肾脾相关的理论研究
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摘要
目的肾与脾均是人体的重要脏器,二者关系密切,医家李中梓将其关系概括为“肾为先天之本,脾为后天之本”。肾脾作为人身之根本,在人体中占有非常重要的地位。然肾与脾的关系不止于此。①中医基础理论是以整体观为指导,不能脱离整体而单纯谈论肾与脾的关系,要把肾与脾置于肾藏象与脾藏象两个功能系统中,从两个功能系统的各个方面对二者关系进行探讨。②从历代文献的散在记录和现代研究来看,对肾脾相关性,仅是局限在肾脾之间某一方面的论述,缺乏对肾脾相关的完整的内涵研究。肾脾相关理论在临证运用上,缺乏良好的针对性,应该进一步去完善。所以,本课题对古今文献资料中有关肾脾相关方面的内容进行整理、归纳和总结,使之系统化,并对肾脾相关的内涵和肾脾同病、肾脾同治进行进一步的探讨,以期对今后的临床辨证和实验研究提供理论依据。
方法挖掘古今文献资料；总结医家临床经验；提炼升华已有理论。
结果肾脾相关即肾脾两个功能系统,包括肾脾的经脉循行、五行归属、物质基础、生理特性等各个方面在生理病理上的联系。本文从肾藏象与脾藏象两个功能系统的角度,对肾脾之间相互制约、相互为用的关系进行了探讨,初步阐释了肾脾相关的源流、内涵和临床应用等三个方面的内容。研究结果认为,肾脾经脉相通、肾阳温煦脾阳、谷气充养元气、共主水液代谢、共司气血化生等五个方面是肾脾相关的基本内涵,并分别阐明了各自的相关机理。肾脾不仅生理密切相关,而且病理相互影响。发病时,或肾病及脾,或脾病及肾,或肾脾同时发病,而成肾脾同病之证。肾脾同病,表现为肾脾气虚,肾脾阴虚,肾脾阳虚,肾脾阴阳亏虚,肾脾虚实夹杂；治疗时,常常须要肾脾兼顾,采取肾脾同治的原则,补肾不忘益脾,补脾不忘固肾。
结论肾脾之间通过正经、经筋、络脉和奇经沟通气血,加强联系。肾脾互济,水土合德,万物方能化生。可见,肾脾互养互促,两者休戚相关,共同维持着人的生命活动。
Objective:Kidney and spleen are body's vital organs. Their relations were summed up as "Kidney being the innate foundation, spleen being acquired foundation". As the fundamental role in human body, their relations are more than what we mentioned. First of all, the basic theories of Chinese Medicine is guided by holistic concept. Therefore, kidney and spleen should be discussed within various aspects of functional systems of kidney visceral manifestation and spleen visceral manifestation. What's more, according to the scattered historical documents and the modern research, the discourses about their relativity have been limited only between some aspect of kidney and spleen, not including their major functional system. Correlation theory of kidney and spleen in clinic is not well targeted. Therefore, in order to support the theoretical basis for experimental study of the clinical syndrome, this research will collate, generalize and summarize the content about the relationship of kidney and spleen in the ancient and modern documents, and carries on further discussion for the kidney spleen related connotation and kidney spleen same sickness, treat kidney and spleen simultaneously.
Method:Excavation historical documents and modern research; Summarized the clinical experience of Doctors;Refined theory of sublimation.
Result:Kidney and spleen's relationship means that kidney system and spleen system associate intimately each other in the pathology and physiology. This paper provides preliminary interpretation of the origin, connotation and clinical application of kidney and spleen's relationship and discusses the relationship that kidney and spleen constrain and depend on each other.
Conclusion:The relationship includes:the channels of kidney and spleen are lined each other; kidney-Yang wa(?)s up spleen-Yang; the essence Qi from food stuff can supplement the primordial Qi; they both manage the metabolism of body fluid and production of Qi-blood. Kidney and spleen can communicate Qi-blood by means of twelve regular meridians, eight extra channels, collaterals and meridian-musculatures. The theory of the fine elements. Only if the kidney and the spleen sever each other, can the body be nurtured and function perfectly. It can draw conclusion that kidney and spleen constrains and promote each other, and the both system are solidarity.
Pathologically, kidney disease can affect spleen, or spleen disease can affect kidney, or the two organs are in disorders at the same time. According to the therapeutic principle of treating kidney and spleen simultaneously, it can be adopted that treating deficiency syndrome with replenishing method, replenishing deficiency and reducing excess together, design methods such as invigorating the spleen, nourishing kidney, warming kidney and spleen, nourishing kidney-spleen and eliminating pathogenic factors.
方法挖掘古今文献资料；总结医家临床经验；提炼升华已有理论。
结果肾脾相关即肾脾两个功能系统,包括肾脾的经脉循行、五行归属、物质基础、生理特性等各个方面在生理病理上的联系。本文从肾藏象与脾藏象两个功能系统的角度,对肾脾之间相互制约、相互为用的关系进行了探讨,初步阐释了肾脾相关的源流、内涵和临床应用等三个方面的内容。研究结果认为,肾脾经脉相通、肾阳温煦脾阳、谷气充养元气、共主水液代谢、共司气血化生等五个方面是肾脾相关的基本内涵,并分别阐明了各自的相关机理。肾脾不仅生理密切相关,而且病理相互影响。发病时,或肾病及脾,或脾病及肾,或肾脾同时发病,而成肾脾同病之证。肾脾同病,表现为肾脾气虚,肾脾阴虚,肾脾阳虚,肾脾阴阳亏虚,肾脾虚实夹杂；治疗时,常常须要肾脾兼顾,采取肾脾同治的原则,补肾不忘益脾,补脾不忘固肾。
结论肾脾之间通过正经、经筋、络脉和奇经沟通气血,加强联系。肾脾互济,水土合德,万物方能化生。可见,肾脾互养互促,两者休戚相关,共同维持着人的生命活动。
Objective:Kidney and spleen are body's vital organs. Their relations were summed up as "Kidney being the innate foundation, spleen being acquired foundation". As the fundamental role in human body, their relations are more than what we mentioned. First of all, the basic theories of Chinese Medicine is guided by holistic concept. Therefore, kidney and spleen should be discussed within various aspects of functional systems of kidney visceral manifestation and spleen visceral manifestation. What's more, according to the scattered historical documents and the modern research, the discourses about their relativity have been limited only between some aspect of kidney and spleen, not including their major functional system. Correlation theory of kidney and spleen in clinic is not well targeted. Therefore, in order to support the theoretical basis for experimental study of the clinical syndrome, this research will collate, generalize and summarize the content about the relationship of kidney and spleen in the ancient and modern documents, and carries on further discussion for the kidney spleen related connotation and kidney spleen same sickness, treat kidney and spleen simultaneously.
Method:Excavation historical documents and modern research; Summarized the clinical experience of Doctors;Refined theory of sublimation.
Result:Kidney and spleen's relationship means that kidney system and spleen system associate intimately each other in the pathology and physiology. This paper provides preliminary interpretation of the origin, connotation and clinical application of kidney and spleen's relationship and discusses the relationship that kidney and spleen constrain and depend on each other.
Conclusion:The relationship includes:the channels of kidney and spleen are lined each other; kidney-Yang wa(?)s up spleen-Yang; the essence Qi from food stuff can supplement the primordial Qi; they both manage the metabolism of body fluid and production of Qi-blood. Kidney and spleen can communicate Qi-blood by means of twelve regular meridians, eight extra channels, collaterals and meridian-musculatures. The theory of the fine elements. Only if the kidney and the spleen sever each other, can the body be nurtured and function perfectly. It can draw conclusion that kidney and spleen constrains and promote each other, and the both system are solidarity.
Pathologically, kidney disease can affect spleen, or spleen disease can affect kidney, or the two organs are in disorders at the same time. According to the therapeutic principle of treating kidney and spleen simultaneously, it can be adopted that treating deficiency syndrome with replenishing method, replenishing deficiency and reducing excess together, design methods such as invigorating the spleen, nourishing kidney, warming kidney and spleen, nourishing kidney-spleen and eliminating pathogenic factors.
引文
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[12]陈芝喜,刘小斌.健脾补肾药对脾虚大鼠细胞因子水平的影响[J].放射免疫学杂志,2003,16(04)：217-219.
[13]陈芝喜,刘小斌,周名璐,等.健脾补肾药对脾虚大鼠环核苷酸及甲状腺激素水平的影响[J].放射免疫学杂志,2003,16(05)：278-280.
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[21]王慧茹,贺清珍.辨治脾阴虚的临证心得[J].现代中医药,2003,20(02)：30-31.
[22]刘汝荣.脾阴虚证治3则[J].中国中西医结合消化杂志,2000,9(01)：28.
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[1]丛萍.从脾肾论治绝经期崩漏74例[J].陕西中医,2007,28(03)：39.
[2]杨季国.遗尿病证脾肾同治浅识[J].中医药学刊,1993,11(03)：37.
[3]高权国,董建文等.肾脾双补法治疗骨质疏松症、32例观察[J].中医药信息,2001,18(04)：28-30.
[4]王慧茹,贺清珍.辨治脾阴虚的临证心得[J].现代中医药,2003,10(02)：30-31.
[5]刘汝荣.脾阴虚证治3则[J].中国中西医结合消化杂志,2000,9(01)：198-199.
[6]饶宏孝.从脾肾论治几种慢性病证报道[J].贵阳中医学报,1989,(01)：25-26.
[7]张春玲,苏秀文.曲生教授脾肾论学术思想介绍[J].长春中医药大学学 报,2009；25(02)：68-169.
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[9]蓝继,林胜友.从脾肾论治化疗后潮热汗出症临床观察[J].光明中医,2009,24(01)：53-55.
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[14]陈芝喜,刘小斌,周名璐,等.健脾补肾药对脾虚大鼠环核苷酸及甲状腺激素水平的影响[J].放射免疫学杂志,2003,16(05)：278-280.
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[2]杨立娜.肾肝相关的理论研究[D].武汉：湖北中医学院,2007.
[3]张效霞.脏腑功能辨析[D].济南：山东中医药大学,2006.
[4]刘成丽.中医脾肾相关学说源流探讨[J].中国中医基础医学杂志,2004,10(11)：7-9.
[5]张瑞兰.脾与肾的实质探秘[J].湖北中医杂志,2001,23(10)：8.
[6]韩丽萍,魏敏惠.肾为先天之本与补肾中药对基因的影响分析[J].中国中医基础医学杂志,2003,9(06)：18.
[7]郑敏麟,阮诗伟.中医藏象实质细胞生物学假说之一——“脾”与线粒体[J].中国中医基础医学杂志,2002,8(05)：10.
[8]谢新才.中医基础理论现代探析.[M].北京：中国中医药出版社,1994：79.
[9]廉南,曹均告,曾晓蓉,等.补脾补肾治法对免疫功能影响的实验研究[J].甘肃中医,1993,6(23)：5-7.
[10]孙爱华,李津婴,张钵方,等.肾与脾关系物质基础的实验观察-脾虚、肾虚形成与转化机理探讨[J].中医杂志,1998,39(01)：47-49.
[11]高守泉,王勇庆,彭淑珍,等.脾肾相关性的实验研究[J].湖南中医药导报,1998,4(12)：26-27.
[12]陈芝喜,刘小斌.健脾补肾药对脾虚大鼠细胞因子水平的影响[J].放射免疫学杂志,2003,16(04)：217-219.
[13]陈芝喜,刘小斌,周名璐,等.健脾补肾药对脾虚大鼠环核苷酸及甲状腺激素水平的影响[J].放射免疫学杂志,2003,16(05)：278-280.
[14]周安方,杨立娜.论五脏相关的理论基础[J].湖北中医学院学报,2008,10(40)：25.
[15]上海中医学院主编.中医年鉴.[M].人民卫生出版社出版,1983：38-39.
[16]曲清文.中医五脏相关学说述要与《临证指南医案》脏腑辨证用药的相关性研究[D].广州：广州中医药大学,2007.
[17]丛萍.从脾肾论治绝经期崩漏74例[J].陕西中医,2007,28(03)：39.
[18]杨季国.遗尿病证脾肾同治浅识[J].中医药学刊,1993,11(03)：37.
[19]高权国,董建文.肾脾双补法治疗骨质疏松症32例观察[J].中医药信息,2001,18(04)：56-58.
[20]沈自尹,王文健.中医虚证辨证参考标准[J].中西医结合杂志,1986,6(10)：598.
[21]王慧茹,贺清珍.辨治脾阴虚的临证心得[J].现代中医药,2003,20(02)：30-31.
[22]刘汝荣.脾阴虚证治3则[J].中国中西医结合消化杂志,2000,9(01)：28.
[23]饶宏孝.从脾肾论治几种慢性病证报道[J].贵阳中医学报,1989,10(01)：25-26.
[24]张春玲,苏秀文.曲生教授脾肾论学术思想介绍[J].长春中医药大学学报,2009；25(02)：168-169.
[25]喻生保,辛小红,邓勇.化疗不良反应的中医治疗[J].实用中西医结合临床,2003,3(04)：44.
[26]何健飞,吴雪峰,杨华.贞芪扶正口服液治疗恶性肿瘤放化疗后脾肾亏虚证临床观察[J].山东中医杂志,2007,26(05)：299-300.
[27]蓝继,林胜友.从脾肾论治化疗后潮热汗出症临床观察[J].光明中医,2009,24(01)：53-55.
[1]丛萍.从脾肾论治绝经期崩漏74例[J].陕西中医,2007,28(03)：39.
[2]杨季国.遗尿病证脾肾同治浅识[J].中医药学刊,1993,11(03)：37.
[3]高权国,董建文等.肾脾双补法治疗骨质疏松症、32例观察[J].中医药信息,2001,18(04)：28-30.
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