从“脾藏意”探讨五加减正气散治疗腹泻型肠易激综合征的理论依据  

Discussion on the Theoretical Basis of Wujiajian Zhengqi Powder in the Treatment of IBS-D from the"Spleen Storing Idea"

作　　者：王伟[1] 孙轸 邓华亮[1] WANG Wei;SUN Zhen;DENG Hualiang(Department of GastroenterologyⅡ,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;不详)

机构地区：[1]山东中医药大学附属医院消化内二科,山东济南250014

出　　处：《中国医学创新》2024年第27期175-179,共5页Medical Innovation of China

基　　金：国家自然青年基金(81904128);国家中医药管理局科技司共建科技项目(GZY-KJS-SD-2023-035);山东省中医药重点学科中医脾胃病学(鲁卫中医药科教字[2022]4号);山东省中医药科技项目(面上项目M-2023167)。

摘　　要：腹泻型肠易激综合征(IBS-D)发病率居高不下,精神心理异常导致的脑-肠轴紊乱是重要致病因素。中医学认为,“脾失健运”“脾不藏意”是病机关键。脾居中焦,为五脏气机之“枢轴”,情志之根本。“脾藏意”包含了认知、情绪、生理等不同内涵,与脑-肠轴密切相关,既是藏象理论的重要组成部分,也是中医情志病与西医心理学互通的桥梁。五加减正气散可通过强脾意、运脾营,多途径、多靶点发挥增强免疫、调节肠道菌群、抗炎止泻、调节内脏高敏等作用。本文从“脾藏意”探讨五加减正气散治疗IBS-D的理论依据,为进一步揭示该经方对脑-肠轴的调控靶点提供理论依据,为从脾论治消化心身疾病提供新的思路与方法。The incidence of irritable bowel syndrome with diarrhea(IBS-D)remains high,and the braingut axis disturbance caused by mental and psychological abnormalities is an important pathogenic factor.Traditional Chinese medicine believes that"dysfunction of spleen in transportation"and"spleen not storing idea"are the key to the pathogenesis,the spleen is in the middle jiao,which is the"pivot"of the five zang viscera Qi movement and the foundation of emotion."Spleen storing idea"contains different connotations such as cognition,emotion and physiology,and is closely related to the brain-gut axis.It is not only an important part of the theory of Zang Xiang,but also a bridge between emotional diseases of traditional Chinese medicine and western medicine psychology.Wujiajian Zhengqi Powder can enhance immunity,regulate intestinal flora,anti-inflammation and diarrhea,regulate visceral hypersensitivity and other functions in multi-channel and multi-target through strengthening spleen idea and activating spleen nutrient.This paper discusses the theoretical basis of Wujiajian Zhengqi Powder in the treatment of IBS-D from the"spleen storing idea",provides a theoretical basis for further revealing the target of the regulation of brain-gut axis of this classical prescriptions,and provides new ideas and methods for treating digestive psychosomatic diseases from"spleen".

关 键 词：“脾藏意” 五加减正气散 腹泻型肠易激综合征 

分 类 号：R259[医药卫生—中西医结合]