基于一气周流探讨从脾论治双心疾病  

Discussion on the treatment of psychic-cardiac disease from the perspective of spleen based on the theory of Qi circulation

作　　者：许雪 刘桂林[2] XU Xue

机构地区：[1]山东中医药大学第一临床医学院,山东济南250014 [2]山东中医药大学第二附属医院,山东济南250002

出　　处：《中医临床研究》2023年第35期17-20,共4页Clinical Journal Of Chinese Medicine

基　　金：山东省中医药科技发展计划项目(2015-158)。

摘　　要：社会的巨大进步使得人们生活质量与精神压力不断攀升,同时也增加了心系疾病并发心理疾患的人数。现代医学称心系疾病与心理疾患相互伴发、相互影响、共存者为“双心疾病”。该病发病率较高,现已成为严重的健康问题。目前西医治疗双心疾病多采用常规治疗联合精神类药物,难以取得理想效果。中医治疗“双心疾病”的独到优势在于整体辨证施治、因人制宜,在调理身心的同时可解决西药效果不理想的难题。黄玉璐提出的“一气周流”理论强调中土脾胃做轴,中气左升右降带动肝心肺肾四象轮转,形成循环无端的“圆运动”,强调中气为人体气机升降出入之根本。文章基于一气周流、土枢四象理论及现代医家对双心疾病的认识,探讨双心疾病的发病机制与治法治则,认为双心疾病的发病根源在于中土不运,中土不运所致痰瘀互结、气机不畅、气血不和、心失所养为发病关键。治疗应以培补中土、恢复中气正常升降为基础,以调和气血、疏肝养心、祛痰活血为主,使中气健运、安神达郁,恢复机体一气周流之状态,则一身之病尽除。治病必求于本,从脾出发对双心疾病进行辨治分析,更有利于标本兼顾,发挥中医药在双心疾病论治中的优势。The tremendous progress of society has made a continuous increase in quality of life and mental pressure of people,and also increases the proportion of people with cardiac diseases plus psychological disorders.Modern medicine calls cardiac diseases and psychological disorders co-occurring,interacting,and co-existing as psychic-cardiac disease.The disease has a high incidence,T and is now a serious health problem.At present,Western medicine mostly uses conventional treatment plus psychotropic medicines to treat psychic-cardiac disease,which is difficult to achieve ideal results.The unique advantage of TCM in treating psychic-cardiac disease lies in overall syndrome differentiation and personalization,which can not only regulate the body and mind,but also solve the problem of unsatisfactory effects of western medicine.The theory of Qi(气)circulation proposed by HUANG Yulu emphasizes that spleen-stomach is the axis,and that the left ascending and right descending of Qi of middle Jiao(中焦)drive the rotation of the liver,heart,lungs,and kidneys,forming a circular motion without end,emphasizing that Qi of middle Jiao is the material fundation of the ascending and descending of Qi in human body.Based on the theory of Qi circulation,the theory of the other four organs are ruled by the spleen,and modern physicians’understanding on Psychic-cardiac disease,this study explores the pathogenesis and treatment principles of psychic-cardiac disease.It is believed that the root causes of the psychic-cardiac disease lies in the lack of transportation of the spleen,resulting in the accumulation of phlegm and blood stasis,impeded Qi movement,disharmony of Qi and blood,and the loss nourishment of heart,which are the core pathogenesis.Therefore,the treatment should be based on nourishing spleen and restoring the normal rise and fall of Qi of middle Jiao.The focus should be on regulating Qi and blood,soothing the liver and nourishing the heart,dispelling phlegm and promoting blood circulation,so as to promote the healthy circulat

关 键 词：一气周流 双心疾病 中土虚滞 脾胃 

分 类 号：R256.2[医药卫生—中医内科学]