基于《脾胃论》"胆气春升"理论初步构建脂肪肝辨治体系OA

The"ascending of gallbladder qi in spring"theory originates from the Huangdi Neijing(Inner Canon of Yellow Emperor).The theory states that the Shaoyang gallbladder meridian represents yang in its first stage,characterized by faint yang qi--the initial emergence of yang qi,embodying a generative force with the nature of clear yang ascending,aligning with the rising qi in spring.Gallbladder qi promotes the vital essence of the viscera.Li Gao inherited and developed the theories from the Huangdi Neijing and the Shanghan Lun(Treatise on Cold Pathogenic Diseases),explicitly proposing the"ascending of gallbladder qi in spring"theory,whose connotation can be summarized into three aspects:"initiation","vitality",and"qi smoothing or regulating".The liver and gallbladder both pertain to wood,with the liver as yin and the gallbladder as yang.They synergize physiologically,jointly governing ascending and dredging and regulating qi movement.Based on Li Dongyuan's interpretation of"ascending of gallbladder qi in spring",this study explores the pathogeneses of fatty liver from the perspectives of liver-gallbladder disharmony,dysfunction of the six fu-organs in transformation,and metabolic disorders of qi,blood,and body fluids,attributing its occurrence to deficiency,stagnation,and counterflow of qi.The fatty liver treatment framework is preliminarily constructed under the theory of"ascending of gallbladder qi in spring",emphasizing dispelling wind and ascending yang,smoothing qi flow,and warming the gallbladder and resolving phlegm.