以脾藏象为例论《灵枢》《素问》脏腑体系建构方法差异性  

Differences in the methodology to construct zang-fu system between Suwen and Lingshu: A case study of the spleen manifestation

作　　者：贺娟[1] He Juan(Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029

出　　处：《北京中医药大学学报》2021年第12期1067-1072,共6页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家社会科学基金“冷门绝学”研究专项(No.20VJXG033)。

摘　　要：关于《黄帝内经》,历代医家皆重《素问》而轻《灵枢》。作者以脾藏象为例,通过对脾与胃的解剖关系、脾开窍于唇、脾藏营、脾瘅、脾病则四肢不用等脾之系列生理病理现象的揭示,以及《黄帝内经》重胃轻脾的经文等,系统论证了《黄帝内经》之“脾”系解剖学之胰腺,进而阐述《灵枢》以实证为基础建立脏腑系统的特征。《素问》则以关系为主,脾之属土、不主于时、脾胃为五脏气机之枢轴及重脾轻胃等理论特征,系古代哲学思想影响的结果。《素问》之哲学化的医学理论,系建立在《灵枢》实证认识基础上,是对实证认知的补充与完善,《灵枢》的实证研究方法在脏腑理论中的作用应得到现代中医学足够的重视。Between the two parts of Huangdi Neijing(Huangdi's Internal Classic)i.e.Suwen(Fundamental Questions)and Lingshu(Spiritual Pivot),the former has attracted more attention than the latter from physicians in all dynasties.Taking the spleen as an example,the paper argues that the spleen in Huangdi Neijing is the pancreas anatomically based on the physiological and pathological phenomena of the spleen such as the anatomical relationship between the spleen and the stomach,lips as the window of the spleen,spleen storing nutrients,spleen disorder due to excessive heat,and paralysis of limbs due to spleen dysfunction as well as texts that demonstrated more emphasis on the stomach and less on the spleen in Huangdi Neijing.Furthermore,it expounds that in Lingshu the zang-fu system was built up based on empirical knowledge while in Suwen on the relationship,e.g.the spleen corresponds to earth in the five elements,the spleen does not dominate any specific season,and the spleen and stomach play a pivotal role in qi activity of the five zang organs.Such relations together with theories that attach more importance to the spleen than the stomach in Suwen are a result of the influence of ancient Chinese philosophy.The philosophy-oriented medical theory in Suwen is based on and complements the empirical knowledge in Lingshu.The empirical research methodology applied to the study of zang-fu theory in Lingshu warrants due attention in modern Chinese medicine.

关 键 词：素问 灵枢 藏象 脾 胃 脏腑体系 

分 类 号：R221[医药卫生—中医基础理论]