脾胃学说历史沿革  

The Profile of Spleen-Stomach Doctrines

作　　者：张学毅 马红星 

机构地区：[1]重庆市奉节县中医院中医内科,重庆奉节404600

出　　处：《实用中医内科杂志》2014年第6期174-175,177,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：春秋战国到两汉是脾胃学说形成与奠基阶段,《黄帝内经》阐述了脾胃生理功能;《伤寒杂病论》重点阐述外感疾病与脾胃基础疾病的辨证关系,调理脾胃成为治疗外感病重要法则。唐宋为发展时期,《千金要方》与《千金翼方》以五脏六腑为纲,寒热虚实为目,确立"春夏取冷太过",提出"温食",顾护脾阳。金元至明清时期是脾胃学说的鼎盛时期,张元素著《医学起源》、《脏腑标本寒热虚实实用药式》"土实泻之"、"土虚补之"、"本湿除之"、"标湿渗之";李东垣《脾胃论》"饮食伤脾论"、"甘温除大热"至今仍有重要指导意义。明清是充实、完善阶段,叶天士继承东垣补脾升阳,创立胃阴辨治说,弥补了东垣略于治胃,重在温补,不及养阴的不足,纠正了举世皆以治脾之药笼统治胃,甚则阴阳不辨的弊病,对脾胃学说的发展作出了重要贡献;李中梓重视脾、肾,提出:"人之有脾胃,犹兵家之有饷道,饷道一绝,万众立散,脾胃一败,百药难施","有胃气则生,无胃气则死";薛己结合温病,巩固了脾阴学说,提出"阴虚乃脾虚也,脾为至阴"。近年在中西医学基础理论基础上建立了40余种脾虚模型,综合观测,证实脾胃与人体多系统(消化、神经、内分泌、免疫及血液)密切关系。The spring and autumn and Warring States to Han Dynasty is the spleen and stomach theory formation and the stage of foundation, ＂Huangdi Neijing＂ describes the physiological function of spleen and stomach; ＂Treatise on Febrile Diseases＂ focuses on the dialectical relationship between exogenous diseases and the spleen and stomach disease, spleen and stomach become the treatment of exogenous diseases important rule. The Tang and Song Dynasty is theperiod of development, ＂Prescriptions＂ and ＂Qian Jin Yi Fang＂ as the key link to the viscera, cold and heat for the purpose, to establish ＂the summer cold too＂, put forward the ＂warm food＂, protecting the spleen yang. Jin and Yuan Dynasty to Ming and Qing Dynasties period was the heyday of the spleen and stomach theory, Zhang Yuansu ＂origin of medicine＂, ＂internal organs were cold and heat utility drug type soil real diarrhea＂, ＂soil＂ tonic ＂, the wet removal＂, ＂standard wet permeability of Li Dongyuan＂; ＂spleen and stomach＂ diet ＂spleen injury theory＂, ＂sweet of eliminating heat＂ still has an important guiding significance. Ming and Qing Dynasties is the enrichment, perfection, ye Tianshiinherit Dong Yuan spleen and stomach yin sun, founded in the Dong Yuan said, slightly to cure stomach, focusing on the temperature compensation, not Yin deficiency, correct world with spleen stomach medicine cage rule, even can not identify the ills of yin and Yang, made important contributions development of the spleen and stomach ; Li Zhongzi takes the spleen, kidney, puts it ： ＂the man＇s stomach, and the military have pay, pay channel must, the divergence, the spleen and stomach failure, medicine is hard to use＂, ＂Qi is born, without vitality is dead＂; Xue has combined withfehrile diseases, strengthen spleen yin theory, put forward the ＂Yin deficiency and spleen but, as to yin＂. In the basis of Chinese and Western Medicine on the basis of the establishment of more than 40 models, a comprehensive ohservation, confi

关 键 词：脾胃学 黄帝内经 伤寒杂病论 千金要方 金翼方 钱乙 张元素 李东垣 李中梓 薛己 

分 类 号：R22[医药卫生—中医基础理论]