中医药研究论丛

212.5 心与包络辨
TJ TCM.21(2) : 47-58, 2018
心与包络辨
Distinguish Between the Heart and Xin Bao Luo Meridians
陈必诚1* 锺岳伦1 黄廷宇1
1 中国医药大学学士後中医系,台中,台湾
【摘要】
近世西医日益发展,不论是影像学、生理学、解剖学等皆有可观的进步,然而对於中国传统医学,尤其是在经络理论、经络实质的方面仍然是一知半解。有鉴於此,本文将从古典文献、解剖学两观点切入探讨,试图寻找对应中医经络学说中的「心」与「心包络」之实质,并在古典与现代医学文献中找出证据,厘清心与心包络的实质与特性。在「心经」方面,我们发现《灵枢·经脉》中关於心经体内循行的部分经文与解剖学的「大动脉系统」有关。
而在「心包络」实质方面,我们共进行三方面的探讨:首先,一般认为的心包络等同心包膜(pericardium) 之观点稍嫌局限,未能解释临床上内关治疗冠心病的原理,故此乃一个需厘清之点;接着,我们透过心包络、三焦相表裏的关系与三焦的膜理论,推论心包络应为人体内各种膜类上之中小动脉系统;最後,我们认为「心主手厥阴心包络之脉」的「心主」应理解成「由心所主宰」之意,故「心主心包络」之意是:心包络是听命於心,而既然「包」是指一切膜类,而「络」是细小血管,因此「心主心包络」便是「由心所主宰的一切膜类上的中小血管系统」。综合心经、心包络经两方面的讨论可知:心与心主手厥阴心包络两条经脉,就包含了大动脉系统与各种膜上的中小动脉系统!
【关键词】心经、动脉系统、心包络、心主、内关
Bih-Cheng Chen1*Yuen-lun Chung1Ting-Yu Huang1
1School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
【Summary】
With the growing development of western medicine in recent decades,considerable progress has been made in medical imageology, physiology, anatomy and etc. However, the limited knowledge on especially meridian theory and its intrinsic features still remain in Traditional Chinese Medicine. In view of this,this study reviews and investigates the intrinsic features of “Heart” and “Xin Bao Luo” in the Meridian theory based on classical literature and anatomical
perspectives. Through the classical and modern medical literature, we attempt to clarify the intrinsic features as well as the characteristics of the Heart and “Xin Bao Luo” from the evidence found. For the Heart meridian, we discover that part of the description of the meridian pathway in the body is related to the aortic system in anatomy through the ‘Magic Pivot, Chapter 10-Meridians’. As for the intrinsic features of “Xin Bao Luo”, the following three discussions are included:Firstly, the limitation in the general perception of “Xin Bao Luo is equivalent to Pericardium” has failed to explain the principle of clinical treatment of Coronary Heart Disease by Neiguan (PC6). Hence, it remains as one of the key points required to be clarified. Secondly, through the exterior-interior relationship of Xin Bao Luo” and San Jiao (Triple membrane) and its membrane theory, “Xin Bao Luo” is inferred as the middle and small arterial system of various membrane types. Finally, we believe that “Heart governs the “Xin Bao Luo” meridian of Hand Jue Yin” is being comprehended as “The heart is the dominating organ”.
Hence “Heart governs “Xin Bao Luo” ” is referred as ‘The Heart is governing all the middle and small artery system on the membranes within the body’ since Bao” is defined as all the membranes while “Luo” is defined as the arterioles. Integrating the discussion on the “Heart” and “Xin Bao Luo”, it is learnt that the two meridians-Heart meridian and “Heart governs the “Xin Bao Luo” meridian of Hand Jue Yin” include the aortic system and the middle and small artery system on the various membranes.
【Keywords】Heart meridian, Arterial System, Pericardium, Heart governs,
Neiguan (PC6)