基于《黄帝内经》探究冲脉概念及临床应用

Study on the Concept and Clinical Application of Chongmai Based on The Inner Canon of the Yellow Emperor

通过梳理、分析冲脉在《黄帝内经》中的相关记载,考证冲脉概念的形成基础、发展脉络,认为冲脉是古人在观察动脉搏动现象的基础上,在诊脉察病、砭石启脉等临床实践背景下形成的认识,是古人重视实体血脉、气血概念的体现。冲脉的名称、循行和功能定位均体现以上特点。然而,随着医学理论的发展,三阴三阳模式思维对经脉分布与循行的规范,十二经理论占据主导地位,归属于冲脉的动脉位点被十二经分割,导致后世对冲脉的定位与十二经不断交叉与混同,冲脉的独立功能、病证特征日渐模糊,最终使冲脉的临床应用与理论定位脱节。基于冲脉对动脉系统的高度统属,立足于气血的盛衰与虚实、畅通与瘀阻定位冲脉为血海、主生殖与月经等内涵与妇科、寒邪客居和神志几方面的病证,并制定相应的治疗方法,在临床中具有独特的价值与意义。

Through combing and analysing the relevant records of Chongmai in The Inner Canon of the Yellow Emperor(《黄帝内经》),the basis for the formation of the concept of Chongmai,its development,and the connotation of its name and reality are examined.It is believed that the concept of Chongmai is based on the observation of arterial pulsation by ancient people,and the practice of pulse diagnosis and blood letting by healing stone,to reflect the importance placed on the entity of the blood vessels,the concept of qi and blood in clinical practice.The name,route and function of Chongmai all reflect the above characteristics.With the development of medical theory and the standardization of the distribution and route of meridians by the three-Yin and three-Yang model thinking,the theory of the twelve meridians has taken a dominant position,and the arterial sites belonging to Chongmai are divided by the twelve meridians,resulting in the intersection and confusion between the positioning of the Chongmai and the twelve meridians in later generations.The independent function and disease characteristics of the Chongmai are becoming increasingly blurred,ultimately leading to a disconnection between the clinical application and theoretical positioning of Chongmai.Based on the high degree of belonging of the human arterial system to Chongmai,and based on the exuberance-decline and excess-deficiency,free and stasis of qi and blood,this article concluded that the connotation of Chongmai as the sea of blood,governs reproduction and menstruation,dominates disease of gynaecology,cold pathogen intruding the body,and mental disease,and formulates corresponding treatment methods,which has a unique value and significance in clinic.