北京中医药2026，Vol.45Issue(2)：217-221,5.DOI:10.16025/j.1674-1307.2026.02.012
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
Professor TIAN Delu's medication experience in differentiating and treating liver fibrosis by stages based on the principle of"the liver,serving as a firm organ,being tempered by softness"
摘要
Abstract
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.关键词
田德禄/肝纤维化/肝为刚脏必柔以济之/分期辨治/名医经验Key words
TIAN Delu/liver fibrosis/"the liver,serving as a firm organ,being tempered by softness"/stage-based differentiation and treatment/experience of famous doctor引用本文复制引用
周静鑫,孙慧怡,张雯,聂里红,王文颖,李志红,田德禄..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[J].北京中医药,2026,45(2):217-221,5.基金项目
第六批北京市级中医药专家学术经验继承工作项目 （）
中华中医药学会雏鹰计划中医临床青年人才研修项目 （）
北京市通州区科技创新人才资助项目(JCQN2024022) （JCQN2024022）
北京中医药大学东直门医院临床研究和成果转化能力试点项目(DZMG-MLZY-23009) （DZMG-MLZY-23009）
田德禄"三名"传承工作室项目(2023-SZ-F-1) （2023-SZ-F-1）
