【摘要】 中医学范畴的“卫”包含多种概念，其中，“营卫”“卫气”之“卫”以其独特的循行特点，将其护卫周身、祛邪不入的功能发挥尽致。“脾为之卫”则描述了脾脏运化水谷精微，化生气血，充养人体后天的营养和能量的功能。文章基于中医之“卫”理论的核心要义，创新性地关联“卫”与免疫微环境，初步探讨了“卫气循行”“脾为之卫”及“营卫和谐”在自身免疫性疾病中的作用机制。首先，突破中医“卫气营血”理论的传统解读，将温病传变规律与免疫应答由防御→激活→失衡→损伤的动态分期紧密结合，为通过“卫分–气分–营分–血分”对自身免疫性疾病辨证施治提供了理论支撑。其次，超越“脾主运化”的传统理解，提出“脾–肠–免疫轴”假说，阐明了脾虚通过肠道菌群失调、代谢紊乱及黏膜免疫屏障破坏导致免疫失衡的潜在病理机制，为“脾为之卫”赋予现代生物学解释。最后，结合时间免疫学与中医时序医学，揭示卫气昼夜循行节律与免疫细胞活性及细胞因子分泌时序的同步性，为基于中医“因时制宜”理论优化给药时间窗口、提高疗效时效提供理论基础。本研究推动了中医免疫学理论的现代化阐释，为中西医结合探索自身免疫病机制与临床干预开辟新路径，上述假说还需后续实验与临床研究验证以推动中医理论实证化。更多还原

【Abstract】 The “Wei”(卫) of traditional Chinese medicine(TCM) contains a variety of concepts, among which, the words “Ying Wei(营 卫)” and “Wei Qi(卫 气)” describe the unique characteristics of Wei Qi circulating in the body and its function of protecting the whole body and preventing external pathogenic factors from entering the body. “The spleen acting as the protector of the body” describes the function of “spleen” to transport water and grain, to generate Qi and blood, and to nourish the acquired nutrition and energy of the human body. Based on the core essence of the theory of “Wei” in TCM, this article innovatively correlates “Wei” with the immune microenvironment and preliminarily explores the mechanism of “circulation of Wei Qi”, “Spleen as the defense” and “harmony of Ying and Wei” in autoimmune diseases. Firstly, it breaks through the traditional interpretation of the theory of “defense, Qi, nutrient and blood pattern identification” in TCM and closely combines the law of transmission and transformation of “warm disease” with the dynamic stages of immune response from defense-activation-imbalance-injury, providing theoretical support for the syndrome differentiation and treatment of autoimmune diseases through “defense aspect-Qi aspect-nutrient aspect-blood aspect”. Secondly, transcending the traditional understanding of “spleen governs transportation and transformation”, the hypothesis of “spleen-intestine-immune axis” is proposed, clarifying the potential pathological mechanism of immune imbalance caused by spleen deficiency through intestinal flora imbalance, metabolic disorder and mucosal immune barrier disruption, giving a modern biological explanation to “spleen as the defense”. Finally, combined with chronoimmunology and traditional Chinese chronomedicine, the synchrony between the circadian rhythm of Wei Qi circulation and the activity of immune cells and the timing of cytokine secretion is revealed, providing a theoretical basis for optimizing the administration time window and improving the efficacy timelines based on the theory of “adapting to the times” in TCM. This research has promoted the modern interpretation of TCM immunology theory, opening up new paths for the integration of traditional Chinese and Western medicine to explore the mechanism and clinical intervention of autoimmune diseases. The above hypotheses still need to be verified by subsequent experiments and clinical studies to promote the practicalization of TCM theory.更多还原