基于“脏腑别通理论”探讨脾-肠-炎症因子与肌少症相关性  

A discussion on the correlation between spleen-intestine-inflammatory factors and sarcopenia based on“linkage between Zang and Fu”theory

作　　者：付煜 王慧[1] 滕士超[1] FU Yu;WANG Hui;TENG Shichao

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《中医临床研究》2023年第18期81-84,共4页Clinical Journal Of Chinese Medicine

基　　金：老年肌少症患者中医证候分布规律及证型间代谢组学差异性研究(BJ20020);老年医学临床技术应用研究项目单位(LD2021003);老年医学临床技术应用研究项目带头人(LR2021003)。

摘　　要：肌少症是随着年龄增加,骨骼肌量减少或伴有肌肉力量和肌肉功能减退的老年综合征之一。随着全球老龄化进程加快,老年人数量上升,肌少症的患病率相继增加,随之而来的是老年人跌倒死亡风险增加,肌少症更逐渐成为研究热点。肌少症,在中医学中可归属于“痿证”“肉痿”等范畴。中医认为肌少症多由“脾胃虚弱、肝肾不足、痰湿困阻”所致。其中着重研究了脾胃、肝肾在发病中的重要性,忽视了其他脏腑与肌少症之间的联系。同时,中医理论与临床研究未形成良好衔接。脏腑别通是指五脏别有相通之处,与传统经络学说脏腑相表里不同,是对脏与腑关系更深层次的总结。明代李梴《医学入门•脏腑条分》最早记载了不同于阴阳表里的脏腑联系,提出“脾与小肠相通(脾病宜泻小肠火,小肠病宜润脾土为主)”与现代医学脾与小肠生理功能密切相关相对应。文章基于“脾与小肠相通”理论,通过查阅古籍经典及文献,通过探讨“脾与小肠”之间的联系,以进一步探究脾-小肠与肌少症的相关性。结合炎症因子等现代医学及临床研究,探究“小肠-炎症因子与肌少症”的相关性,为老年肌少症的发病机制及临床研究提供理论依据,为临床防治该病提供借鉴。Sarcopenia is one of several syndromes of aging where skeletal muscle volume decreases with increasing age or is accompanied by a decline in muscle strength and function.With the acceleration of global aging process,the number of the elderly increases,the prevalence rate of sarcopenia increases successively,followed by the increasing of the elderly fall and death risks,sarcopenia has gradually become a research focus.Sarcopenia can be classified as“impotence syndrome”,“meat impotence”and other categories in traditional Chinese medicine.According to traditional Chinese medicine,sarcopenia is mostly caused by“weak spleen and stomach,deficiency of liver and kidney,phlegm-dampness”.The importance of spleen,stomach,liver and kidney in pathogenesis is emphasized,while the relationship between other viscera and sarcopenia is ignored.At the same time,TCM theory and clinical research dose not form a good connection.“Linkage between Zang(脏)and Fu(腑)”refers to the connection between the five viscera and six Fu organs,which is different from the traditional meridians theory and is a deeper summary of the relationship between six Fu organs.Yixue Rumen(《医学入门》)from LI Chan,a TCM master in Ming Dynasty(明代),was the first to record the connection between Zang and Fu organs,which is different from the exterior and interior relationship of Yin(阴)and Yang(阳).He proposed that“spleen and small intestine are connected(treating spleen disease should purge small intestine fire,and treating small intestine disease should moisten the spleen soil)”,which corresponds to the close correlation between spleen and small intestine physiological functions in modern medicine.Based on the theory of“Linkage between Zang and Fu”,this paper further explores the correlation between spleen and small intestine and sarcopenia by referring to ancient classics and literature and exploring the connection between“spleen and small intestine”.Combined with modern medical and clinical studies on inflammatory fact

关 键 词：脏腑别通 中医理论 老年肌少症 炎症因子 

分 类 号：R25[医药卫生—中医内科学]