脾胃备化盛衰理论的脾瘅四态初探

A Preliminary Study on the Four States of Spleen in the Theory of Spleen and Stomach Preparation

国医大师吕仁和教授指出脾瘅期是代谢性疾病的病前亚健康状态,该期具有高度的可逆性,是防止疾病演进的关键阶段,重点在于把握分期。刘尚建主任医师在师承吕仁和教授思想的基础上,从内经典籍出发,将脾胃正常生理功能高度概括为“脾胃备化”。脾与胃两脏阴阳物质基础不同,故生理功能及盛衰变化方面亦存在差异。基于“脾胃备化”理论及脏腑阴阳属性的不同,提出脾瘅期的核心病机是“备化失司,盛衰失衡”,备化为常,失司为变,盛衰为本,失衡为要,核心脏腑在于脾和胃。根据脾胃不同阶段的备化盛衰及相应临床表现,将脾瘅期分为脾胃俱旺、胃强脾弱、胃弱脾强、脾胃俱虚四态,以四态指导脾瘅期治疗,充分发挥中医“治未病”优势。

Professor LU Renhe,a master of traditional Chinese medicine,pointed out that the stage of spleen collapse is a pre-morbid sub-health state of metabolic diseases.This stage is highly reversible and is a key stage to prevent the progression of the disease.Chief Physician LIU Shangjian,based on the thoughts of professor LU Renhe,based on the internal classics,highly summarized the normal physiological function of the spleen and stomach as“pleen and stomach preparation”.The Yin and Yang of the spleen and the stomach are different in material basis,so physiological functions and changes in ups and downs also exist differences.Based on the theory of“spleen and stomach preparation”and the different attributes of yin and yang of the viscera,it is proposed that the core pathogenesis of the spleen stage is“the failure of preparation and the imbalance of prosperity and decline”,preparation becomes permanence,failure of division is change,prosperity and decline are the basis,imbalance is the need,the nuclear heart lies in the spleen and stomach.According to the ups and downs of the spleen and stomach in different stages and the corresponding clinical manifestations,the spleen stage is divided into four states:the spleen and the stomach are prosperous,the stomach is strong but the spleen is weak,the stomach is weak but the spleen is strong,and the spleen and the stomach are weak,give full play to the advantages of traditional Chinese medicine in“preventive treatment”.