《黄帝内经》“心与脾胃相关”理论发微

Exploration of Thoughts of Heart Associating with Spleen-stomach in Huangdi's Canon of Medicine

通过分析《黄帝内经》中有关心与脾胃之间生理上相互关联的论述,并引用《金匮要略》及医家有关脾胃功能失调与胸痹心痛的医案,阐述了心与脾胃相关。分析认为,心与脾胃相关表现在:(1)在生理方面,足阳明胃脉与心相通;胃之大络(虚里)通于心;足太阴脾脉之支者亦与心相通;而血脉是将中焦化生之"气"输送至全身的通道。(2)温养推动脉中营血正常周行的"宗气"来源于胃,化生于脾;宗气进入心脏与脉中,温养推动脉中之营血,使其正常周行。(3)脾胃中的阳气将水谷之气化生为津液,内注五脏六腑,外行四末分肉皮肤之间而不休,维持着人体正常的生命活动。(4)胃中水谷之气化生的"营"气,滋养心脏与血脉,维持人体正常的生命活动。(5)脾主思,思则气结,容易导致心脉痹塞。(6)足阳明胃经之主血不利所生疾病。

Heart associating with spleen-stomach is put forward after analyzing the arguments of heart having the physiological connection with spleen-stomach recorded in Huangdi＇s Canon of Medicine, and by quoting the medical record of treatment of Qi obstruction in chest and cardialgia based on the disorder of spleen-stomach function recorded in Synopsis of the Golden Chamber. Heart associating with spleen-stomach is manifested as：（1）in respect of physiological function,Stomach Meridian of Foot-Yangming is connected with the heart,the grand collateral of stomach（Xuli）and the branch of Spleen Meridian of Foot-Taiyin are also connectd with the heart,and blood vessels are the channel for transporting Qi generated from the middle energizer.（2）Pectoral Qi,which has the actions of warming and maintaining the circulation of blood in the vessels, is generated from the stomach and spleen,and then flows into the heart and vessels to warm and maintain the circulation of blood in the vessels.（3）Spleen-stomach yang promotes the production of body fluid from the food essence,and then the body fluid pours into five Zang-organs and six Fu-organs, circulates in the extremities, muscles and skin, which maintains the normal activities of the life.（4）Nutrient Qi is generated from the food essence by the stomach,and can nourish heart and blood vessels, which maintains the normal activities of the life.（5）Spleen governs thinking, and the obstruction of heart and vessels will occur if over-thinking induces Qi stagnation.（6）Stomach Meridian of Foot-Yangming is responsible for the diseases of blood disorder.