基于阴阳学说探讨中医药调节胰腺分泌治疗慢性胰腺炎的作用
Exploring the Role of Traditional Chinese Medicine in Regulating Pancreatic Secretion for Chronic Pancreatitis Treatment Based on Yin-Yang Theory
DOI: 10.12677/acm.2025.1592464, PDF,   
作者: 柯 兴*：广西中医药大学第一临床医学院，广西 南宁；彭卓嵛#：广西中医药大学第一附属医院脾胃病科一区，广西 南宁
关键词: 阴阳学说；慢性胰腺炎；胰腺分泌；Yin-Yang Theory； Chronic Pancreatitis； Pancreatic Secretion
摘要: 阴阳学说作为中医药体系的核心理论之一，在指导各类疾病的辨证论治中展现出了广泛而有效的应用。慢性胰腺炎(CP，即chronic pancreatitis)，在中医学的范畴内，常被视为“腹痛”、“消渴”、“癥瘕”等病症，其发病机理与阴阳的变化紧密相连。胰腺在生理功能上，不仅扮演着沟通五脏六腑、分泌和排泄胰液的重要角色，还辅助脾胃的运化，藏泄精微气血，这与中医阴阳理论中阴阳相互对立制约、相互消长以达到平衡、以及相互转化的原理，存在着深刻的内在联系。阴阳平衡是机体维持正常生理功能的基石，而调整阴阳失衡可能是治疗慢性胰腺炎的关键所在。因此，本文旨在从中医阴阳学说的角度出发，深入探讨中医药对胰腺分泌功能的调节作用，以期为慢性胰腺炎的治疗开辟新的思路。
Abstract: The Yin-Yang theory, as one of the core theoretical frameworks of Traditional Chinese Medicine (TCM), demonstrates extensive and effective application in guiding syndrome differentiation and treatment for various diseases. Within the TCM paradigm, chronic pancreatitis (CP) is often categorized as disorders such as “abdominal pain”, “consumptive thirst”, and “abdominal mass”. Its pathogenesis is closely linked to imbalances in Yin and Yang. Physiologically, the pancreas not only plays a crucial role in communicating with the Zang-Fu organs and secreting/excreting pancreatic juice but also assists the Spleen and Stomach in transformation and transportation, storing and discharging essence (Jing), Qi, and blood. This function exhibits a profound intrinsic connection with the principles of Yin-Yang theory, which encompass mutual opposition and restraint, mutual waxing and waning to achieve balance, and mutual transformation. Yin-Yang balance is the cornerstone of maintaining normal physiological functions in the body. Therefore, restoring Yin-Yang equilibrium may be key to treating chronic pancreatitis. This article aims to explore the regulatory effects of TCM on pancreatic secretory function from the perspective of the Yin-Yang doctrine, seeking to provide new insights for the treatment of chronic pancreatitis.
文章引用：柯兴, 彭卓嵛. 基于阴阳学说探讨中医药调节胰腺分泌治疗慢性胰腺炎的作用[J]. 临床医学进展, 2025, 15(9): 108-115. https://doi.org/10.12677/acm.2025.1592464

参考文献

[1] 屈琳林, 易湘, 孙红玉, 等. 急慢性胰腺炎免疫反应的研究进展[J]. 解放军医学杂志, 2018, 43(1): 75-78.
[2] Hart, P.A. and Conwell, D.L. (2020) Chronic Pancreatitis: Managing a Difficult Disease. American Journal of Gastroenterology, 115, 49-55.
[3] 彭立嗣, 王凯旋, 黄浩杰, 等. COX-2与慢性胰腺炎关系的研究进展[J]. 解放军医学杂志, 2018, 43(10): 897-900.
[4] An, J., Jiang, T., Qi, L., et al. (2023) Acinar Cells and the Development of Pancreatic Fibrosis. Cytokine & Growth Factor Reviews, 71, 40-53.
[5] Hu, F., Lou, N., Jiao, J., et al. (2020) Macrophages in Pancreatitis: Mechanisms and Therapeutic Potentia. Biomedicine & Pharmacotherapy, 131, Article 110693.
[6] 阳敦学, 卢先州, 彭秀达. 慢性胰腺炎治疗进展[J]. 中南医学科学杂志, 2018, 46(6): 667-670.
[7] 张宇鹏. 中医阴阳学说探析[J]. 中国中医基础医学杂志, 2022, 28(1): 9-12.
[8] 李胜男, 张怀亮. 中医阴阳学说研究进展[J]. 辽宁中医药大学学报, 2014, 16(1): 202-204.
[9] 祝世讷. 对阴阳学说的五点新认识[J]. 山东中医药大学学报, 2016, 40(6): 491-494+537.
[10] 印会河, 张伯讷. 中医基础理论[M]. 上海: 上海科学技术出版社, 1984: 11.
[11] 孙广仁, 郑洪新. 中医基础理论[M]. 北京: 中国中医药出版社, 2012: 28-29.
[12] 赵建新, 田元祥. 图解黄帝内经[M]. 西安: 陕西师范大学出版社, 2012: 111.
[13] Githens, S. (1988) The Pancreatic Duct Cell: Proliferative Capabilities, Specific Characteristics, Metaplasia, Isolation and Culture. Journal of Pediatric Gastroenterology and Nutrition, 7, 486-506.
[14] Atkinson, M.A., Campbell-Thompson, M., Kusmartseva, I., et al. (2020) Organisation of the Human Pancreas in Health and in Diabetes. Diabetologia, 63, 1966-1973.
[15] Zhou, Q. and Melton, D.A. (2018) Pancreas Regeneration. Nature, 557, 351-358.
[16] Gyr, K., Beglinger, C. and Stalder, G.A. (1985) Interaction of the Endo and Exocrine Pancreas. Schweizerische Medizinische Wochenschrift, 115, 1299-1306.
[17] Henderson, J.R., Daniel, P.M. and Fraser, P.A. (1981) The Pancreas as a Single Organ: The Influence of the Endocrine upon the Exocrine Part of the Gland. Gut, 22, 158-167.
[18] Vujasinovic, M., Valente, R., Del Chiaro, M., et al. (2017) Pancreatic Exocrine Insufficiency in Pancreatic Cancer. Nutrients, 9, Article 183. [Google Scholar] [CrossRef] [PubMed]
[19] Special Committee on Chronic Pancreatitis, Pancreatic Disease Specialized Committee and Chinese Medical Doctor Association (2019) Standards for the Diagnosis and Treatment of Pancreatic Exocrine Insufficiency (2018, Guangzhou). Journal of Clinical Hepatology, 35, 294-298.
[20] 中国医师协会胰腺病专业委员会慢性胰腺炎专委会. 胰腺外分泌功能不全诊治规范(2018, 广州) [J]. 临床肝胆病杂志, 2019, 35(2): 294-298.
[21] Kleeff, J., Whitcomb, D.C., Shimosegawa, T., et al. (2017) Chronic Pancreatitis. Nature Reviews Disease Primers, 3, Article 17060.
[22] 刘凤斌, 胡玲, 陈苏宁, 等. 消化系统常见病慢性胰腺炎中医诊疗指南(基层医生版) [J]. 中华中医药杂志, 2019, 34(12): 5785-5789.
[23] 曲鹏飞, 韩俊泉, 张树智. 王红教授应用大承气汤治疗急性胰腺炎胰腺内分泌功能损伤思路阐释[J]. 中国中西医结合外科杂志, 2024, 30(1): 124-126.
[24] 黄悦. 阴阳学说的存在基础探析[J]. 光明中医, 2013, 28(3): 445-446.
[25] 王履. 医经溯洄集[M]. 上海: 上海浦江教育出版有限公司, 2011: 43.
[26] 刘燕池. 刘燕池中医基础理论讲稿[M]. 北京: 人民卫生出版社, 2009: 70.
[27] 周明倩, 李海昌, 谢志军, 等. 基于中医阴阳理论探讨糖尿病中胰岛素/胰高血糖素平衡关系[J]. 贵阳中医学院学报, 2015, 37(4): 58-60.
[28] Whitcomb, D.C. (2019) Pancreatitis: TIGAR-O Version 2 Risk/Etiology Checklist with Topic Reviews, Updates, and Use Primers. Clinical and Translational Gastroenterology, 10, e00027.
[29] Schneider, A., Lohr, J.M. and Singer, M.V. (2007) The M-ANNHEIM Classification of Chronic Pancreatitis: Introduction of a Unifying Classification System Based on a Review of Previous Classifications of the Disease. Journal of Gastroenterology, 42, 101-119.
[30] Huang, H., Liu, Y., Daniluk, J., et al. (2013) Activation of Nuclear Factor-κB in Acinar Cells Increases the Severity of Pancreatitis in Mice. Gastroenterology, 144, 202-210.
[31] Karagianni, V.T., Papalois, A.E., et al. (2012) Nutritional Status and Nutritional Support before and after Pancreatectomy for Pancreatic Cancer and Chronic Pancreatitis. Indian Journal of Surgical Oncology, 3, Article 348.
[32] Cai, G.H., Huang, J., Zhao, Y., et al. (2013) Antioxidant Therapy for Pain Relief in Patients with Chronic Pancreatitis: Systematic Review and Meta-Analysis. Pain Physician, 16, 521-532.
[33] 马淑杰. 慢性胰腺炎与糖尿病的临床风险因素分析[J]. 中国卫生标准管理, 2015, 6(4): 46-47.
[34] 贺娟. 以脾藏象为例论《灵枢》《素问》脏腑体系建构方法差异性[J]. 北京中医药大学学报, 2021, 44(12): 1067-1072.
[35] 赵帆, 张根明, 王晓阳, 等. 浅论中医学对胰腺实体解剖的认知过程[J]. 世界科学技术-中医药现代化, 2022, 24(8): 2926-2931.
[36] 陈瑜, 张晓芹, 刘芳, 等. 慢性胰腺炎的辨证分型及中医药治疗进展[J]. 中国医药指南, 2012, 10(30): 434-435.
[37] 中华中医药学会脾胃病分会. 消化系统常见病慢性胰腺炎中医诊疗指南(基层医生版) [J]. 中华中医药杂志, 2019, 34(12): 5785-5789.
[38] 中国中西医结合学会消化系统疾病专业委员会. 慢性胰腺炎中西医结合诊疗共识意见(2020) [J]. 中国中西医结合消化杂志, 2020, 28(10): 731-739.
[39] 乔雅兰, 马正业, 冯丽娟, 等. 慢性胰腺炎的中医证型及证素分布规律[J]. 中日友好医院学报, 2020, 34(5): 307-308.
[40] 曾方政, 程绩, 郑辉, 等. 慢性胰腺炎急性发作的危险因素及预后因素分析[J]. 中国急救复苏与灾害医学杂志, 2022, 17(3): 374-377.
[41] 陈佳赢, 林一帆, 雷春红. 慢性胰腺炎急性发作的相关因素分析及中药干预的意义[J]. 按摩与康复医学, 2017, 8(11): 5-7.
[42] Beyer, G., Habtezion, A., Werner, J., et al. (2020) Chronic Pancreatitis. The Lancet, 396, 499-512.
[43] 夏梦幻, 王庆其. 基于《黄帝内经》浅析“脾胃为脏腑之本” [J]. 中华中医药杂志, 2018, 33(9): 3856-3858.
[44] 沈丕安. 中药药理与临床应用[M]. 北京: 人民卫生出版社, 2006: 76-118.

为你推荐