“湿胜则濡泻” 出自《黄帝内经》，其不仅是对泄泻病机的阐释，也是指导中医临床治疗泄泻的重要原则之一。“濡 泻”病机既可源于外湿侵袭，又可来自内湿停聚，内湿与外湿合而为患，内伤脾阳，脾阳不振，而成泄泻。基于“湿胜则 濡泻”脾阳不振、水湿停聚的病机，其治则当温运脾阳。现代中医临床实践及相关机制研究表明，温运脾阳治则与现代医 学之线粒体功能密切相关。苓桂术甘汤、附子理中汤等温阳健脾以缓解“濡泻”的机制与改善线粒体能量代谢障碍有关； 升阳益胃汤、升阳除湿汤等通过升阳除湿以缓解“濡泻”的机制与改善炎症状态下的线粒体损伤有关；小建中汤、理中汤 等通过运脾以缓解“濡泻”的机制与改善线粒体氧化损伤有关。“湿胜则濡泻”的病机内涵及其温运脾阳治则的现代机制探 索将为湿邪的病因病机、湿证的证候研究提供借鉴，并可对居于岭南、长江中下游地区等潮湿气候环境下及在现代社会不 良膳食结构复合影响下的泄泻防治提供参考。

The statement of heavy dampness leading to watery diarrhea was recorded in Huang Di Nei Jing （The Yellow Emperor’ s Inner Classic） ，which is not only an interpretation of the pathogenesis of diarrhea，but also one of the important principles to guide the clinical treatment of diarrhea in traditional Chinese medicine. The watery diarrhea can be caused by the invasion of external dampness，or results from the retention and accumulation of internal dampness. The combination of internal dampness and external dampness causes internal injury of spleen yang，and then the spleen yang is inactivated，which eventually results in diarrhea. Based on the pathogenesis of spleen yang inactivation and water-dampness retention and accumulation in heavy dampness leading to watery diarrhea，the therapeutic principle of warming and activating spleen yang should be performed. Modern Chinese medicine clinical practice and related mechanism research showed that the therapy of warming and activating spleen yang was closely related to the mitochondrial function in modern western medicine. The mechanism Linggui Zhugan Decoction and Fuzi Lizhong Decoction in relieving watery diarrhea by warming and activating spleen yang is related to the improvement of the energy metabolism disorder in the mitochondrion； the mechanism of Shengyang Yiwei Decoction and Shengyang Chushi Decoction in relieving watery diarrhea by raising yang and eliminating dampness is related to the improvement of mitochondrial damage in the inflammatory state； the mechanism of Xiao Jianzhong Decoction and Lizhong Decoction in relieving watery diarrhea by activating spleen is related to the improvement of mitochondrial oxidative damage. The exploration of the pathogenesis of heavy dampness leading to watery diarrhea and the modern mechanism of therapy of warming and activating spleen yang will provide reference for the study of the etiology and pathogenesis of pathogenic dampness and the dampness syndrome，and can provide reference for the prevention and treatment of diarrhea patients in the humid climate environment such as in Lingnan area and the middle and lower reaches of the Yangtze River and under the combined influence of improper dietary structure in modern society.

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国家自然科学基金项目 （编号：82174244，81973720）