中医“脾主长夏”理论内涵的探讨

Discussion on Theoretical Connotation of "Spleen Taking Charge of Energy of Long Summer" in Traditional Chinese Medicine

通过分析当前对"脾主长夏"理论的不同认识,提出"脾主长夏"的本质内涵为:脾是机体在长夏季节起主要调节作用的自稳时间调节系统。脾与胃相表里,脾升胃降实质概括了整个消化系统的功能。通过脾胃纳运相成、升降相因、燥湿相济的协同作用,从而维持机体"应长夏而变"的自稳调节稳态。脾主运化、主升清、喜燥恶湿,为太阴湿土,与长夏湿气相应。胃主受纳、主通降、喜润恶燥,为阳明燥土。在当旺的长夏季节,脾虚而胃强,脾易受湿困而致主运化、主升清等功能都相对低下,胃得湿润炎热之助而致主受纳、腐熟水谷、主通降功能相对增强。长夏季节湿盛而脾虚胃强的功能状态处于支配地位,发挥着对自身脾胃系统及其他四脏重要的调控作用;其他季节脾胃功能则处于从属地位,通过其长养转化之性,协助或抑制其他四脏以维持机体应时而变的调节稳态。长夏季节由于脾弱胃强,机体表现为消化功能增强,吸收功能减弱,易发生脘腹胀满、大便溏薄等消化系统疾病。正确把握"脾主长夏"的本质内涵对认识临床消化系统疾病季节性发作的病理、诊断、预防、养生与治疗,都具有重要的指导意义。

After analyzing current different understandings on the theory of ＂spleen taking charge of energy of long summer＂, the author put forward the essential connotation that the spleen is a self-balanced regulation system based on time, and the spleen mainly regulates the body in long summer. The spleen is exteriorly-interiorly related to the stomach. The spleen governs ascending and the stomach governs descending, which actually summarizes the function of the whole digestive system. The spleen and stomach co-keep the self-balanced condition for the body, through the coordination of receiving and transportation, ascending and descending, dryness and dampness. The spleen is respon- sible for transportation and transformation, ascending of the clear, with a preference for dryness and aversion to dampness, which is regarded as Taiyin wet earth, corresponding with dampness in the long summer. The stomach governs receiving and descending, with a preference for moistness and aversion to dryness, which is considered to be the Yangming dry earth. In the long summer, spleen deficiency due to dampness retention may lead to hypo-func- tions of transporting and transforming, ascending of the clear; stomach excess thanks to the help of moistness and heat may lead to relative hyper-functions of receiving and decomposing food, as well as descending. The functional condition of spleen deficiency and stomach excess duo to abundant dampness in the long summer plays a dominant role in regulation on their own system and other four zang-organs; in other seasons, the functions of spleen and stomach are in a subordinate state assisting or inhibiting other four zang-organs, in pace with time, to keep balanced condition for the body, through their characteristics of nourishing and transforming. Due to spleen deficiency and stomach excess in the long summer, manifestations of the body are hyper-function of digestion and hypo-function of absorption, and may easily lead to problems in the digestive system, such as abdominal distension and loose stool.Correct understanding on the essential connotation of ＂spleen taking charge of energy of long tant significance on the pathology, diagnosis, prevention, healthcare and treatment of seasonal system. summer＂ has an impor-attacks in the digestive