基于“土壅木郁”理论论治肥胖

Treatment of Obesity Based on “Soil Obstructing Wood Depression”

摘要: 肥胖已成为全球高发的慢性代谢性疾病，现代临床干预常存在远期疗效不稳定、不良反应明显等问题。中医学对肥胖的认知源远流长，其理论体系立足于整体观念，认为肥胖的发生与人体多个脏腑功能的紊乱密切相关。本文基于“土壅木郁”理论，探讨肥胖发病及论治，认为肥胖的核心病机是由脾虚湿盛导致的中焦壅滞，土壅则气机升降失司，进而郁遏肝气，木气不舒则进一步加重水湿、痰浊、膏脂的停聚，形成“壅滞–郁遏”的恶性循环。治疗以理脾气、疏肝气为两大法门，恢复中焦运化与肝木条达之职，为临床诊治提供更多新思路。

Abstract: Obesity has become a chronic metabolic disease with high incidence in the world. Modern clinical intervention often has problems such as unstable long-term efficacy and obvious adverse reactions. The cognition of obesity in traditional Chinese medicine has a long history, and its theoretical system is based on the overall concept. It is believed that the occurrence of obesity is closely related to the dysfunction of multiple organs in the human body. Based on the theory of “soil obstruction and wood depression”, this paper discusses the pathogenesis and treatment of obesity. It is believed that the core pathogenesis of obesity is the stagnation of middle energizer caused by spleen deficiency and dampness. Earth obstruction leads to the loss of qi movement, and then the stagnation of liver qi is suppressed. The discomfort of wood qi further aggravates the stagnation of water dampness, phlegm turbidity and ointment fat, forming a vicious circle of “stagnation-depression”. Regulating spleen qi and soothing liver qi are the two main methods of treatment, restoring the function of middle energizer and liver wood, and providing more new ideas for clinical diagnosis and treatment.