还原《黄帝内经》“三焦器官”概念及其临床意义  

Reduction of ‘triple energizer organ’ concept of Huangdi Neijing and its clinical significance

作　　者：柳红良 董斐[2] LIU Hong-liang;DONG Fei(Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Institute of Chinese Medicine Epidemic Disease,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院广安门医院脾胃病科,北京100053 [2]北京中医药大学中医疫病研究院,北京100029

出　　处：《中华中医药杂志》2022年第8期4232-4236,共5页China Journal of Traditional Chinese Medicine and Pharmacy

摘　　要：通过部位划分的三焦,在结构上将心肺、脾胃、肝肾分别归属于上、中、下三焦,在功能上又把三焦功能与脏腑等同,虽然三焦结构和功能范围更加全面,但实际临床意义却越来越小。通过追本溯源,笔者发现《黄帝内经》不存在将三焦按部位划分之意,只有“六腑之三焦”的概念。三焦是一个具有明确结构的组织器官,其结构基础为“肉分之间”非实质之处,结合现代医学,可以将此结构进一步深入探讨,即三焦器官是一个间质组织,基本功能是气化,发挥的是通道作用。三焦气化功能发挥“通透性网状效应”,由于病理产物聚积,导致三焦气化通道出现不畅或闭塞,进而会造成五脏六腑功能表达不全甚至闭塞。笔者认为,三焦器官是急性传染性疾病发生发展过程中病机传变规律重要的参与者,与慢性内伤疾病“一脏累及多脏”的病机传变思维模式不同。三焦疾病在临床上是常见病,有特定的生理、病理特点以及治疗原则,还原《黄帝内经》“三焦器官”概念,具有非常重要的临床价值。According to the triple energizer divided by body parts,the heart and lung,spleen and stomach,liver and kidney are respectively assigned to the upper energizer,middle energizer and lower energizer in structure,and the function of the triple energizer is equivalent to that of the zang-fu organs.Although the structure and function of the triple energizer are more comprehensive,the practical clinical significance is getting smaller and smaller.By going back to the source,there is no intention to divide the triple energizer into different parts in Huangdi Neijing,only the concept of the ‘triple energizer of six fu organs’.The triple energizer is a tissue organ with definite structure.Its structural basis is the insubstantial place between flesh points.Combined with modern medicine,this structure can be further discussed,that is,the triple energizer organ is an interstitial tissue,the basic function is gasification,play the role of passage.The function of the triple energizer gasification plays a net effect of permeability.Due to the accumulation of pathological products,the gasification channel of the triple energizer appeared obstructed or blocked,and then caused the functional expression of the viscera was incomplete or even blocked.The author believes that the triple energizer organ is important participant in the pathogenesis of acute infectious diseases,which is different from the thinking mode of chronic internal injury diseases involving multiple organs.The triple energizer disease is a common disease in clinic,with specific physiological and pathological characteristics and treatment principles.Reduction of ‘triple energizer organ’ concept of Huangdi Neijing has very important clinical value.

关 键 词：三焦器官 黄帝内经 中医解剖物质形态 三焦的生理病理 三焦病的治则 

分 类 号：R223.1[医药卫生—中医基础理论]