“肝主疏泄”的现代生物学阐释  

Modern Biological Interpretation of Liver Governing Free Flow of Qi

作　　者：肖开慧 任翼 徐帅 李丽[1] 马惠芳[2] 赵静洁[1] XIAO Kaihui;REN Yi;XU Shuai;LI Li;MA Huifang;ZHAO Jingjie(Beijing Friendship Hospital,Capital Medical University,Beijing 100500,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京友谊医院,北京100050 [2]北京中医药大学,北京100029

出　　处：《世界中医药》2022年第24期3519-3523,共5页World Chinese Medicine

基　　金：国家自然科学基金项目(82004109);北京市自然科学基金项目(7204250);首都卫生发展科研专项(2022-2-20213)。

摘　　要：在历代各家学说的基础上,“肝主疏泄”的内涵和外延不断丰富与扩展:从单纯的疏通、排泄逐步拓展为多系统、多方面的生理功能,如调畅情志、调节气血、调理脾胃、排泄胆汁、通利水道、疏泄生殖等。在传统中医理论中,肝与脑的关系尤为密切,主要体现在生命活动、精神活动和感觉运动3个方面。现综合近年来相关研究和最新进展,将“肝主疏泄”的现代生物学调控机制具体阐述为:肝主疏泄的控制系统是大脑边缘系统;其作用途径是以下丘脑-垂体-肾上腺轴、微生物-肠-脑轴为代表的神经-内分泌-免疫网络;其效应器为以内脏、血管平滑肌及骨骼肌为代表的肌肉组织。“肝主疏泄”科学内涵的进一步阐释,有利于拓宽研究思路,为临床应用提供理论依据。On the basis of the thoughts and summaries of doctors of the past dynasties,the connotation and denotation of liver governing free flow of qi have been continuously enriched and expanded,which gradually developed from single dredging and excreting to various multi-system physiological functions,such as regulating emotions,qi and blood as well as spleen and stomach,excreting bile,dredging water channels,and regulating reproduction.In traditional Chinese medicine(TCM)theory,liver and brain are particularly closed,mainly reflected in the three aspects of life activity,mental activity and sensory and motor activity.On this basis,this paper,by integrating the relevant research and the latest progress in recent years,elucidated the modern biological regulatory mechanism of liver governing free flow of qi as follows:The control system of liver governing free flow of qi was the limbic system of the brain,by the way of neuro-endocrine-immune network represented by hypothalamic-pituitary-adrenal axis and microbiome-gut-brain axis,and acting on muscle tissues represented by smooth muscle of internal organs and blood vessels and skeletal muscle.Further explaining the scientific connotation of liver governing free flow of qi is conducive to broadening its research ideas,which provides theoretical basis for clinical application.

关 键 词：肝主疏泄 边缘系统 神经-内分泌-免疫网络 下丘脑-垂体-肾上腺轴 微生物-肠-脑轴 平滑肌 骨骼肌 

分 类 号：R223[医药卫生—中医基础理论] R360[医药卫生—中医学] R180