基于“肝藏魂”理论探析肠易激综合征脑肠 互动异常的病机与论治

Exploration of the Pathogenesis and Treatment of Brain-Gut Interaction Abnormalities in Irritable Bowel Syndrome Based on the Theory of “The Liver Stores the Soul”

摘要: 系统探析中医“肝藏魂”理论与肠易激综合征(IBS)脑肠互动异常的内在医理关联，阐释IBS发病的核心中医病机，为该病临床辨证施治提供新的理论思路与学术支撑。方法：采用文献研究法与医理思辨法，梳理“肝藏魂”理论的学术溯源与核心内涵，结合现代医学IBS脑肠互动异常的病理机制，构建二者的医理关联模型，进而辨析IBS的核心病机并确立相应治疗原则与分证治法。结果：“肝藏魂”理论与IBS脑肠互动异常在经络结构载体、核心调控功能、病理演变规律层面存在高度医理契合性；肝失藏魂是IBS发病的根本病机，脑肠失和为核心病理枢纽，肠腑传导失司为发病之标，三者通过“肝–脑–肠”轴线形成递进式恶性循环。结论：基于“肝藏魂”理论可完整阐释IBS脑肠互动异常的全链条内在机制，突破了现有研究多聚焦“肝主疏泄”的同质化局限，丰富了IBS的中医病机理论体系，为临床从“调肝安魂”论治IBS奠定了坚实的理论基础。

Abstract: This study systematically explores the intrinsic medical theoretical connections between the Traditional Chinese Medicine (TCM) theory of “the liver stores the soul” and brain-gut interaction abnormalities in irritable bowel syndrome (IBS), elucidating the core TCM pathogenesis of IBS and providing novel theoretical insights and academic support for clinical syndrome differentiation and treatment of the disease. Methods: By employing literature research and medical theoretical reasoning, we reviewed the academic origins and core connotations of the “the liver stores the soul” theory. We then integrated this with the pathological mechanisms of brain-gut interaction abnormalities in IBS as understood by modern medicine to construct a medical theoretical correlation model between the two. Subsequently, we analyzed the core pathogenesis of IBS and established corresponding treatment principles and syndrome-specific therapeutic methods. Results: There is a high degree of medical theoretical congruence between the “the liver stores the soul” theory and brain-gut interaction abnormalities in IBS at the levels of meridian structural carriers, core regulatory functions, and pathological evolution patterns. Liver’s failure to store the soul represents the fundamental pathogenesis of IBS, with brain-gut disharmony serving as the core pathological hub and intestinal dysfunction as the superficial manifestation of the disease. These three factors form a progressive vicious cycle through the “liver-brain-gut” axis. Conclusion: The theory of “the liver stores the soul” provides a comprehensive explanation for the full-chain intrinsic mechanisms of brain-gut interaction abnormalities in IBS, breaking through the homogeneous limitations of existing research that predominantly focuses on “the liver’s role in regulating qi flow”. It enriches the TCM pathogenesis theoretical system of IBS and lays a solid theoretical foundation for clinical treatment of IBS from the perspective of “regulating the liver and calming the soul”.