肝纤维化的病机认识和辨证论治

我国人群肝纤维化发生的主要原因是病毒性肝炎，其中以乙型，丙型和丁型肝炎最多见，肝纤维化的病因主要是湿热疫毒入侵，并与正气不足有关。病机关键为热毒瘀结，肝脾损伤，对肝纤维化的治疗，应以凉血化阏解普基本方法，配合滋养肝脾，利湿化瘀等法，可初步分为以下6个证型进行辨证论治，即肝郁脾虚证，湿热蕴结证，气滞血淤证，热毒瘀结证，气阴两虚证，肝肾阴虚证，认为热毒瘀结是肝纤维化的中心证型。

Pathogenesis and Differential Diagnosis and Treatment of Liver Fibrosis

In China the main cause of liver fibrosis is viral hepatitis, especially hepatitis B, C and D. The etiology of the disease is the invasion of damp heat and deficiency of anti pathogenic factors. The key pathogenesis is accumulation of heat toxin and damage to the liver and spleen. The main method of treatment should be cooling blood, removing blood stasis and toxin, nourishing the liver and spleen, removing dampness, etc. The disease can be differentiated into the following six syndromes: syndrome of liver depression and deficiency of the spleen, syndrome of damp-heat accumulation, syndrome of stagnation of qi and blood, syndrome of accumulation of heat toxin, syndrome of deficiency of qi and yin, and syndrome of deficiency of yin in the liver and kidney. The syndrome of accumulation of heat toxin is the main syndrome of liver fibrosis.