【摘要】 腹泻型肠易激综合征(IBS-D)发病率居高不下，精神心理异常导致的脑-肠轴紊乱是重要致病因素。中医学认为，“脾失健运”“脾不藏意”是病机关键。脾居中焦，为五脏气机之“枢轴”，情志之根本。“脾藏意”包含了认知、情绪、生理等不同内涵，与脑-肠轴密切相关，既是藏象理论的重要组成部分，也是中医情志病与西医心理学互通的桥梁。五加减正气散可通过强脾意、运脾营，多途径、多靶点发挥增强免疫、调节肠道菌群、抗炎止泻、调节内脏高敏等作用。本文从“脾藏意”探讨五加减正气散治疗IBS-D的理论依据，为进一步揭示该经方对脑-肠轴的调控靶点提供理论依据，为从脾论治消化心身疾病提供新的思路与方法。

    【关键词】 “脾藏意” 五加减正气散 腹泻型肠易激综合征

    Discussion on the Theoretical Basis of Wujiajian Zhengqi Powder in the Treatment of IBS-D from the "Spleen Storing Idea"/WANG Wei， SUN Zhen， DENG Hualiang. //Medical Innovation of China， 2024， 21(27)： -179

    [Abstract] The incidence of irritable bowel syndrome with diarrhea (IBS-D) remains high， and the brain-gut axis disturbance caused by mental and psychological abnormalities is an important pathogenic factor. Traditional Chinese medicine believes that "dysfunction of spleen in transportation" and "spleen not storing idea" are the key to the pathogenesis， the spleen is in the middle jiao， which is the "pivot" of the five zang viscera Qi movement and the foundation of emotion. "Spleen storing idea" contains different connotations such as cognition， emotion and physiology ......