非酒精性脂肪肝病中医证型的研究进展.docVIP

非酒精性脂肪肝病中医证型的研究进展 　　摘 要 非酒精性脂肪性肝病（NAFLD）是临床最常见的一类脂肪肝，多因饮食失节、多坐少动、精神抑郁、肥胖超重等所致，现代医学认为胰岛素抵抗和遗传易感性是NAFLD发病的关键因素。目前，中医文献报道的NAFLD治疗仍以中药为主，涉及辨证分型及证候研究者相对缺乏。以往，多数中医师因各自对NAFLD的认识和临床经验不同，辨证思路亦不相同，必然造成证型分类难以标准化、统一化，从而影响NAFLD的中医药规范化治疗。因此，为了更好地认识本病的中医证型规律，本文简述近年来NAFLD中医证型的研究进展。 　　关键词 非酒精性脂肪肝病 中医证型 研究进展 　　中图分类号：R575.5 文献标识码：A 文章编号：1006-1533（2015）18-0025-03 　　Research progress of the traditional Chinese medicine syndromes of nonalcoholic fatty liver disease 　　LIU Bin（1.Traditional Chinese Medicine University， Shanghai 200032， China； 2. Geriatrics Department of the Traditional Chinese and Western 　　Medicine Hospital of Baoshan District， Shanghai 201999， China） 　　ABSTRACT The nonalcoholic fatty liver disease （NAFLD） is a kind of the most common clinical fatty liver， which was mostly caused by diet disloyal， sedentary， depression， obesity and overweight etc. The modern medicine thinks that the insulin resistance and genetic susceptibility are the key factors for the pathogenesis of NAFLD. At present， the Chinese medicine literature reports that the NAFLD is still treated with the traditional Chinese medicine （TCM） mainly， but there is in the relative lack of the researchers in the syndrome differentiation and syndrome type. In the past， because of their different knowledge and clinical experience in NAFLD of the majority TCM physicians， the dialectical thinking is not the same so that this inevitably leads to difficultly standardize and unify the syndrome classification， thereby to affect the NAFLD standardization of TCM treatment. Therefore， in order to better understand the characteristics of TCM syndromes of this disease， the author summarizes the research progress of TCM syndromes of NAFLD in the recent years. 　　KEY WORDS nonalcoholic fatty liver； TCM syndromes； research progress 　　西医学认为，非酒精性脂肪性肝病（NAFLD）是一种与胰岛素抵抗（IR）及遗传易感密切相关的代谢应激性肝损伤，NAFLD大致可分为三类：①非酒精性单纯性脂肪肝；②非酒精性脂肪性肝炎（NASH）；③非酒精性脂肪肝相关肝硬化、肝癌[1]。2005年范建高等[2]的调查发现，上海市成人中NAFLD患病率高达15.35%，占脂肪肝患者总数的88.78%。2011年张红燕等[3]从南通市体