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231.7 自主神经在中医“肺与大肠相表里”理论里的角色

TJ TCM.23(1) : 77-92, 2020

DOI : 10.6516/TJTCM.202003_23(1).0007

自主神经在中医“肺与大肠相表里”理论里的角色

The Role of Autonomic Nerves in The Theory “The Lung Stands in Interior-Exterior Relationship With The Large Intestine Theory” in Chinese Medicine

方建喨1,2　王丰彬2*

1 戴德森医疗财团法人嘉义基督教医院中医部，嘉义，台湾

2 国立中正大学心理学研究所，嘉义，台湾

【摘要】

对於客观存在的生理病理，如果中西医两者的论点都正确，应该可以得出相同的结论，本文希望可以经由这观点，来探讨在中医临床上持续运用的中医脏象学说中“肺与大肠相表里”理论；目前运用现代生理病理学角度探讨“肺与大肠相表里”理论的相关学说有MEK/ERK 信号通路学说、微生物菌群学说、黏膜免疫学说、特殊分子学说、胚胎发育学说，都认为肺与大肠间互为因果关系，但本篇文章藉由自主神经系统及中医对临床疾病的症状表现观察，认为“肺与大肠相表里”在部分的表现上，并不呈现因果关系，而是同时出现的“相关”关系，即先由病理或生理上的表现，影响到大脑与自主神经间讯息传递（传出或传入），後续呈现“肺”与“大肠”外在同时表现的变化，因而影响到中医师在临床上的观察，而认为肺与大肠之间为因果关系。而这新论点显示在现代生理病理学中，大脑对於五脏六腑的影响并非个别单线互传讯息，而是多方面的影响，因而由现代生理病理学讨论“脏腑互为表里”的理论时，也必须同时讨论大脑与自主神经在其中所扮演的角色。

【关键词】肺与大肠、自主神经、大脑、奔豚病

Chien-Liang Fang1,2　Feng-Bin Wang2*

1Department of Traditional Chinese Medicine, Ditmanson Medical Foundation Chia-yi

Christian Hospital, Chiayi, Taiwan

2Department of Psychology, National Chung Cheng University, Chiayi, Taiwan

【Summary】

Based on the physiological and pathological observations that are objective,both of the viewpoints of medical treatment by the western medicine and Traditional Chinese Medicine (TCM) should reach the same conclusions. In this review, we try to give a novel interpretation for “the lung stands in interiorexterior relationship with the large intestine theory” that has been long adapted in the practice of TCM. Five perspectives have been used to discuss the physiological pathology of the lung stands in interior-exterior relationship with the large intestine theory: MEK/ERK signal pathway theory、micro-ecology theory、mucosal immune system theory、special molecule theory、Embryonic development theory. They all reach the same conclusion that the lung and the colon have a mutual cause-effect relationship. Based on new anatomical data of the autonomic nervous system (ANS) and the clinical observations, we proposed that the lung and large intestine not only have a mutual cause-effect relationship but also a correlated; the physiological and pathological conditions of the visceral diseases are transmitted via the afferent and efferent pathways of the ANS to and out of the central nervous system (CNS); thus, the symptoms observed in the lung and large intestine has been misinterpreted to have a mutual cause-effect

relationship. Actually, the neural connections between the brain and the viscera are multiple rather than single. Therefore, if discuss the TCM of “the visceral stands in interior-exterior relationship with another visceral”, we should consider with the brain and autonomic nerves from the perspective of modern physiology and pathology.

Keywords：lung stands in interior-exterior relationship with the large intestine,autonomic nervous system, brain, Bentun disease

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