试述《脾胃论》中以脾胃为核心的五脏观  

Discussion of Five Zang-Organs View with Spleen and Stomach as Core in Pi Wei Lun

作　　者：程建林 翁畅 孙可昕 陈双钰 李佳扬 裘生梁[2] CHENG Jianlin;WENG Chang;SUN Kexin;CHEN Shuangyu;LI Jiayang;QIU Shengliang(The First Clinical Medical School of Zhejiang Chinese Medical University,Hangzhou Zhejiang 310053,China;Zhejiang Provincial Hospital of Chinese Medicine,Hangzhou Zhejiang 310006,China)

机构地区：[1]浙江中医药大学第一临床医学院,浙江杭州310053 [2]浙江省中医院,浙江杭州310006

出　　处：《新中医》2024年第16期32-36,共5页New Chinese Medicine

基　　金：浙江省中医药科学研究基金项目(2022ZA056);浙江省新苗人才计划项目(2023R410006)。

摘　　要：通过对《脾胃论》进行分析,认为“内伤脾胃,百病由生”是《脾胃论》的核心思想,体现以脾胃为核心的五脏观。胃与脾的关系表现为生理、病理上的阴阳对立统一关系。脾主四肢,脾胃虚弱则四肢得不到充养而致骨痿。心与脾共同参与血之生成;情志上心主神,统领五志,情志伤脾则波及心神;脾胃虚则“阴火”侵心,多表现为亢盛。脾肺为母子关系,生理上相互协调,病理上脾病及肺。肝胆春生升发之气可协助脾胃升清,木郁则乘土,宜疏肝解郁。脾胃虚则气机枢纽不利,气机逆乱,易生厥证,可补脾胃、调气血以治之。脾肾为先后天关系,相互资生,共调津液。肾藏水火,肾中相火离位,上逆乘脾,遂成阴火;肾水泛滥,使人五液增多,脾湿太过,则湿浊内生。Through the analysis of PiWeiLun(Treatise on the Spleen and Stomach),it is believed that"internal damage to the spleen and stomach leads to the generation of various diseases"is the core idea of Pi Wei Lun,which reflecting the five zang-organs view with the spleen and stomach as the core.The relationship between the stomach and spleen manifests as the unity and mutual opposition of yin and yang in physiology and pathology.The spleen governs the extrimites,and if the spleen and stomach are weak,the extrimites cannot be fully nourished,and thus leading to bone dysfunction.The heart and spleen participate in the generation of blood jointly;emotionally,the heart governs the spirit,leading the five minds,and if emotions damage the spleen,it will affect the heart and spirit;spleen and stomach deficiency leads to yin fire invading the heart,which often manifested as hyperactivity.The spleen and lung are in a mother-child relationship,physiologically coordinated with each other,and pathologically spleen disease can affect the lung.The qi generated by the liver and gallbladder in spring can assist the spleen and stomach in ascent of the clear,and the wood constraint can attack the earth;it is recommended to soothing the liver and resolving constraint.Spleen and stomach deficiency leads to disturbance of qi movement,with disordered qi circulation and easy occurrence of syncope syndrome,which can be treated by tonifying the spleen and stomach,and regulating qi and blood.The spleen and kidney have a congenital and postnatal relationship,mutually nourishing each other and regulating body fluids.The kidney stores water and fire,and the ministerial fire in the kidney is displaced.Ascending counterflow attacking the spleen results in the formation of yin fire;overflow of kidney water causes an increase in five fluids,and excessive dampness in the spleen can lead to internal dampness and turbidity.

关 键 词：《脾胃论》 五脏观 脾胃核心 

分 类 号：R229[医药卫生—中医基础理论]