“四至”理论源流、内涵及应用  

Origin,Connotation and Application of the“Si Zhi”Theory

作　　者：武艺超 宋连英[1] 张耀圣[1] WU Yichao;SONG Lianying;ZHANG Yaosheng(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《山东中医杂志》2025年第2期161-163,204,共4页Shandong Journal of Traditional Chinese Medicine

基　　金：吴阶平医学基金会临床科研专项资助基金项目(编号:320.6750.2022-25-2)。

摘　　要：“四至”理论即“和气”“肌气”“骨气”“神气”与阴茎勃起“怒”“大”“坚”“热”相对应,是对阴茎勃起过程的概括。通过梳理各时期对“四至”理论的认识,初步阐述了“四至”理论的内涵:“和气”即“肝气”,“肌气”即“脾气”,“骨气”即“肾气”,“神气”即“心气”,勃起及阳痿的治疗与肝、脾、肾、心的生理功能相关。进而认为“怒”“大”“坚”“热”与西医学勃起充盈期、肿大期、完全勃起期、强直期相对应。基于“四至”理论,提出阳痿治法:疏肝气、养肝血以调和气;健脾气、祛痰湿以养肌气;温肾阳、补命门以壮骨气;补心气、宁心神以安神气。The“Si Zhi”theory refers to the corresponding relationship among“He-qi”,“Ji-qi”,“Gu-qi”,“Shen-qi”and“anger”,“big”,“firm”,and“heat”of penile erection,which is a generalization of the process of penile erection.By combing the understanding of the theory of“Si Zhi”in the history,the connotation of the theory is preliminarily elaborated:“He-qi”refers to“liver qi”,“Ji-qi”refers to“spleen qi”,“Gu-qi”refers to“kidney qi”,“Shen-qi”refers to“heart qi”.Erection and treatment of impotence are related to the physiological functions of liver,spleen,kidney and heart.Furthermore,it is considered that“anger”,“big”,“firm”and“heat”correspond to the latency phase,tumescence phase,full erection phase and rigid erection phase of erection in modern medicine.Based on the theory of“Si Zhi”,the treatment for impotence is proposed as follows:soothing liver qi and nourishing liver blood to regulate He-qi;invigorating spleen qi and dispelling phlegm and dampness to nourish Ji-qi;warming kidney yang and tonifying life gate to strengthen Gu-qi;tonifying heart qi and tranquilizing mind to calm Shen-qi.

关 键 词：阳痿 四至 勃起 疏肝健脾 温肾宁心 

分 类 号：R698.1[医药卫生—泌尿科学] R277.5[医药卫生—外科学]