肝脾关系内涵变迁的内外在动力及其启示

The Internal and External Motivation for the Relationship Changing between Liver and Spleen and Its Connotation

为更好地理解肝脾关系,作者通过对历代文献中肝脾关系论述的整理,分析肝脾关系内涵变化及引起变化的内外在动力。认为:肝脾关系内涵变化源于中医理论的不断变迁,其内在动力在于不同时期原有中医理论与社会医疗实践及科学实验的矛盾,并受当时主流思潮、社会需求等外在动力的推动。在此作用下,不同时期肝脾关系内涵表现为:汉唐时期强调土、木生克关系,宋金元强调相火和元气的关系,明清强调肝、脾之气的关系,民国现代后从生理功能角度强调肝主疏泄促进脾胃运化,二者关系逐渐紧密,理论地位逐渐突出。文章不仅有助于更好地理解肝脾关系、肝主疏泄等理论,同时对现代中医脏象理论和中医理论的构建、创新都有积极的意义。

In order to gain a better understanding of the relationship between liver and spleen,this article analyzed classic literature regarding it and tired to find out the external and internal cause of its evolution.It can be concluded that theoretical changes of their relationship originated from the alteration of Traditional Chinese Medicine（TCM） theories.The internal cause are different TCM theories in different ages and clinical experience and the external causes comes from social demand and major trend of thought of the society.In summary,in Tang and Han dynasties,the relationship between earth and wood was emphasized;in Song,Jin and Yuan dynasties,the relationship between heat and original qi was put into much emphasis;in Ming and Qing dynasty,practitioners emphasize the relationship between spleen and liver,while after that,there being a theory of the governing function of liver on spleen and liver.The relationship between liver and spleen are thus closer step by step.This paper is beneficial for people to better understand liver and spleen,which could also contribute to TCM development and viscera theory construction.