从“气化则湿化”论治脾虚湿蕴型肥胖及验案举隅

Treatment of Obesity with Spleen Deficiency and Dampness Accumulation Based on “Dampness Resolves When Qi Transforms” and a Case Example

摘要: 本文以“气一元论”为理论基础，基于“气化则湿化”理念，探讨脾虚湿蕴型肥胖的中医治疗。肥胖已成为全球范围内常见的健康问题，在我国超半数成年居民超重或肥胖，肥胖从中医辨治角度多以“湿”为核心，这点在脾虚湿蕴型肥胖尤为明显。其中脾虚湿蕴型肥胖因湿邪与脾虚相互影响形成病理闭环，湿邪的祛除就成为治疗关键，因此以气一元论入手，基于“气化则湿化”理论，提出以调理脾胃气机升降为核心的治疗思路，故马天明教授以温胆汤为基础方拟除湿温胆汤，通过调理脾胃气机升降平衡，调畅全身气机，使患者湿邪代谢通畅，从而达到减肥目的，以期为肥胖治疗提供参考。

Abstract: This article takes “Qi Monism” as its theoretical foundation and explores the TCM (Traditional Chinese Medicine) treatment of obesity of the spleen deficiency and dampness accumulation type based on the concept that “dampness is resolved when Qi is activated”. Obesity has become a common health issue worldwide. In China, over half of adult residents are overweight or obese. From the perspective of TCM syndrome differentiation and treatment, “dampness” is mostly regarded as the core factor of obesity, which is particularly prominent in obesity of the spleen deficiency and dampness accumulation type. In this type of obesity, pathogenic dampness and spleen deficiency interact with each other to form a pathological loop, so the elimination of pathogenic dampness becomes the key to treatment. Therefore, starting from Qi Monism and based on the theory that “dampness is resolved when Qi is activated”, this article proposes a treatment approach centered on regulating the ascending and descending of Qi movement in the spleen and stomach. When Qi movement is unobstructed, the metabolic pathway of pathogenic dampness will be smooth. Hence, Professor Ma Tianming formulated the Chushi Wendan Decoction (Dampness-Removing Wendan Decoction) based on the basic formula of Wendan Decoction. By regulating the balance of ascending and descending Qi movement in the spleen and stomach and smoothing the Qi movement throughout the body, this decoction promotes the smooth metabolism of pathogenic dampness in patients, thereby achieving the goal of weight loss, with the expectation of providing a reference for the treatment of obesity.

基金项目

黑龙江省中医药科研项目(项目编号：ZYW2022-021)。

声 明

该病例报道已获得患者知情同意。

NOTES

^*第一作者。

^#通讯作者。