浅论中医学对胰腺实体解剖的认知过程

Discussion on the Cognitive Process of Pancreatic Anatomy in Ancient Books of Traditional Chinese Medicine

中医学古籍中罕有关于“胰腺”的明确记载,缺乏直观、系统的理论论述。本文试图通过对各个时期具有代表性的医学典籍所记载内容的分析,结合现代解剖学相关理论,梳理中医学对胰腺实体解剖的认识过程。通过分析,笔者认为中医学对胰腺实体解剖的认识具有阶段性:(1)先秦两汉时期,存在胰腺实体解剖,但并非认为胰腺是脏器;(2)唐宋时期,胰腺实体解剖更加清晰,在医学上胰腺附属于脾,并非为独立的脏器;(3)明清时期,胰腺实体解剖明确,部分医家以独立脏器论之,出现“脾”“、胰”之争。中医学理论缺少对胰腺的单独论述,目前学界的主流观点多为“胰属脾”,线性归属以脾笼统代之略显单薄,不利于理论的丰富与发展。笔者认为胰腺藏象应独立于脾单独讨论,现代解剖学对胰腺命名同一,形态结构清楚,位置描述明确,可直接补充进中医学胰腺藏象(藏)理论中,为完善胰腺藏象理论搭建解剖学基础。

There are few clear records about"pancreas"in ancient books of traditional Chinese medicine,and there is a lack of intuitive and systematic theoretical discussion.This paper attempts to comb through the understanding process of pancreatic solid anatomy in traditional Chinese medicine by analyzing the contents recorded in the representative medical classics of various periods and combining with the relevant theories of modern anatomy.Through analysis,the author believes that the understanding of pancreatic solid anatomy in traditional medicine has stages:(1)In the Pre-Qin and Han Dynasties,pancreatic solid anatomy existed,but pancreas was not considered as an organ.(2)In the Tang and Song dynasties,the pancreas was more clearly dissected.In medicine,the pancreas was attached to the spleen,not an independent organ.(3)In the Ming and Qing Dynasties,the anatomy of the pancreas was clear.Some doctors regarded the pancreas as an independent organ,and the dispute of"spleen"and"pancreas"The theory of Traditional Chinese medicine lacks a separate discussion on pancreas,and the mainstream view in the academic circle is"pancreas belongs to spleen",and the linear attribution of spleen is a little thin,which is not conducive to the enrichment and development of the theory.We believe that the pancreatic images should be discussed independently from the spleen.The modern anatomy of pancreas has the same name,clear shape and structure,and clear description of its position,whichcan be directly added into the theory of pancreatic zangxiang in Traditional Chinese medicine,so as to build an anatomical basis for perfecting the theory of pancreatic zangxiang.