三焦功用再思考及与生物管道理论的联系

Rethinking on Sanjiao functions and connections between Sanjiao function and theory of bio-pipe

本文通过梳理中医古今重要文献并结合临床实际,对三焦生理、病理等进行了较为深入地思考和探索,认为三焦是体内水、火、气、血、谷运行的通道,是联系内外、沟通表里、维持升降、平衡阴阳、调和寒热、调节虚实的关键,是全身五脏六腑、气血津液精等的枢纽,是生命之枢,病变主要以肺—脾—肾三焦水液气化系统和心—肝—肾三焦相火系统失常为主,治疗以畅达三焦,和解少阳,通利枢机为要,代表方为三仁汤和小柴胡汤。并从"生物管道"理论角度认识三焦,认为管道不通是三焦病变的核心病机,从而达到更好地认识和诊治三焦疾病的目的。

This paper deeply explored the physiology and pathology of Sanjiao through arranging ancient and modern important literatures and combining with clinical practice, and regarded that Sanjiao was the passageway in the body for water, fire, qi, blood and grain circulates, and it was also the key for connecting the inside and outside, communicating the surface and inner side, maintaining upward and downward of qi movements, balancing yin and yang, accommodating heat and cold and regulating deficiency and excess. It was the junction for five zang viscera, six fu viscera, qi, blood, fluid, humors and essence, and in other words, it was the pivotal of life. The pathological changes of Sanjiao mainly presented in abnormal functions of pneumatolysis system of lung-spleen-kidney or abnormal functions of ministerial fire system of heart-liver-kidney. So the treatments should be attached importance to clearing heat-dampness in sanjiao, reconciling shaoyang and removing obstruction from pivot, and the representive decoctions were Sanren decoction and Xiaochaihu decoction. Sanjiao should be understood from the angle of bio-pipe theory, which considered that clogged pipe was the principal pathogenesis of Sanjiao lesion, so as to understand and treat Sanjiao disease preferably.