基于生理功能论三焦解剖定位

Anatomical localization of Sanjiao based on physiological function

三焦,六腑之一,最早出现于中医经典名著《黄帝内经》,主通行元气,运行水谷,运行水液。其中相关描述文字深奥,前后含义不尽相同,解剖定位似有若无,且以“孤腑”出现的形式明显有异于其他五组阴阳相应的脏腑,故三焦自古就是医家研学探究的热点。经后世历代医家不断发挥与补充,三焦的内涵得到增益拓展,特别是三焦与心包络互为阴阳表里的概念的提出,让三焦更接近传统意义的“腑”。但对于三焦“名”与“形”之争却一直未能获得共识。《灵枢·论勇篇》《灵枢·本脏篇》《素问·金匮真言论篇》等是最早认为三焦“有名有形”的经典,但到《难经·二十五难》《难经·三十八难》等却认为三焦是“有名无形”。《黄帝内经》与《难经》对三焦的不同认知,导致对其“有名有形”与“有名无形”的争论亘古通今。根据唯物主义物质为第一性的基本观点,三焦有名有形。借助现代医学研究方法、调整研学思路,文章以三焦生理功能及现代生理学为依据,通过相互对应推导出三焦的解剖定位,夯实三焦研学的科学性。

Sanjiao(三焦),one of the six Fu organs(六腑),first appears in the classic Huangdi Neijing(《黄帝内经》),it is in charge of the passage of vital energy,transporting water and food,and running water.In the classic,the relevant description words are profound,the meanings are different from each other,the anatomical location seems to be absent,and the appearance of“Gufu(孤腑)”is obviously different from the corresponding zang-fu(脏腑)organs of other five groups of Yin(阴)and Yang(阳),therefore,Sanjiao(三焦)has been a hot spot of medical research since ancient times.In the later generations,the connotation of Sanjiao is expanded,especially the concept that Sanjiao and pericardium are the interior and exterior of Yin and Yang,which makes Sanjiao closer to traditional Fu-organ(腑).But for the dispute of Sanjiao’s“name”and“shape”,it has not been able to achieve a consensus.Lingshu Lunyong Pian(《灵枢,论勇篇》),Lingshu Benzang Pian(《灵枢,本脏篇》),Suwen Jingui Zhenyanlun Pian(《素问,金匮真言论篇》),etc.,are the earliest classics that point out that Sanjiao is“appellative and tangible”.However,in Nanjing Ershiwunan(《难经,二十五难》),Nanjing Sanshibanan(《难经,三十八难》),etc.,Sanjiao is considered to be“appellative but invisible”.The different cognition of Sanjiao in Huangdi Neijing(《黄帝内经》)and Nanjing(《难经》)has led to the debate on“appellative and tangible”and“appellative and invisible”of Sanjiao.Based on the basic view that materialism matter is primary,that Sanjiao must be appellative and tangible.With the help of modern medical research methods and adjusting research ideas,and based on the physiological function and modern physiology,the anatomical localization of Sanjiao is deduced to,and tamps the scientific nature of the research of Sanjiao in this paper.