基于三焦理论探讨盆底器官疾病的生理基础

Discussion on Physiological Basis of Pelvic Floor Organ Diseases based on Sanjiao Theory

盆底功能障碍性疾病是困扰当今广大女性的医学难题,其病程长,病变复杂,涉及肛肠、泌尿、妇产等多学科,严重影响患者的身心健康。因此,以整合多学科系统诊疗,研究盆底生理基础,是理清该类疾病的病理机制、整合治疗方案的前提。一直以来,现代中医研究基本从脾、肝、肾等脏腑入手,没有完整概括盆底生理,故提出“盆底的生理基础源于整体三焦膜腠”的论点。三焦膜腠以有形之体,支撑和化生肌肉、韧带,进而稳固盆底,并围筑和贯通周身腔隙,稳定和缓冲内压变化,从而调节盆底。三焦膜腠的完整通畅,是其气化功能运行的前提,使上中下三部津气血通流,能滋化源、充养元气,濡养盆底;又传化水液糟粕,能清湿浊、化瘀血、通滞气,通调盆底。该文通过辨明三焦形质与功能,梳理、论述其与盆底生理的密切关系,为从中医方面进一步梳理探讨盆底相关疾病的三焦病机本质、病理过程、治则及方药运用,促进整合盆底医学的发展提供理论依据。

Pelvic floor dysfunction is a medical problem that plagues the majority of women today.It has a long course of disease and complex lesions,involving multiple disciplines such as anorectal,urology,obstetrics and gynecology,and seriously affects the physical and mental health of patients.Therefore,to integrate multidisciplinary system of diagnosis and treatment,to study the physiological basis of pelvic floor,is the premise to clarify the pathological mechanism of this kind of disease and integrate the treatment plan.For a long time,modern TCM research has basically started from the spleen,liver,kidney and other organs,and has not fully summarized the physiology of the pelvic floor.Therefore,it is proposed that“the physiological basis of the pelvic floor originates from the overall Sanjiao membrane”.With a tangible body,the Sanjiao membrane can support and metaplasticize muscles and ligaments,thereby stabilizing the pelvic floor,enclosing and penetrating the cavities around the body,stabilizing and buffering changes in internal pressure,thereby regulating the pelvic floor.The completeness of the Sanjiao Membrane is the premise of its gasification function,which makes the upper,middle and lower parts of the body flow through,which can nourish the source,replenish the vitality,and nourish the pelvic floor;Clear dampness and turbidity,remove blood stasis,stagnate Qi,and regulate pelvic floor.In this paper,by identifying the shape,quality and function of Sanjiao,combing and discussing its close relationship with pelvic floor physiology,in order to further comb and explore the pathogenesis,pathological process,treatment principle and prescription application of Sanjiao related diseases of pelvic floor from the perspective of traditional Chinese medicine,and promote the integration of pelvic floor The development of basic medicine provides a theoretical basis.