中医玄府理论研究述评

Review of the theoretical research of Xuanfu in traditional Chinese medicine

刘完素拓展了《黄帝内经》玄府的概念,近30多年来,大量学者在刘完素的论述基础上系统总结和完善了玄府学说,形成较为完善的玄府理论。玄府是遍布全身,无物不有的至微至细的结构,是人体组织中气血津液运行与交换的通道,物质与信息交流的场所,具有畅达气机、输布津液、渗灌气血、运转神机等功能。玄府郁闭或开通太过是玄府的基本病机,治法上以开通玄府为要。一些学者根据玄府的结构和功能特点,提出了玄府-细胞膜假说、玄府-细胞间隙、玄府-离子通道的玄府生物学实质假说,并在实验中证实。目前,玄府理论广泛用于指导内科、五官科、皮肤科疾病的诊疗并获得一定的疗效。但玄府理论的研究尤其是玄府的生物学实质、玄府与络脉的关系依然存在一些争议,应建立专家共识,纳入中医基础理论,才能便于玄府理论及临床应用的推广。

LIU Wan-su developed the concept of Xuanfu originated in Huangdi Neijing.In the past 30 years,many experts have systematically summarized and improved the Xuanfu theory on the basis of LIU Wan-su,and constructing a relatively complete theoretical system.Xuanfu is a very tiny channel or orifice,which is widely distributed all over the body and performed a key role in the movement and exchange of qi,blood and body fluid.That’s to say,Xuanfu is the place for material,energy and information exchange in human tissue,it has the functions of ascending,descending,exiting and entering of qi,blood,body fluid and spirit.The basic pathogenesis of Xuanfu is closed or open too much,so the key to the treatment method for such diseases is to dredge or close Xuanfu properly.According to the structural and functional characteristics of Xuanfu,some experts put forward the Xuanfu-cell membrane hypothesis,Xuanfu-cell gap,Xuanfu-ion channel hypothesis about the biological essence.Xuanfu theory is also widely applied to guide in the clinical treatment of the diseases including internal medicine,ophthalmology,otorhinolaryngology and dermatology and obtain beneficial effects.However,there are still some controversies in the study of Xuanfu theory,especially in the biological essence of Xuanfu and the relationship between Xuanfu and collaterals.It is necessary to establish an expert consensus and incorporate it into the basic theory of TCM so as to facilitate the spread of the theory and clinical application of Xuanfu.