宗气理论概述及现代研究进展

Overview of Pectoral Qi Theory and Modern Research Progress

本文通过系统回顾宗气理论相关文献,对宗气的定义沿革、生理功能、虚实变化、宗气亏虚临床表现及宗气理论的现代研究进展等内容进行总结和归纳,以深化对宗气内涵的理解。宗气内涵主要有以下4种观点:宗气是由肺所吸入的自然界的清气结合脾胃化生的水谷之气积于胸中而成;宗气的实质即心肺阳气;宗气是升至胸中之谷气的一种特称;宗气是积于胸中并在左乳下跳动的动气。其生理功能包括走息道以司呼吸,贯心脉以行气血,宗心肺而主燮理,统诸气而安脏腑、布津液,抵御外邪,提携神明、保持神思脑力健旺,职司视、听、声、色、嗅、动,汇元气以全生机。宗气失常主要表现在"虚实"二端,其中虚表现为宗气亏虚、宗气下陷,实表现为宗气痹阻、宗气上逆。宗气亏虚证的常见临床表现主要症状为气短,动则加重,甚则气喘。伴见症状为面色白或晦暗、神疲、乏力、少气懒言、不寐、头晕、目眩、自汗、消瘦、舌淡暗、苔薄白、脉沉、脉细或脉弱。并发症状为心肺气血运行不畅之胸闷、胸痛、心悸、紫绀、咳嗽、咳痰、大便秘结;脾虚不运之纳呆、便溏、腹胀;阳虚气化失利之四肢逆冷、畏寒、浮肿、小便不利、口干。另外,从宗气论治的疾病,以心肺疾病为主,逐渐扩展到其他系统疾病。同时,以宗气理论指导治疗疾病的临床研究多有报道,从现代医学角度对宗气的实质也进行了探讨。总而言之,宗气理论提出很早,但系统研究尚难以满足临床诊疗需要,许多问题有待深入研究和解决。

In this paper, through a systematic review of literatures on pectoral qi theory, we summarized the defini-tion of pectoral qi, physiological function, deficiency-excess changes, clinical manifestations of pectoral qi deficiency and modern research progress of pectoral qi theory, in order to deepen the understanding of pectoral qi connotation. The connotations of pectoral qi have four major kinds of views. The pectoral qi is a combination of the natural fresh air inhaled by the lungs and the foodstuff essence-qi transformed by the spleen-stomach accumulated in the thorax. The substance of pectoral qi is heart-lung yang qi. Pectoral qi is the special title of acquired essences in the thorax. Pectoral qi accumulated in the thorax is the beating-qi beneath the left breast. Its physiological function includes flowing through the respiratory tract to promote the respiration movement of the lungs, permeating the heart and ves-sels to promote circulation of qi and blood, comprehensively regulating of the heart and lungs, controlling all qi and zang-fu, accumulating body fluids, resisting external evils, controlling mental activities, maintaining mental state healthy and vigorousness, controlling vision, hearing, sound, color, smell and movement, converging primordial qi to maintain the vigor and vitality. Disorders of pectoral qi are mainly manifested as deficiency or excess. Deficiency is mainly manifested in pectoral qi insufficiency, or pectoral qi sinking. Excess is mainly manifested in pectoral qi ob-struction, or pectoral qi counterflow. The common clinical manifestations of pectoral qi insufficiency include short-ness of breath and panting on exertion. The concomitant symptoms are pale or dim complexion, lassitude, lack of strength, shortage of breath and disinclination to talk, insomnia, dizziness, spontaneous sweating, emaciation, darkish tongue with thin and white fur, sunken thin or weak pulse. And it commonly superimposed with failing to circulation qi-blood of heart and lungs as chest distress, chest pain, palpitations, cyanosis, cough, expectoration, and hard stool. Spleen transportation and transformation dysfunction were manifested as poor appetite, loose stool, and abdominal dis-tension. Impairment of qi transformation due to yang deficiency is manifested as cold limbs, aversion to cold, edema, urination difficulty, and dry mouth. In addition, diseases which are treated with pectoral qi are give priority to the heart-lung diseases, and then gradually extend to diseases of other systems. At the same time, there are many reports on using pectoral qi theory in disease treatment. The essence of pectoral qi is also discussed from the perspective of modern medicine. Generally speaking, pectoral qi theory has been put forward early; however, the systematic study is difficult to meet the needs of clinical diagnosis and treatment. There are many problems which remain to be further studied and solved.