CAJ | 학술논문

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,脾统血被描述为具有统摄血液于经脉之中循行,并防止其溢于脉外的功能.通过文献研究和临床实践,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,而不溢出脉外"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,而不溢出脉外的生理功能;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.
안조전통적중의장상이론,비유"주승청、주운화、주통혈"삼대생리공능.기중,비통혈피묘술위구유통섭혈액우경맥지중순행,병방지기일우맥외적공능.통과문헌연구화림상실천,침대비통혈이론제출료이하견해:1)비장공능구유내재관련성:비주운화유뢰이비기적추동;주승청유뢰우비기적승발;주통혈유뢰우비기적고섭,병지출운화시승청적전제、승청시통혈적기출、통혈시승청운화적결국.2)주통혈이론구유독립성:비통혈생리공능가용"비유통섭、공제혈액재맥중상태운행,이불일출맥외"묘술;여지대응적"비불통혈"병리특성시지비기우허불능통섭혈액소표현적증후.주요표현응당묘술위:"재신피핍력,기단라언,식소편당,면색무화,설담태백맥세약등비기허기출상,병견만성출혈,여편혈、뇨혈、기뉵、치뉵,부녀가견월경과다、붕루등".3)비주통혈이론구유탁전성:협의적비통혈시지비장유통섭혈액재경맥지중순행,이불일출맥외적생리공능;엄의적비통혈응당포괄생혈、행혈、지혈、과혈사충생리여병리변화과정.탁전적비통혈이론인위,생혈위통혈지본,행혈위통혈지도,과혈위통혈지추,지혈위통혈지과.
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 meridi-ans.On the basis of the articles and practice in clinic, we have some opinions as follows:1)There is a correla-tion 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 basis of governing blood is to send up nutrients upwards.Governing blood is the result of other two kinds of spleen functions.2) The theory of spleen governing blood has its own independence.Normally, the spleen gov-erning blood means that the spleen can keep the blood flowing in the vessels.But if the spleen Qi is deficient , there will be some symptoms such as exhaustion, shortness of breath and laziness of speech, loose stools, lus-terless complexion, whitish tongue and white tongue coating,thin and weak pulse.Besides the symptoms a-bove, the failure of spleen Qi to check the blood also leads to some chronic bleeding founded in stool, urine, muscle, gums, menorrhagia, metrorrhagia and metrostaxis.3)The theory of spleen governing blood can be ex-panded.In a narrow sense, it means keeping the blood flowing in the vessels.In the broad sense, it should be understood from four aspects:generating blood, flowing blood, controlling blood and wrapping blood.All of these aspects can explain the functions of 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 and controlling blood is the result.