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为“脾胃相表里”提供血流动力学诠释 ——多尺度生理模型的仿真研究
Title: A Hemodynamic Interpretation of the “Interior–Exterior Relationship between the Spleen and Stomach”: A Simulation Study Based on a Multiscale Physiological Model
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摘要
摘要
目的：基于腹腔干解剖结构的血流动力，探索“脾胃相表里”内涵，提供数理量化依据。
方法：基于流体力学、工程控制论、生物化学、生理学、解剖结构，构建多器官的多尺度生理数学模型；并模拟脾静脉梗阻所致区域性门静脉高压的病理状态。
结果：各脏腑的血流并不是平均分配，在餐前后的血流分配比例大幅度改变，脾胃的动力能量、功效输出随之改变，各脏腑的血流分配互相制约进而互相影响功能效率。
局限：本研究处于理论架构的推理论证及文献数据对比验证，未进行实验室、临床试验。个体差异等未进一步分析研究。
结论：“脾胃相表里”在血流动力学层面符合能量、控制、动力能效、功能效率科学数理关系。具有明确的物质基础及数理关系。
Abstract
Abstract Objective: Based on the precise anatomical structure of the celiac trunk—which gives rise to three major branches (left gastric artery, splenic artery, and common hepatic artery), with the splenic artery traveling along the superior border of the pancreas and sequentially giving off pancreatic branches (supplying the pancreas), short gastric arteries and left gastroepiploic artery (supplying the stomach), and terminal splenic branches (entering the spleen)—this study explores the hemodynamic implications of the traditional Chinese medicine (TCM) theory ”Spleen and Stomach being exterior-interiorly paired” and provides a quantifiable foundation for its integrative interpretation. Methods: A multi-scale physiological mathematical model incorporating six organ modules (stomach, spleen, pancreas, small intestine, liver, and gallbladder) was constructed based on fluid dynamics (series-parallel hybrid circuit model with common-path resistance), neuro-control theory (Hill equation), and biochemistry (Bergman minimal model). The core anatomical assumption of the model is that the celiac trunk, as a common pathway, possesses finite resistance (R_proximal = 0.004 mmHg·min/mL), with the left gastric, splenic, and common hepatic arteries branching from the terminal point of this common pathway. Using physiological parameters reported in the literature as boundary conditions, the model simulated neural signal transmission, vascular resistance changes, organ blood flow distribution, hormone secretion, and glucose metabolism over 0–120 min postprandially. Pathological states of regional portal hypertension due to splenic vein obstruction were also simulated. Results: (1) Neural sensory signals peaked within 5 min postprandially, occurring 8–15 min earlier than the peak glucose load (18–25 min), confirming the pre-regulatory role of neural signals in digestive blood flow. (2) Postprandial active gastric vasodilation increased gastric blood flow from approximately 550 mL/min at fasting to approximately 750 mL/min postprandially (an increase of ~36%), while splenic blood flow decreased from 370 mL/min to approximately 350 mL/min (a decrease of ~5–6%), and pancreatic blood flow decreased from 82 mL/min to approximately 77 mL/min (a decrease of ~6%), validating the hemodynamic principle that ”gastric flow increase leads to splenic and pancreatic absolute flow reduction.” (3) Pancreatic blood flow was identical between high-sugar and mixed meals, yet peak insulin levels differed significantly (22 vs. 18 μU/mL), demonstrating that pancreatic secretion is driven by glucose and incretins rather than by blood flow per se. (4) Splenic vein obstruction elevated portal pressure from 8 mmHg to 15 mmHg, reducing gastric perfusion from 489.9 mL/min to 413.7 mL/min, a reduction of 15.6%, which inversely supports the hemodynamic basis of "spleen disease affecting the stomach.” Limitations: This study is limited to reasoning and argumentation within a theoretical framework and comparative verification with literature data; no laboratory or clinical trials were conducted. Individual differences and other factors were not further analyzed or studied. Conclusion: The TCM theory ”spleen and stomach being exterior-interiorly paired” possesses a definitive tripartite anatomical-physical-physiological hemodynamic substrate: the celiac trunk serves as a common pathway connecting the left gastric, splenic, and common hepatic arteries; its finite resistance creates pressure coupling among the three branches; gastric vasodilation leads to absolute reduction in splenic and pancreatic perfusion through the common-path pressure drop mechanism; and portal pressure transmission enables splenic pathology to affect gastric perfusion. This study provides a quantifiable, verifiable, anatomically grounded modern physiological interpretative framework for this classical TCM theory.关键词
关键词：脾胃相表里/血流动力学/公共管程阻力/腹腔干/多尺度生理模型/仿真验证Key words
Keywords: spleen and stomach being exterior-interiorly paired/ hemodynamics/ shared conduit resistance/ celiac trunk/ multi-scale physiological model/ simulation validation引用本文复制引用
李大煊.为“脾胃相表里”提供血流动力学诠释 ——多尺度生理模型的仿真研究[EB/OL].(2026-10-22)[2026-10-28].https://sinoxiv.napstic.cn/article/26393048.学科分类
中医学版本历史
| 版本 | 时间 | DOI号 | 操作 |
|---|---|---|---|
| v2 | 2026-10-28 16:40:09 | 10.12383/202610170003V2 | 全文下载 |
| v1（当前版本） | 2026-10-22 16:58:47 | 10.12383/202610170003V1 | 全文下载 |