三焦實質之探討; The study of The Essence of San-Chiao

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題名:	三焦實質之探討;The study of The Essence of San-Chiao
作者:	王人澍;Jen-Shu Wang
貢獻者:	中國醫藥大學中國醫學研究所
關鍵詞:	經;難經;中藏經;三焦;自律神經系統;腦幹與脊髓;Nei Jing;Nan Jing;Chung Zhang Jing;triple burner;autonomic nervous system;spinal cord and the brain stem
日期:	2004
上傳時間:	2010-01-20
摘要:	本研究目的，依現代解剖生理學，探討《內經》、《難經》與《中藏經》的三焦功能，包括「孤腑」、「六腑之功能」、「原氣之別使」、「主諸氣」、「總領五臟、六腑、營衛、經絡、內外、左右、上下之氣也」等。由於器官與生理的體用關係，每個器官皆有其獨特的生理功能，而每種生理功能也都有其相對應的器官，中醫三焦器官有名無形或有名有形歷代醫家均有不同的說法。歷代文獻及解剖圖均以臟腑、經絡為核心，五行架構下的泛中醫臟腑理論皆未正式列入生命最高的主控中樞「腦」，與貫穿各類神經的「腦與臟腑」及「腦與肢體」的中間主控器官「脊髓」，三焦為有功能卻無明確對應之器官。本文以《內經》、《難經》、《中藏經》原文之典籍文獻、現代解剖生理學相關書籍、中醫研究方法論等相關書籍為研究資料的主要來源。本研究首次提出並採用以現代醫學的生理解剖學為標準架構，將中醫生理學解剖學做三個重要的調整(此法簡稱3M-I.C.W.M.)，中西醫兩者在採取同一架構下進行對照，調整方式如下： 1. 將被古代中醫降貶為「奇恆之府」的「腦」，提昇回歸其主控生命的中樞層級。 2. 體腔內的「臟腑」純為內臟器官，不再兼具有腦的功能。 3. 讓在中醫生理解剖學上似乎毫無功能的「脊髓」回歸擔任「腦與內臟」與「腦與肢體」，即「中樞」與「周邊器官組織」兩者之間功能互動的傳導及主控器官；並讓「骨髓」回歸為生血的器官。直接採取現代生理學的器官與生理功能之「體用關係」，本文認為三焦應具有實質的器官。歸納本文的各項資料，《內經》「有經無腑」的狹義三焦生理對應器官應包括迷走神經、內臟感覺神經與自律神經，其功能包括：調節「心肺之宣發、脾胃之運化、膀胱與大腸之濟泌別濁。」另外噴嚏、嘔吐、咳嗽、出汗與皮脂的分泌，亦可由此獲得充分的解釋。歸屬《難經》與《中藏經》生理範圍之廣義六腑腑級的三焦對應器官應為脊髓，同時應包括延腦、橋腦、中腦的腦幹，除了分出自律神經成為「腦與臟腑」之中間主控調節器官之功能外，同時亦是「腦與肢體」的中間連屬器官，執行調節肢體感覺訊息之傳入與運動訊息之傳出的各項神經功能。上焦調節的範圍本文認為應該擴大，包括頭頸部與五官；下焦調節的範圍則應納入生殖系統的各項功能。本研究最終的結論：讓「奇恆之府」中的「髓」找到生理功能，同時讓「有名無形」或「有形而不知其形」的三焦找到實質器官；包括腦幹與脊髓為三焦之體，三焦為脊髓與腦幹之用；若原氣在腦的理論可以成立，五臟六腑的腦功能歸回到生命的最高中樞「腦」；「原氣之別使」的三焦及腦幹與脊髓可以依現代解剖學銜接到腦的下部，執行其「主持諸氣」包括調節內臟器官與肢體的相關功能；則中西醫的器官生理架構似乎可以藉本研究做初步的銜接。脊髓為三焦實質之結論，似乎可以引導出傳統經絡理論之學理性探討的需要性。; The purpose of this study is based on the modern anatomy and physiology to investigate the functions of the triple burner recorded in Nei Jing, Nan Jin, and Chung Zhang Jing which including ”single bowel”, ”functions of six bowels”, ”messenger of the original qi”, “mastering qis”, ”qi that masters viscera and bowels, construction and defense, channels, internal and external, left and right, up and down.” Generally speaking, there is an established relationship between organs and functions that each organ has an unique physiological function and vice versa. However, the triple burner is identified either with a shape or shapeless according to various scholars over the centuries. Anatomic pictures are mainly organized into viscera, bowels, and channels in the ancient documents. The brain of the central nervous system and the spinal cord of the autonomic nervous system are obviously missing from the Chinese medicine that was constructed by the five phases theory. Likewise, the triple burner has a physiologic activity but its organ is not clearly defined. This thesis is based on the materials from original text of Nei Jing, Nan Jin, and Chung Zhang Jing, books of the current anatomy and physiology, and references in the methodology of Chinese medical research. Under the standard structure of modern anatomy and physiology, this study tried to re-constructure the foundation of anatomy and physiology in the Chinese medicine in three adjustments. Both Chinese and western medicine were compared under the same structural basis. The changes are the following: 1. Bring back the brain to the central control level of life from the lower ‘unusual organ’status in the ancient medicine. 2. The viscera and bowels are just the internal organs that are no longer possess the function of the brain. 3. Spinal cord which was useless in Chinese medicine is now considered as the bridge between the central and peripheral organs and plays a role of conduction and autonomic system. Through the understanding of relationship between organs and functions, the triple burner should have a corresponding organ. Deduction from the all references concluded that the narrow definition of triple burner from Neil Jing, should include the visceral sensory nerve and autonomic nerve and its function consisting: regulations of the effusion by the heart and lungs; the movement and formation by the stomach and spleen; the movement of fluids and discharging urine by the intestine and bladder. In addition, sneezing, coughing, vomiting, sweating, and seborrhea are also explained by this category. The broad definition of triple burner from ‘Nan Jing’ and ‘Chung zhang Jing’ , corresponds with spinal cord, including medulla oblongata, pons and brain stem. Besides autonomic nerve system (ANS) as the control master between the central and visceral organs,
顯示於類別:	[中國醫學研究所] 博碩士論文

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