基于“肝常有余，脾常不足”理论探讨胆胀病的辨证治疗

Exploration on Syndrome Differentiation and Treatment of Gallbladder Distention Based on the Theory of “Liver Often Having Excess and Spleen Often Having Deficiency”

摘要: 基于“肝常有余，脾常不足”的理论可将胆胀病的病机归纳为肝气郁结，脾虚失运，病机归纳为气滞、湿热、瘀血、脾虚四类，因此在治疗上当根据其偏盛、不足分别施以疏肝胆不通之气、清中焦之湿热、化胆中有形实邪、复肝脾之气机的治疗手法。临床上可以此理论为纲灵活用药治疗胆胀病，以达到阴平阳秘的目的。

Abstract: Based on the theory that “the liver is often excessive, while the spleen is often deficient,” the pathogenesis of gallbladder distension can be summarized as liver qi stagnation and spleen deficiency impairing transportation. The pathological mechanisms are categorized into four types: qi stagnation, damp-heat, blood stasis, and spleen deficiency. Therefore, treatment should address the excess or deficiency accordingly by dispersing stagnant qi in the liver and gallbladder, clearing damp-heat in the middle energizer, resolving tangible pathogenic factors in the gallbladder, and restoring the qi dynamics of the liver and spleen. Clinically, this theory can serve as a guiding principle for flexible medication in treating gallbladder distension, aiming to achieve the balance of yin and yang.