[1]董宁,李芳,鱼涛.基于“亦脏亦腑”论治急性胰腺炎[J].陕西中医,2026,(8):1094-1098.[doi:DOI:10.3969/j.issn.1000-7369.2026.08.015]
 DONG Ning,LI Fang,YU Tao.Treating acute pancreatitis based on both dirty and organs theory[J].,2026,(8):1094-1098.[doi:DOI:10.3969/j.issn.1000-7369.2026.08.015]
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基于“亦脏亦腑”论治急性胰腺炎

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2026年8期
页码:
1094-1098
栏目:
长安医学
出版日期:
2026-08-05

文章信息/Info

Title:
Treating acute pancreatitis based on both dirty and organs theory
作者:
董宁李芳鱼涛
(陕西省中医医院,陕西 西安710003)
Author(s):
DONG NingLI FangYU Tao
(Shaanxi Provincial Hospital of Traditional Chinese Medicine,Xi’an 710003,China)
关键词:
胰腺脏腑亦脏亦腑急性胰腺炎分期论治证治思路
Keywords:
PancreasZangfuBoth Zang and FuAcute pancreatitisStepwise treatment approachDiagnosis and treatment
分类号:
R 657.5
DOI:
DOI:10.3969/j.issn.1000-7369.2026.08.015
文献标志码:
A
摘要:
基于胰腺“亦脏亦腑”生理特性,探讨急性胰腺炎中医证治思路。胰腺既具有脾脏消化、化生“藏”的功能,又具有六腑传化物、主通降“泻”的特点,因此病理状态下兼具脏病与腑病特征。据此将急性胰腺炎分为两大证候阶段,急性发作期以腑实证为主,病机核心为腑气不通、不通则痛,治疗当“从腑论治”,以通为用、以降为顺,运用通里攻下之法,以缓解腹痛腹胀,减轻炎症反应。恢复期以脏(脾)虚证为主,表现为脾胃虚弱、气阴两伤,治疗当“从脏论治”,以补为主,重在健脾和胃、益气养阴,以促进器官功能恢复、防止复发。长安张氏升清降浊学术流派提出“脾脏本源于胰腺”与“胰腺亦脏亦腑”理论,据此确立证治思路,为急性胰腺炎中医治疗提供参考。
Abstract:
Based on physiological characteristic of the pancreas as both Zang(visceral organ) and Fu(hollow organ),explores a approach to traditional Chinese medicine diagnosis and treatment of acute pancreatitis.The pancreas possesses both digestive and transformative functions associated with spleen (Zang) and the transmitting and descending characteristics typical of six Fu organs,thus exhibiting features of both Zang and Fu disorders in pathological conditions.Accordingly,acute pancreatitis was divided into two main syndrome stages:during acute phase,condition primarily manifests as Fu organ syndrome characterized by obstruction,with the core pathogenesis being blocked Qi flow in Fu organs-leading to pain and treatment should focus on addressing Fu organs,emphasizing unblocking and promoting descent through methods that clear interior stagnation and relieve constipation,thereby alleviating abdominal pain and distension and reducing inflammatory responses.In recovery phase,the syndrome was mainly characterized by deficiency of Zang organ(spleen),presenting as spleen-stomach weakness and dual deficiency of Qi and Yin.Treatment should therefore target Zang organ,focusing on tonification,particularly strengthening spleen and harmonizing stomach,replenishing Qi and nourishing Yin,to promote organ function recovery and prevent recurrence.Chang’an ZHANG School’s academic tradition of ascending clear and descending turbid proposes theories that spleen originates from pancreas and pancreas was both Zang and Fu,establishing corresponding diagnostic and therapeutic framework that offers methods for treating acute pancreatitis in traditional Chinese medicine.

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备注/Memo

备注/Memo:
国家中医药管理局第七批全国老中医药专家学术经验继承工作项目(国中医药办人教函〔2021〕272号);陕西省特支计划科技创新领军人才项目(646);陕西省重点研发计划项目(2024SF-YBXM-499);长安张氏升清降浊学术流派传承工作室建设项目(SXZYLP-2024005)
更新日期/Last Update: 2026-08-13