基于“五脏相关论”和“五神藏”理论从脾论治小儿自闭症研究进展  

Treatment of Autism in Children from the Spleen Perspective Based on the Theories of the Interconnection of the Five Zang-Organs and the Five Spiritual Depots

作　　者：刘玲佳[1] 樊燕萍 王俊宏[1] 陈溪 LIU Lingjia;FAN Yanping;WANG Junhong;CHEN Xi(Department of Paediatrics,Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine,Beijing 100700,China;The First Clinical College of Beijing University of Traditional Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院儿科,北京100700 [2]北京中医药大学第一临床医学院,北京100700

出　　处：《临床误诊误治》2025年第6期95-100,共6页Clinical Misdiagnosis & Mistherapy

基　　金：全国老中医药专家学术经验继承工作指导老师及继承人项目[国中医药办人教函(2021)272号];北京中医药大学东直门医院临床研究和成果转化能力提升试点项目(DZMG-QNZX-24020)。

摘　　要：小儿自闭症的核心病机为“以脾脏功能失调”为核心的五脏、神志失常,即脾主升清功能不足、脾失运化。从“五脏相关论”和“五神藏”理论角度分别对脾主升清异常之五脏失养、脾失运化致脾意之思辨知行异常进行病机分析,认为脾脏在本病发病中具有重要作用,进而归纳为“脾为五脏之母,脾意主思辨知行”的发病特点以及“脾气不足、脾失统血”的核心病机。提出脾主升清功能不足主要体现在脾气不足,从而影响精微传输,导致小儿发育受到影响,以自拟健脾方加减治疗,可补脾益气、以助升清。脾失运化主要体现在脾失统血,从而影响脾意,导致小儿思辨知行异常,可在健脾方的基础上加用补血之药,以补益脾胃、充养脾意。旨在建立“脾为五脏之母,脾健则五神安”的辨治体系,以为临床诊治提供理论参考。The core pathogenesis of autism in children is characterized as the dysharmony of the five zang-ograns and the spiritual disorders centered on"spleen dysfunction",namely,the insufficiency of the spleen's function of ascending the clear qi and the failure of the spleen in transportation and transformation.From the perspective of"the theory of the interconnection of the five zang-organs"and"the theory of the five spiritual depots",this paper conducts a pathological analysis of insufficient nourishment of the five zang-organs due to abnormal ascending of clear qi by the spleen,and abnormalities in the spleen's yi(intellect)in terms of thinking,discrimination,knowledge,and action caused by the spleen's failure to transform and transport.It is proposed that the spleen plays a pivotal role in the pathogenesis of this condition,thus summarizing the disease characteristics as"the spleen being the mother of the five zang-organs,with spleen yi governing thinking-discrimination-knowledge-action,"and the core pathogenesis as"insufficient spleen qi and failure of the spleen to govern blood.".The deficiency of the spleen's function of ascending clear qi is primarily manifested as insufficient spleen qi,which impairs the transportation of essential nutritive substances and thereby affects pediatric development.Treatment involves modifying a self-formulated spleen-strengthening formula to replenish spleen qi and assist in ascending clear qi.The spleen's failure to transform and transport is mainly reflected in its inability to govern blood,which disrupts spleen yi(intellect)and leads to abnormalities in children's thinking,discrimination,knowledge,and action.In such cases,blood-tonifying herbs are added to the spleen-strengthening formula to nourish the spleen and stomach and enrich spleen yi.This approach aims to establish a differentiation and treatment system based on the principles that"the spleen is the mother of the five zang-organs,and a healthy spleen ensures tranquility of the five spirits,"providing a theoretical refer

关 键 词：小儿自闭症 五脏相关论 五神藏 从脾胃论治 脾主运化 脾不统血 综述 

分 类 号：R729[医药卫生—儿科]