基于《黄帝内经》“清浊相干”理论探讨脾胃病病机及半夏泻心汤的治疗作用  

Pathogenesis of Spleen and Stomach Diseases and Therapeutic Effect of Banxia Xiexintang Based on Theory of"Mutual Interference of Clear and Turbid Qi"in Huangdi Neijing

作　　者：张雪萍 王倩影 钟卓泰 姚梦茜 陈磊 张涛[1] 魏玮[1] 苏晓兰[1] ZHANG Xueping;WANG Qianying;ZHONG Zhuotai;YAO Mengxi;CHEN Lei;ZHANG Tao;WEI Wei;SU Xiaolan(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院,北京100102

出　　处：《中国实验方剂学杂志》2024年第14期225-231,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家重点研发计划项目(2022YFC3500503)。

摘　　要：基于《黄帝内经》“清浊相干”理论,对脾胃病病机及半夏泻心汤对脾胃病的治疗作用进行探讨。认为“清浊相干”是由于清浊二气混杂,所引起的阴阳逆乱、气机失衡的病理状态,可以用于阐释归纳脾胃病发病机制。基于“清浊相干”理论,可将脾胃病病机总结为脾胃气乱、营卫失和及寒热相争。半夏泻心汤是治疗脾胃病的重要方剂,在治法上兼顾辛开苦降、通调营卫、寒热并调,可以通过调节气机升降、兼顾表里阴阳、兼施虚实补泻,从而达到调理脾胃病“清浊相干”病理状态的目的。结合现代研究结果可以发现,半夏泻心汤能够调节胃肠动力、恢复消化系统黏膜免疫屏障功能,并且具有在寒凉药物及温热药物并用的情况下发挥最大治疗效用的特点,与半夏泻心汤在“清浊相干”理论下发所挥的治疗作用相对应。深挖“清浊相干”理论内涵,并基于该理论探讨脾胃病病机及半夏泻心汤的治疗作用,能够进一步挖掘脾胃病与“清浊”理论的内在联系,为脾胃病的临床诊断及治疗提供思路及理论层面的参考。Based on the theory of"mutual interference of clear and turbid Qi"in Huangdi Neijing(《黄帝内经》),this study explored the pathogenesis of spleen and stomach diseases and the therapeutic effects of Banxia Xiexintang on them.It suggested that"mutual interference of clear and turbid Qi"represents a pathological state of Yin and Yang disturbance and imbalance in Qi circulation due to the mixture of clear and turbid Qi,which can elucidate the pathogenesis of spleen and stomach diseases.According to this theory,the pathogenesis of spleen and stomach diseases was summarized as Qi disorder in spleen and stomach,disharmony between Ying Qi and Wei Qi,and conflict between cold and heat.Banxia Xiexintang,as a crucial prescription for treating spleen and stomach diseases,achieves its therapeutic effects by dispersing stagnation with pungent flavor,descending adverse Qi with bitterness,regulating Ying Qi and Wei Qi,and harmonizing cold and heat.By regulating Qi circulation,balancing internal and external factors,and addressing deficiency and excess,it can rectify the pathological state of"mutual interference of clear and turbid Qi"of spleen and stomach diseases.Modern research reveals that Banxia Xiexintang can modulate gastrointestinal motility,restore mucosal immune barrier function of the digestive system,and exhibit optimal therapeutic effects when combined with both coldcool and warm-hot medicines,aligning with its therapeutic role under the theory of"mutual interference of clear and turbid Qi".By delving into the essence of the"mutual interference of clear and turbid Qi"theory and exploring the pathogenesis of spleen and stomach diseases and the therapeutic effects of Banxia Xiexintang based on this theory,this study further elucidated the inherent connection between spleen and stomach diseases and the"mutual interference of clear and turbid Qi"theory,offering insights and theoretical references for the clinical diagnosis and treatment of spleen and stomach diseases.

关 键 词：“清浊相干” 脾胃病 半夏泻心汤 《黄帝内经》 

分 类 号：R2-0[医药卫生—中医学] R242R2-031R259R289.1R222.16R256.3