田德禄基于"肝为刚脏必柔以济之"分期辨治肝纤维化的用药经验OA

Liver fibrosis falls within the categories of"hypochondriac pain","jaundice",and"abdominal mass"in traditional Chinese medicine(TCM).Based on the physiological characteristic that"the liver,serving as a firm organ,being tempered by softness",Professor TIAN Delu considers liver fibrosis to result from excessive consumption of rich,greasy,and alcoholic foods,or invasion by external pathogens such as viruses.These factors lead to disharmony of the liver's substance and function,as well as qi and blood,resulting in dysfunction of the Zang-fu organs.Consequently,pathological products such as dampness,heat,toxin,stagnation,and blood stasis accumulate,congeal,and obstruct the liver collaterals,causing damage to the liver.In the early stage,the disease is predominantly characterized by excess;over time,it develops into a pattern of mixed deficiency and excess,and in the late stage,it is marked by deficiency of healthy qi with persistence of pathogenic factors.Treatment should adhere to the pathogenesis,following the principle of"eliminating pathogenic factors,tonifying deficiency,and regulating qi and blood",with stage-based differentiation and management.In the early stage,treatment focuses on soothing the liver and regulating qi,activating blood and resolving stasis,and clearing damp-heat.In the middle stage,while eliminating pathogenic factors,treatment also emphasizes regulating the liver and strengthening the spleen.In the late stage,therapy focuses on reinforcing healthy qi and consolidating the root,tonifying the liver,spleen,and kidney.Throughout all stages,regulation of blood and unblocking of the collaterals are consistently applied to restore the physiological state of balance between firmness and softness of the liver,thereby reversing liver fibrosis.