基于五脏相关学说探讨以心脾相关理论治疗脾胃病的思路与临床应用  

Exploring the Idea and Clinical Application of Treating Spleen and Stomach Diseases with Heart-spleen Related Theory based on Five-viscera Related Theory

作　　者：黄远程 刘鹏[1] 黄超原 文艺[2] 李培武[2] 庄昆海[2] 刘凤斌[2,3] HUANG Yuancheng;LIU Peng;HUANG Chaoyuan;WEN Yi;LI Peiwu;ZHUANG Kunhai;LIU Fengbin(First Clinical Medical School,Guangzhou University of Chinese Medicine,Guangdong 510006,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong 510405,China;Baiyun Hospital of The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong 510470,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510006 [2]广州中医药大学第一附属医院,广东广州510405 [3]广州中医药大学第一附属医院白云医院,广东广州510470

出　　处：《西部中医药》2024年第6期33-37,共5页Western Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81904139,81973819);国家中医药管理局区域中医(专科)诊疗中心建设项目(国中医药医政函〔2018〕205号);广州中医药大学一流学科研究重点项目[2018(6)号];刘凤斌广东省名中医传承工作室建设项目(粤中医办函〔2020〕1号)。

摘　　要：从心脾相关理论源流、心脾关系辨析出发,探讨基于心脾相关理论的脾胃病病因病机与治疗方法,认为心脾相关理论萌芽于秦汉、发展于晋唐,兴盛于宋元,完善于明清,成熟于近代。在相互关系方面,心脾通过经络、五行、气血、精神情志相关,并在现代研究中的脑-肠轴学说中得到验证。在病因病机方面,火衰土虚、心火乘脾、心脾两虚、心胃不和是心脾相关理论中的最常见的脾胃病发病机制。临床治疗时,可针对各个病机分别以益火补土、泻心扶脾、补心健脾、调心安脾为核心治疗方法。在用药方面,以附子、干姜、桂枝、炙甘草温补心阳,以黄芪、黄连补脾泻火,以黄芪、人参、龙眼肉、当归补心健脾,以首乌藤、玫瑰花、合欢皮等调养心神以安脾胃。Starting from the origin of heart and spleen related theories and the analysis of the relationship between heart and spleen,this paper explores the causes,pathogenesis and treatment methods of spleen and stomach diseases based on heart and spleen related theories,and concludes that the heart and spleen related theories sprouted in the Qin and Han dynasties,developed in the Jin and Tang dynasties,and flourished in the Song and Yuan dynasties,perfected in the Ming and Qing dynasties,and matured in modern times.In terms of mutual relationships,the heart and spleen are related through meridians,five elements,Qi and blood,and spiritual emotions,and have been verified in the brain-gut axis theory in modern research.In terms of etiology and pathogenesis,fire failure and earth deficiency,heart fire invading the spleen,heart-spleen deficiency,and heartstomach disharmony are the most common pathogenesis of spleen and stomach disorders in the theory of heartspleen correlation.In clinical treatment,the core therapeutic methods for each pathogenesis can be benefiting the fire and replenishing the earth,removing the heart-fire to support the spleen,tonifying the heart to strengthen the spleen,and regulating the heart to tranquilize the spleen,respectively.In terms of medication,Fuzi(Aconiti lateralis radix praeparata),dried ginger,Guizhi(cinnamomi ramulus),and Zhigancao(glycyrrhizae radix et rhizoma praeparata cum melle)are used to warm and replenish the heart yang,Huangqi(Astragali radix)and Huanglian(Coptidis rhizoma)coptis are used to nourish the spleen and reduce fire,Huangqi,ginseng,longan,and Danggui(Angelicae sinensis radix)are applied to replenish the heart and spleen,and Shouwuteng(Polygoni multiflori caulis),Meiguihua(rosae rugosae flos)and Hehuanpi(Albiziae cortex)are used to nourish the mind and calm the spleen and stomach.

关 键 词：五脏相关 心脾相关 脾胃病 

分 类 号：R256.3[医药卫生—中医内科学]