肝纤维化从肾论治探讨

发布时间：2018-06-10 09:00

本文选题：肝纤维化 + 肝细胞　；参考：《中国中医基础医学杂志》2017年09期

【摘要】：肝纤维化的主要病机是肾虚应从肾论治。中医认为"虚极及肾",从病程、肝细胞再生能力、肝细胞端粒长度、卵圆细胞、肝细胞EMT现象、甲胎蛋白、白蛋白、肥大细胞、TGF-β通路、Wnt/β-catenin通路等方面看,肝纤维化时肝细胞的再生能力转而弱于间质的增殖修复能力,说明肝细胞生机不足;肝组织开始出现胚胎化特征,说明已"损及胎元",所以肝纤维化应从肾论治。目前对肝纤维化的辨证主要有肝郁脾虚、肝肾阴虚、脾肾阳虚、瘀血阻络、湿热中阻和气滞血瘀,从肾论治为主者极少。在肝纤维化病理中,如果主要着眼于"纤维"就会更注重"实证";如果主要着眼于"肝细胞"就会更注重"虚证"。尽管肝细胞占肝脏细胞总数超过80%,但在肝纤维化过程中的病理生理作用一直被忽略。即使目前重视程度提高,但主要也集中在其产生纤维方面的作用,而相对忽视其衰老和增殖修复能力下降。
[Abstract]:The main pathogenesis of liver fibrosis is kidney deficiency should be treated from the kidney. TCM believes that "deficiency pole and kidney" can be seen from the aspects of course of disease, ability of liver cell regeneration, length of telomere, oval cell, EMT phenomenon of liver cell, alpha-fetoprotein, albumin, mast cell TGF- 尾 pathway and Wnt- 尾 -catenin pathway. The regeneration ability of liver cells is weaker than that of mesenchymal proliferation and repair, which indicates that the liver cells lack of vitality, and that the liver tissue begins to have the characteristics of embryogenesis, which indicates that it has "damaged the fetal elements", so the liver fibrosis should be treated from the kidney. At present, there are mainly liver stagnation and spleen deficiency, liver and kidney yin deficiency, spleen and kidney yang deficiency, blood stasis blocking collaterals, damp-heat middle obstruction and qi stagnation and blood stasis. In liver fibrosis pathology, if focus on "fiber" will pay more attention to "empirical", if focus on "liver cells" will pay more attention to "deficiency syndrome". Although liver cells account for more than 80% of liver cells, the pathophysiological role of liver fibrosis has been neglected. Although the current attention is increased, it mainly focuses on its fiber production, while ignoring the decline of its aging and proliferative repair ability.
【作者单位】：中国中医科学院中医基础理论研究所;
【基金】：中央级公益性科研院所基本科研业务费专项资金自主选题项目(YZ-1660)-补肾法对肝纤维化大鼠的干预作用及对TGF-β/Smad信号通路的影响
【分类号】：R259

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