;LI Rongzhi;ZHANG Yu;WANG Fei;HAO Chenyuan;SHU Guangjie(Henan University of Chinese Medicine,Zhengzhou 450000,China;Henan Province Hospital of Traditional Chinese Medicine,Zhengzhou 450000,China;Zhengzhou University,Zhengzhou 450053,China)
出处
《中国实验方剂学杂志》
北大核心
2025年第4期244-255,共12页
Chinese Journal of Experimental Traditional Medical Formulae
基金
河南省中医药科学研究专项(2022ZY1068)
河南省中医药科学研究专项(2019ZYBJ12)
河南省高等学校重点科研项目(22A360014)
河南省中医药拔尖人才培养项目(豫中医科教[2018]35号)。
关键词
阳化气
阴成形
玄府
慢性肝病
微观机制
理法方药
Yang transforming Qi while Yin constituting form
sweat pore
chronic liver disease
microscopic mechanism
principles,methods,prescriptions,and medicines
