脾主统血理论的内涵与拓展
首发时间:2015-02-12
摘要:按照传统的中医藏象理论,脾有"主升清、主运化、主统血"三大生理功能。其中,脾统血功能被描述为:具有统摄血液在经脉之中循行,并防止逸出脉外的功能。我们通过文献复习和临床实践,针对脾统血理论提出了以下见解:①脾脏功能具有内在关联性:脾主运化有赖以脾气的推动;主升清有赖于脾气的升发;主统血有赖于脾气的固摄,并指出运化是升清的前提、升清是统血的基础、统血是升清运化的结局。②主统血理论具有独立性:脾统血生理功能可用"脾有统摄、控制血液在脉中常态运行,而不逸出脉外"描述;与之对应的"脾不统血"病理特性是指脾气亏虚不能统摄血液所表现的证候。主要表现应当描述为:"在神疲乏力,气短懒言,食少便溏,面色无华,舌淡苔白脉细弱等脾气虚基础上,并见慢性出血,如便血、尿血、肌衄、齿衄,妇女可见月经过多,崩漏等"。③脾主统血理论具有拓展性:狭义的脾统血是指脾脏有统摄血液在经脉之中循行,而不逸出脉外的生理功能;广义的脾统血应当包括生血、行血、止血、裹血四种生理与病理变化过程。拓展的脾统血理论认为,生血为统血之本,行血为统血之道,裹血为统血之枢,止血为统血之果。
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The Connotation and Expansion of the Spleen Governs the Blood Theory
Abstract:According to traditional Chinese medicine theory of visceral manifestations, the spleen has three physical functions: sending nutrients upward, governing transportation and transformation, governing blood. And the function of governing blood is described as that the spleen can keep the blood flowing in the meridians. On the basic of the articles and practice in clinical, we have some opinions as follow:1)There is a correlation between the functions of the spleen: the spleen qi. All the functions of the spleen depend on the functions of spleen qi in fact. The precondition of sending nutrients upward is transportation and transformation. The basic of governing blood is sending up nutrients upwards. Governing blood is the result of the other two kinds of spleen functions.2)The theory of spleen governing blood has its own independence. Normally, the spleen governing blood means that the spleen can keep the blood flowing in the vessels. But if the spleen qi is deficient, there would be some symptoms such as exhausted, shortness of breath and laziness of speech, loose stools, lusterless complexion, whitish tongue and white tongue coating,thin and weak pulse. Besides the symptoms above, the failure of spleen qi to check the blood also lead to some chronic bleeding founded in stool, urine, muscle, gums, menorrhagia, metrorrhagia and metrostaxis.3)The theory of spleen governing blood can be expanded. In a narrow sense, it means keeping the blood flowing in the vessels. In the broad sense, it should be understand from four aspects: generating blood, flowing blood, controlling blood and wrapping blood. All of these aspects can explain the function of the spleen in physiology and pathology. In this theory, we can say that, generating blood is the basis, flowing blood is the way, wrapping blood is the center ,controlling blood is the result.
Keywords: Integration of traditional chinese and western medicines Theory of spleen manifestations Spleen governing blood Failure of spleen to govern blood
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