从肝与命门藏象剖析古代医家的方位理论  

Analysis of ancient medical physicians′ spatial theory from the perspective of liver and mingmen visceral manifestation

作　　者：席崇程 张杰[1] 吴文军[1] 张之文[1] 翟双庆[2] 冯全生[1] XI Chongcheng;ZHANG Jie;WU Wenjun;ZHANG Zhiwen;ZHAI Shuangqing;FENG Quansheng(Chengdu University of Traditional Chinese Medicine,Chengdu 611137,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]成都中医药大学,成都611137 [2]北京中医药大学

出　　处：《北京中医药大学学报》2025年第2期187-192,共6页Journal of Beijing University of Traditional Chinese Medicine

基　　金：四川省哲学社会科学基金项目(No.SCJJ24ND210);四川省自然科学基金项目(No.2023NSFSC1811)。

摘　　要：阴阳、藏象和体用学说作为中医学的核心学说,对中医学的形成和发展具有重要的支撑作用。随着中国哲学的不断发展,中医哲学和中医理论受到影响,因此在不同历史时期,医家关于肝与命门藏象的论述各有差异。本文立足于对肝与命门位置的不同认识,结合相关哲学图像和中医解剖图像,深度挖掘古代医家有关左、右、上、下4个方位的理论。古代医家对方位理论的概括形式从最初的圆周运动逐渐转变为上下运动,其关注重点也从上部转向下部。造成这种差异和变化的主要原因为对体用学说认识的侧重点不同,以及对阴阳学说内容关注点的差异。本文梳理肝与命门藏象演变历程,归纳医家方位理论转变及其影响,总结了体用学说与阴阳学说对方位理论的渗透,以期为中医方位理论的研究和临床应用提供指导,推动中医哲学与医学理论的融合与发展。Yin-yang,visceral manifestation,and ti-yong theories are the core theories of traditional Chinese medicine(TCM) and play a crucial role in its formation and development.With the continuous evolution of Chinese philosophy,TCM philosophy and theories have undergone significant influence,resulting in differing interpretations of the visceral manifestation of liver and mingmen across various historical periods by different medical practitioners.This paper focuses on the different understandings of the position of liver and mingmen,combining relevant philosophical images and TCM anatomical illustrations to deeply explore ancient medical theorists′ concepts regarding the four spatial directions of left,right,up,and down.The research reveals that ancient medical theorists′ conceptualization of spatial theory transitioned from an initial circular motion to a vertical movement,with the focus shifting from the upper part to the lower part.The primary reasons for these differences and changes could be explained by the varying emphasis on the ti-yong theory and differing focal points within the yin-yang theory.This study systematically examines the evolution of visceral manifestation theories related to liver and mingmen,highlights the shifts in physicians′ perspectives on spatial theory,and analyzes the influence of the ti-yong theory and yin-yang theory on these changes.The findings aim to provide a theoretical guide for advancing research and clinical application of spatial theory in TCM,thereby fostering the integration of TCM philosophy with medical theory.

关 键 词：肝 命门 藏象 方位理论 

分 类 号：R223.1[医药卫生—中医基础理论]