“心部于表”的应用与中西医阐释  

Application and traditional Chinese and Western medicine interpretation of "heart governing the exterior"

作　　者：张丁元 张婧倩[1] 李宇轩 沈瑛锴 李冬 ZHANG Dingyuan;ZHANG Jingqian;LI Yuxuan;SHEN Yingkai;LI Dong(Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijingg 100070,China;The First Clinical Medical College,Shandong University of Traditional Chinese Medicine,Jinan 250014,China)

机构地区：[1]北京中医药大学东方医院,北京100078 [2]北京中医药大学东直门医院 [3]山东中医药大学第一临床医学院

出　　处：《北京中医药大学学报》2025年第2期181-186,共6页Journal of Beijing University of Traditional Chinese Medicine

基　　金：北京市自然科学基金面上项目(No.7222284);北京市科学技术协会“青年人才托举工程”(No.BYESS2022181);中央高水平中医医院临床科研业务费资助北京中医药大学“岐黄英才-优秀青年科技人才培育计划-科研拔尖人才”(No.K2023A03)。

摘　　要：“心部于表”理论源于《素问·刺禁论篇》,在中医临床实践中占据重要地位。本文梳理了历代医家对于“心部于表”的内涵阐释,归纳总结了“心部于表”在胸痹、温病、皮肤病、鼻鼽、抽动障碍、糖尿病神经病变的临床实践,发现“心部于表”理论广泛应用于临床实践,且疗效甚佳。本文进一步扩展、提升其理论内涵,即心阳、心血、心神3个维度与其所主宰的生命、精神活动及外在总体表现的生理、病理联系与临床应用。此外,通过探讨“心部于表”与西医学“脑-心轴”“脑-皮轴”的联系,间接证实“心部于表”在西医学中的合理性,为“心部于表”理论的进一步发展和应用奠定了基础。The theory of "heart governing the exterior" derives from Prohibition of Pricking in Suwen,which has an important position in the clinical practice of traditional Chinese medicine.This article sorts out the interpretation of "heart governing the exterior" of physicians in the past dynasties,and summarizes the clinical application of "heart governing the exterior" in chest painful impediment,warm disease,dermatosis,allergic rhinitis,tic disorder,and diabetic neuropathy.It is found that the theory of "heart governing the exterior" is widely used in clinical practice and has good effects.This paper further expands and enhances its theoretical connotation,that is,the physiological and pathological connection and clinical application of the three dimensions of heart yang,heart blood,and heart spirit with the life and mental activities dominated by it,as well as the overall external performance.In addition,by exploring the relationship between "heart governing the exterior" and "brain-heart axis","brain-skin axis" in Western medicine,it indirectly confirms the rationality of "heart governing the exterior" in Western medicine,and lays the foundation for the further development and application of the theory of "heart governing the exterior".

关 键 词：心部于表 心阳 心血 心神 脑-心轴 脑-皮轴 

分 类 号：R223.1[医药卫生—中医基础理论]