从胰腺脏腑属性论胰腺内外分泌共病的中医证治思路  

Ideas of Traditional Chinese Medicine Treatment of Pancreatic Endocrine and Exocrine Co-Morbidities from the Attributes of Zang-Fu Organs of Pancreas

作　　者：冷玉琳 印家成 李相龙 张嘉鸿 苏怡 高泓[1,2] 谢春光 富晓旭[1,2] LENG Yulin;YIN Jiacheng;LI Xianglong;ZHANG Jiahong;SU Yi;GAO Hong;XIE Chunguang;FU Xiaoxu(Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,610072;TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province)

机构地区：[1]成都中医药大学附属医院,四川省成都市610072 [2]代谢性疾病中医药调控四川省重点实验室

出　　处：《中医杂志》2025年第2期145-149,156,共6页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82374404);国家中医药管理局中医药创新团队及人才支持项目(ZYYCXTD-C-202209);四川省自然科学基金(2023NSFSC0689,2024NSFSC1863);成都中医药大学苗圃人才专项(MPRC2024006)。

摘　　要：基于现代医学对胰腺内分泌、外分泌部精密关联的研究进展,以及胰腺内分泌、外分泌功能与中医脾脏系统的归属联系,探讨胰腺脏腑属性,认为胰腺似脏非脏、似腑非腑,具有奇恒之腑的属性,可归属于脾。脾主运化、升清散精涵盖了胰腺内分泌、外分泌功能,胰酶和糖调节激素是脾气散精的物质基础。胰腺病证兼具脏虚与腑实特点,胰腺内分泌、外分泌共病治当兼顾脏病宜补、腑病宜通的原则,重在恢复胰(脾)的散精功能,宜补脾气、滋脾阴以补益脾土,通脾络、升脾阳、化脾浊以助脾散精,使脏腑精气盈满而布散周身,改善胰腺内分泌、外分泌功能。Based on advancements in modern medical research regarding the intricate connection between the endocrine and exocrine functions of the pancreas,as well as the relationship between pancreatic functions and traditional Chinese medicine(TCM)spleen system,this paper discussed the categorization of the pancreas.It is proposed that the pancreas is neither a true zang organ nor a fu organ,but possessed the attributes of an extraordinary fu-organ and can be classified under the spleen.The spleen governs transportation and transformation,ascent of the clear and dispersion of essence,which encompasses the endocrine and exocrine functions,and pancreatic enzymes and glucose-regulating hormones form the material basis for the spleen's function of dispersing essence.Diseases of the pancreas exhibit characteristics of both zang-organ deficiency and fu-organ excess,so treatment should simultaneously supplement zang-organ disease and regulate fu-organ disease when pancreas showing endocrine and exocrine co-morbidities,with focus on restoring the pancreas(spleen)'s dispersing essence function.Therapeutic strategies include supplementing spleen qi,nourishing spleen yin to strengthen spleen earth,unblocking spleen collaterals,raising spleen yang,and removing spleen turbidity to support the spleen's dispersing essence function,so as to replenish the essential qi of zang-fu organs,ensure their distribution throughout the body,and improve the endocrine and exocrine functions of the pancreas.

关 键 词：胰腺 内分泌 外分泌 奇恒之腑 脾胰同源 

分 类 号：R259[医药卫生—中西医结合]