中医五脏相关学说的理论研究
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摘要
一、研究目的
21世纪医学发展面临诸多新的考验,医学的发展需要中医学的整体观,需要系统联系的方法论。研究和发展中医理论,是中医学术自身传承与创新的需求,是提高中医药养生防治水平和能力,更好服务于现代卫生保健事业和人类健康的需求。21世纪的中医药现代化,中医理论发展依然是先导。
五脏相关学说是基于对中医学核心理论的继承与发扬的现代创新理论。本研究拟在继承前人学术经验的基础上,进行总结提高,深化、系统化五脏相关学说的理论研究。具体包括：第一,推溯该学说的学术渊源；第二,对邓铁涛五脏相关学术思想做专题研究；第三,阐释中医五脏相关的理论内涵；第四,探讨该学说的方法论意义。
二、研究方法
借助文献资料,通过对历代著名医家医论的研究,梳理中医五脏相关学说的学术渊源和理论基础；对邓铁涛教授有关五脏相关学说的论著进行全面整理,研究邓铁涛教授五脏相关学术思想；在文献疏理和医家学术思想研究基础上,根据中医整体观,结合现代系统论,发挥为系统联系观,进而阐释中医五脏相关理论内涵。
参与临床调研,通过分析现代的疾病谱特点,探讨临床实际对中医学提出的时代需求；结合临床病证的多脏相关性、中药归经的多向性分析,探讨五脏相关理论的实践基础。以重症肌无力为切入点,进行中医五脏相关学说的应用基础研究。首先调研39例重症肌无力的临床资料,分析其并发症、证候分布的五脏相关情况；进而探讨针对当代疾病谱的中医脏腑病机研究、以及中医“五脏系统定位”等问题；最后对五脏相关学说的临床运用路径提出初步设想。
三、研究内容和结果
(一)中医五脏相关的学术渊源与理论基础
中医五脏相关的学术思想渊源于《黄帝内经》。《素问·经脉别论》提出“四时五脏阴阳”,这是《内经》中讨论脏腑和四时阴阳之间联系的主要理论,也成为中医脏腑理论的特色,奠定了中医五脏的认识论基础,是中医学研究人体始终遵循的法则之一。《素问·玉机真脏论》认为“五脏相通,移皆有次”,而相通之理合于四时五行阴阳有次序的转输移动。《素问·灵兰秘典论》曰“十二脏相使”,以官职喻脏腑,以君臣关系讨论脏腑之间的相互关系。《内经》之后,历代医家发挥经旨,验之临床,相继提出五脏旁通、五脏穿凿论、五脏互藏、五脏相互关涉等理论,发展了《内经》的五脏相通学术思想,为五脏相关学说的创立奠定了理论基础。
中医学脏腑理论是伴随着中医临床对病证的病机阐释和用药经验总结而发展的。古代医家对中医五脏病机的阐发体现出以下特点：①医家对五脏病机的研究多各有侧重,甚至形成学术流派；单脏病机的研究较为成熟,但也有医家开始结合临床探讨五脏相兼为病的病机；②病机理论研究的进展与对临床病候的研究密切相关；脏腑病机的研究进展与中药学理论发展也密不可分；③借用五行哲理推导转向具体脏腑病机的阐发和临床经验积累；医家临证多不拘于五行生克之序,一经之病,每兼数经以治,而且也积累了一些调和五脏关系的治则和方药经验。
中医学之五脏各有所主,又互相关涉；五脏各相生相克,实各相成；五脏有可分,有不可分。五脏病机是中医病机学的核心,是中医辨证的关键,而其理论和实践基础是五脏分证和中药归经。中药归经理论使药物作用与临床五脏分证联系起来,成为针对性治疗和调理五脏关系的指导性理论；它是中医临床用药摆脱了对五行推理的依赖,使中医脏腑经络辨证用药突出了实践优位。
(二)邓铁涛教授提出五脏相关学说
在中医学中,五脏联系的思想源远流长,但作为一个理论学说的“五脏相关”,则是由国医大师邓铁涛教授创立的。20世纪50-60年代,学术界对“中医学理论体系的核心”问题展开大讨论。1961年邓铁涛教授发表《如何研究整理祖国医学遗产》,提出“五脏相关学说”,之后相继发表《中医五行学说的辩证法因素》、《中医理论的核心》、《略论五脏相关取代五行学说》等代表性专论,阐明该学说的定义、理论价值和主要内容。
邓铁涛教授其他的著作中也有关于五脏相关学说的研究内容,如从病理机制上对五脏相互关系的归纳；提出以脏腑辨证为总纲,以脏腑相关学说为指导的“杂病辨证纲要”。邓教授运用五脏相关理论解决临床难题,主要体现在对冠心病、高血压病、重症肌无力、慢性肝炎及肝硬化等现代常见多发病及疑难危重病的防治。
五脏相关学说的研究经历了创立阶段、孵化成熟阶段,历经半个世纪的学术探索,2005年7月被纳入国家重点基础研究发展计划(973计划),进入“中医五脏相关理论的继承与创新研究”阶段。
(三)中医五脏相关的理论内涵
中医学肝、心、脾、肺、肾五脏概念是对人体生命过程呈现的整体机能的分类概括,是指人体的五个机能子系统,是一种功能性单元。五脏相关,一是强调子系统内部、子系统之间存在多维联系,构成有机整体,不可机械分割；一则强调人体和自然社会环境之间也存在相关性,亦即“天人相应”。五脏相关,更加突出了中医学的整体观和系统联系的思想,体现了现代中医学对生命现象的功能系统观、脏腑联系观和天人整体观。
中医五脏相关的模式可以称之为N元系统相关模式。五脏是一个整体,有可分有不可分,分则为五个功能子系统,为五元系统相关；结合现代系统理论,按照系统之间、系统内、系统外可分为三个层次,是三元系统相关模式；从气机升降出入看,五脏系统可重新进行系统组合,脾-胃、肝-肺与心-肾各为一个新的系统,形成三元系统；从生理功能的联系、病机的影响、治疗作用的协同等角度,五脏相关又可体现为两个系统之间的关联、三个系统的关联,等等。
中医五脏相关的机理包括：①功能协调,气机相系；②经络沟通,阴阳气化；③生气通天,同气相求。因为影响因素多样性、五脏相关具有动态性、开放性等特点,中医五脏相关具有非线性特征。
(四)五脏相关学说的方法论意义
目前我国的疾病谱特点：由生活、精神、环境等因素导致的多因素疾病成为主要疾病谱,心脑血管病、恶性肿瘤、老年性疾病等成为严重危害人民健康的重要疾病,而且疑难病、情志病日益增多。论文以当代的一个疑难病重症肌无力为例,探讨五脏相关学说的方法论意义。
39例重症肌无力病例资料的研究结果：按照中医五脏病机归属,病例组39个症候的分布为脾胃系统12个、肺系统8个、肾系统7个、肝系统7个、心系统5个；症候出现的321例次中,脾胃系统症候158例次(占49.2%),心系统症候52例次(占16.2%),肺系统症候43例次(占13.4%),肾系统症候34例次(占10.6%),肝系统症候34例次(占10.6%)。从症候的种类分布和发生率分析,都是以脾胃系统为主,而其他四个脏系的症候出现率也都在10%以上,提示该病的脏腑病机首先定位在脾胃,且与其他四脏密切相关。研究结果与邓教授对本病基本病机的概括——“脾胃虚损,五脏相关”相符合。
五脏相关是中医临床一种思维模式,蕴含着一个西医辨病与中医辨证相结合的中西医结合研究方向,具有普适性。针对现代疾病谱进行中医五脏相关病机研究,根据新的病机认识制订中医诊治方案,是经西医辨病而又能体现中医辨证论治特点的诊治模式。这一模式既针对疾病的关键病机制订基本诊治程序,亦针对并发证、伴随病设立药物随证加减的措施。本研究对五脏相关临床诊治程序的初步设想为：①病名诊断,②五脏定位,③相关分析,④立法辨证施治。
四、结论
五脏相关的概念及其理论,是名老中医基于临床实践对现代疾病脏腑病机复杂性现象的高度概括,同时也为这一现象的研究开拓出一个新的方法论。
中医五脏相关学说是对中医学脏腑、病机等核心理论的继承和发展。以现代疾病谱为学术背景,该学说蕴含着“辨病”与“辨证”相结合的中西医结合研究前景。
1 Objective
The development of medicine in the 21st century faces many new challenges. It needs the overall concept and the System-related methodology of Chinese medicine. Research and development of Chinese medical theory is that Chinese medical academic needs of their own heritage and innovation, is to improve health prevention and treatment ability of Chinese medicine and to better serve the cause of modern health care and human health needs. Modernization of Traditional Chinese Medicine in the 21st century, the development of theory is still the pilot.
The wu-zang-correlation doctrine, based on inheritance and development of the core of Chinese medicine theory, is a modern innovation theory. This study is designed to inherit the academic experience of predecessors, then make a summing up the increase, and to deep and systematize the research of wu-zang-correlation doctrine at the end.
2 Method
First, reviewing the academic origin of the wu-zang-correlation doctrine; second, to do a monographic academic thought study about DENG Tietao; third, to interoperate its theoretical connotation.
By analyzing the features of modern disease spectrum, the requirement on TCM under today's clinical practice was studied. Then the practical basis of our research on wu-zang-correlation doctrine was discussed by the analysis of clinical syndromes and the multi-directional of the meridian tropism of Chinese medicine.
With myasthenia gravis as a starting point for the application basic research,39 cases were investigated and surveyed. First of all, analyzing their complications, the distribution of their syndrome; Then discussing zang-fu pathogenesis of TCM to western disease, and the "wu-zang system positioning" and other issues; Finally, an initial ideas about the clinical application ways of wu-zang-correlation doctrine was put forward.
3 Content and results
3.1 Academic origin and theoretical basis
The wu-zang-correlation academic thinking was originated in The Yellow Emperor's Inner Canon of Medicine. Simple Questions has proposed "four seasons, five viscera and yin-yang", which is one of the main theory The Inner Canon to discuss the links between yin-yang, four seasons and five viscera. It has become a feature of Chinese medicine theory of viscera, laying the foundation of knowledge about five viscera, and also the rules that Chinese medical research of the human body has always followed. Simple Questions said that "five viscera regularly communicated with each other", while in common the regular is "four seasons and five elements". Simple Questions has also said that "twelve viscera employed with each other", and used the relationship between monarch and his subjects to discuss the relationship between viscera. The ancient physicians in China have raised "five viscera bypass", "five viscera cross", "five viscera store in each other", "five viscera have effects on each other", and so on. Such theories laid a theoretical foundation for the creation of the wu-zang-connected doctrine.
The development of Zang-fu theories in Chinese medicine is accompanied by the research of disease pathogenesis and lessons learned of drugs in the clinical practice. The research of ancient physicians in China obout the wu-zang pathological machine has shown the following characteristics:①Doctors had different emphases on their study about five viscera, and even engendered academic schools; there were also physicians begin clinical study about the disease pathogenesis while more than one viscera had been lesion;②The advance of theoretical pathogenesis research was closely related to that of symptoms and sings of disease; while the theoretical research advance of both the zang-fu pathogenesis and Chinese medicine were inseparable;③Philosophical reasoning by the five elements has gradually being replaced by the pathogenesis study of concrete viscera and the accumulation of clinical experience.
The five viscera in Chinese medicine have different functional distribution, and have effects on each other meanwhile. The effects, both mutual promotion and restriction, complement each other in fact. So wu-zang in Chinese medicine can be systematized, but could not be separated. The wu-zang pathological machine is the core of pathogenesis study in TCM, and is the key to syndrome differentiation. The meridian tropism theory in Chinese medicine has carry out the targeted therapies on wu-zang, and got rid of the dependency on the five elements theory. It means that priority of Chinese medical practice has been established.
3.2 The wu-zang-correlation doctrine put forward by DENG Tietao
In Chinese medicine, the thought that five viscera are associated with each other goes back to ancient times, but as a doctrine was founded by Professor Deng Tietao.50-60 years of the 20th century, there were a academic debate about "the core of the theoretical system of Chinese medicine". In the paper How to Study and Sort Out and Select from Chinese medicine Heritage, published in 1961, professor Deng put forward "wu-zang-correlation doctrine". Since then several representative monographs have been published to clarify the definition of the doctrine, its value and main content.
Research about wu-zang-correlation doctrine was found in many other writings of Professor DENG, such as the induction of the pathological mechanism relationship between five viscera, the advice that wu-zang-correlation doctrine can be taken as guidance to the syndrome differentiation of miscellaneous diseases. The clinical application of wu-zang-correlation doctrine by Professor DENG is mainly reflected in the prevention and treatment of modern disease those common, frequently-occurring, difficult, complicated and critically, such as coronary heart disease, hypertension, myasthenia gravis, and so on.
The research of wu-zang-correlation doctrine has gone through the creation stage, incubation stage. Included in the National Basic Research Program (973 Program) in July 2005, it entered "the heritage and innovative research of wu-zang-correlation theory" stage.
3.3 Theoretical connotation of wu-zang-correlation doctrine
Those five concepts, liver, heart, spleen, lung and kidney in Chinese medicine were classified the overall function present on human life processes. They are five functional subsystems of the human body. Wu-zang-correlation, means multi-dimensional links within subsystem, between subsystems, to form five viscera an organic whole, and could not be mechanically separated. It also means correlation between body and the natural and social environment, namely "correspondence between man and universe". It gives prominence to the overall concept and system-associated idea in TCM, embodied the functional systems view, zang-fu associated idea and the whole concept of man and universe of modern Chinese medical about life.
The patterns of wu-zang-correlation can be called the N-system-related patterns. Five viscera as a whole, can be systematized into five functional subsystems, that is quinary system related model. Combined with modern systematics, according to system-to-system, intra-system and exo-system, wu-zang-correlation can be systematized into three levels, namely ternary system related model. When activities of qi were considered, the five systems can be re-combination, spleen-stomach, liver-lung and heart-kidney, a ternary system. On the analogy of this, five viscera can be systematized into a certain number of associated systems, when the physiological contact, pathological impact, therapeutic synergy effect, etc are taken into account.
The mechanism of wu-zang-correlation includes:①functional coordination, effect of activities of qi;②meridian communication, yin-yang gasification;③vital energy communicate human body and universe, and each kind to act in unison. Wu-zang-correlation is nonlinear, because the factors are diversity and its dynamic, openness characteristics.
3.4 Methodology meaning of wu-zang-correlation doctrine
The characteristics of our country's spectrum of disease nowadays: multi-factor disease that life, spirit, environment and other factors caused have become major disease spectrum; cardiovascular and cerebrovascular diseases, cancer, old age diseases, etc are the major disease which have done serious harm to people's health, and furthermore, difficult and complicated diseases, emotional illness is increasing.
Results of the clinical research on 39 cases of myasthenia gravis: According to the wu-zang pathogenesis attribution, system distribution of the 39 symptoms in the case group were spleen and stomach system 12, lung system 8, renal system 7, liver system 7, heart system 5; of the 321 times symptoms appeared in total, spleen and stomach symptoms had appeared 158 times (49.2%), and heart system symptoms 52 (16.2%), pulmonary system 43 (13.4%), renal system 34 (10.6%), liver system 34 (10.6%). The result suggested that the zang-fu pathogenesis of the disease firstly located in the spleen and stomach system, and with other 4 system closely related. It corresponded to the summarization of Professor Deng to the basic pathogenesis of myasthenia gravis "asthenic and consumptive of the spleen and stomach, as well as five viscera system correlated".
The wu-zang-correlation is a thinking pattern of clinical medicine, contains a Chinese and western integrative medicine research direction, that may combine western methods to identify disease and the syndrome differentiation in Chinese medical. The wu-zang-correlation doctrine can guide the pathogenesis research on modern diseases, and devising treatment programs according to the new understanding of the diseases. In this study, the diagnosis and treatment procedures related to the wu-zang-correlation doctrine are:①illness diagnosis,②ocate wu-zang pathogenesis attribution,③correlation analysis,④legislation and treatment.
4 Conclusion
The concept and theory of wu-zang-correlation, is the highly condensed summary of the complexity of zang-fu pathogenesis of modern disease, and develop a new methodology for the study of this phenomenon as well.
The wu-zang-correlation doctrine has inherited and developed the core theories in Chinese medical, such as zang-fu and pathogenesis. Under the academic background of the modern disease spectrum, the wu-zang-correlation doctrine contains an integrative medicine research direction to combine the disease identify and the syndrome differentiation.
21世纪医学发展面临诸多新的考验,医学的发展需要中医学的整体观,需要系统联系的方法论。研究和发展中医理论,是中医学术自身传承与创新的需求,是提高中医药养生防治水平和能力,更好服务于现代卫生保健事业和人类健康的需求。21世纪的中医药现代化,中医理论发展依然是先导。
五脏相关学说是基于对中医学核心理论的继承与发扬的现代创新理论。本研究拟在继承前人学术经验的基础上,进行总结提高,深化、系统化五脏相关学说的理论研究。具体包括：第一,推溯该学说的学术渊源；第二,对邓铁涛五脏相关学术思想做专题研究；第三,阐释中医五脏相关的理论内涵；第四,探讨该学说的方法论意义。
二、研究方法
借助文献资料,通过对历代著名医家医论的研究,梳理中医五脏相关学说的学术渊源和理论基础；对邓铁涛教授有关五脏相关学说的论著进行全面整理,研究邓铁涛教授五脏相关学术思想；在文献疏理和医家学术思想研究基础上,根据中医整体观,结合现代系统论,发挥为系统联系观,进而阐释中医五脏相关理论内涵。
参与临床调研,通过分析现代的疾病谱特点,探讨临床实际对中医学提出的时代需求；结合临床病证的多脏相关性、中药归经的多向性分析,探讨五脏相关理论的实践基础。以重症肌无力为切入点,进行中医五脏相关学说的应用基础研究。首先调研39例重症肌无力的临床资料,分析其并发症、证候分布的五脏相关情况；进而探讨针对当代疾病谱的中医脏腑病机研究、以及中医“五脏系统定位”等问题；最后对五脏相关学说的临床运用路径提出初步设想。
三、研究内容和结果
(一)中医五脏相关的学术渊源与理论基础
中医五脏相关的学术思想渊源于《黄帝内经》。《素问·经脉别论》提出“四时五脏阴阳”,这是《内经》中讨论脏腑和四时阴阳之间联系的主要理论,也成为中医脏腑理论的特色,奠定了中医五脏的认识论基础,是中医学研究人体始终遵循的法则之一。《素问·玉机真脏论》认为“五脏相通,移皆有次”,而相通之理合于四时五行阴阳有次序的转输移动。《素问·灵兰秘典论》曰“十二脏相使”,以官职喻脏腑,以君臣关系讨论脏腑之间的相互关系。《内经》之后,历代医家发挥经旨,验之临床,相继提出五脏旁通、五脏穿凿论、五脏互藏、五脏相互关涉等理论,发展了《内经》的五脏相通学术思想,为五脏相关学说的创立奠定了理论基础。
中医学脏腑理论是伴随着中医临床对病证的病机阐释和用药经验总结而发展的。古代医家对中医五脏病机的阐发体现出以下特点：①医家对五脏病机的研究多各有侧重,甚至形成学术流派；单脏病机的研究较为成熟,但也有医家开始结合临床探讨五脏相兼为病的病机；②病机理论研究的进展与对临床病候的研究密切相关；脏腑病机的研究进展与中药学理论发展也密不可分；③借用五行哲理推导转向具体脏腑病机的阐发和临床经验积累；医家临证多不拘于五行生克之序,一经之病,每兼数经以治,而且也积累了一些调和五脏关系的治则和方药经验。
中医学之五脏各有所主,又互相关涉；五脏各相生相克,实各相成；五脏有可分,有不可分。五脏病机是中医病机学的核心,是中医辨证的关键,而其理论和实践基础是五脏分证和中药归经。中药归经理论使药物作用与临床五脏分证联系起来,成为针对性治疗和调理五脏关系的指导性理论；它是中医临床用药摆脱了对五行推理的依赖,使中医脏腑经络辨证用药突出了实践优位。
(二)邓铁涛教授提出五脏相关学说
在中医学中,五脏联系的思想源远流长,但作为一个理论学说的“五脏相关”,则是由国医大师邓铁涛教授创立的。20世纪50-60年代,学术界对“中医学理论体系的核心”问题展开大讨论。1961年邓铁涛教授发表《如何研究整理祖国医学遗产》,提出“五脏相关学说”,之后相继发表《中医五行学说的辩证法因素》、《中医理论的核心》、《略论五脏相关取代五行学说》等代表性专论,阐明该学说的定义、理论价值和主要内容。
邓铁涛教授其他的著作中也有关于五脏相关学说的研究内容,如从病理机制上对五脏相互关系的归纳；提出以脏腑辨证为总纲,以脏腑相关学说为指导的“杂病辨证纲要”。邓教授运用五脏相关理论解决临床难题,主要体现在对冠心病、高血压病、重症肌无力、慢性肝炎及肝硬化等现代常见多发病及疑难危重病的防治。
五脏相关学说的研究经历了创立阶段、孵化成熟阶段,历经半个世纪的学术探索,2005年7月被纳入国家重点基础研究发展计划(973计划),进入“中医五脏相关理论的继承与创新研究”阶段。
(三)中医五脏相关的理论内涵
中医学肝、心、脾、肺、肾五脏概念是对人体生命过程呈现的整体机能的分类概括,是指人体的五个机能子系统,是一种功能性单元。五脏相关,一是强调子系统内部、子系统之间存在多维联系,构成有机整体,不可机械分割；一则强调人体和自然社会环境之间也存在相关性,亦即“天人相应”。五脏相关,更加突出了中医学的整体观和系统联系的思想,体现了现代中医学对生命现象的功能系统观、脏腑联系观和天人整体观。
中医五脏相关的模式可以称之为N元系统相关模式。五脏是一个整体,有可分有不可分,分则为五个功能子系统,为五元系统相关；结合现代系统理论,按照系统之间、系统内、系统外可分为三个层次,是三元系统相关模式；从气机升降出入看,五脏系统可重新进行系统组合,脾-胃、肝-肺与心-肾各为一个新的系统,形成三元系统；从生理功能的联系、病机的影响、治疗作用的协同等角度,五脏相关又可体现为两个系统之间的关联、三个系统的关联,等等。
中医五脏相关的机理包括：①功能协调,气机相系；②经络沟通,阴阳气化；③生气通天,同气相求。因为影响因素多样性、五脏相关具有动态性、开放性等特点,中医五脏相关具有非线性特征。
(四)五脏相关学说的方法论意义
目前我国的疾病谱特点：由生活、精神、环境等因素导致的多因素疾病成为主要疾病谱,心脑血管病、恶性肿瘤、老年性疾病等成为严重危害人民健康的重要疾病,而且疑难病、情志病日益增多。论文以当代的一个疑难病重症肌无力为例,探讨五脏相关学说的方法论意义。
39例重症肌无力病例资料的研究结果：按照中医五脏病机归属,病例组39个症候的分布为脾胃系统12个、肺系统8个、肾系统7个、肝系统7个、心系统5个；症候出现的321例次中,脾胃系统症候158例次(占49.2%),心系统症候52例次(占16.2%),肺系统症候43例次(占13.4%),肾系统症候34例次(占10.6%),肝系统症候34例次(占10.6%)。从症候的种类分布和发生率分析,都是以脾胃系统为主,而其他四个脏系的症候出现率也都在10%以上,提示该病的脏腑病机首先定位在脾胃,且与其他四脏密切相关。研究结果与邓教授对本病基本病机的概括——“脾胃虚损,五脏相关”相符合。
五脏相关是中医临床一种思维模式,蕴含着一个西医辨病与中医辨证相结合的中西医结合研究方向,具有普适性。针对现代疾病谱进行中医五脏相关病机研究,根据新的病机认识制订中医诊治方案,是经西医辨病而又能体现中医辨证论治特点的诊治模式。这一模式既针对疾病的关键病机制订基本诊治程序,亦针对并发证、伴随病设立药物随证加减的措施。本研究对五脏相关临床诊治程序的初步设想为：①病名诊断,②五脏定位,③相关分析,④立法辨证施治。
四、结论
五脏相关的概念及其理论,是名老中医基于临床实践对现代疾病脏腑病机复杂性现象的高度概括,同时也为这一现象的研究开拓出一个新的方法论。
中医五脏相关学说是对中医学脏腑、病机等核心理论的继承和发展。以现代疾病谱为学术背景,该学说蕴含着“辨病”与“辨证”相结合的中西医结合研究前景。
1 Objective
The development of medicine in the 21st century faces many new challenges. It needs the overall concept and the System-related methodology of Chinese medicine. Research and development of Chinese medical theory is that Chinese medical academic needs of their own heritage and innovation, is to improve health prevention and treatment ability of Chinese medicine and to better serve the cause of modern health care and human health needs. Modernization of Traditional Chinese Medicine in the 21st century, the development of theory is still the pilot.
The wu-zang-correlation doctrine, based on inheritance and development of the core of Chinese medicine theory, is a modern innovation theory. This study is designed to inherit the academic experience of predecessors, then make a summing up the increase, and to deep and systematize the research of wu-zang-correlation doctrine at the end.
2 Method
First, reviewing the academic origin of the wu-zang-correlation doctrine; second, to do a monographic academic thought study about DENG Tietao; third, to interoperate its theoretical connotation.
By analyzing the features of modern disease spectrum, the requirement on TCM under today's clinical practice was studied. Then the practical basis of our research on wu-zang-correlation doctrine was discussed by the analysis of clinical syndromes and the multi-directional of the meridian tropism of Chinese medicine.
With myasthenia gravis as a starting point for the application basic research,39 cases were investigated and surveyed. First of all, analyzing their complications, the distribution of their syndrome; Then discussing zang-fu pathogenesis of TCM to western disease, and the "wu-zang system positioning" and other issues; Finally, an initial ideas about the clinical application ways of wu-zang-correlation doctrine was put forward.
3 Content and results
3.1 Academic origin and theoretical basis
The wu-zang-correlation academic thinking was originated in The Yellow Emperor's Inner Canon of Medicine. Simple Questions has proposed "four seasons, five viscera and yin-yang", which is one of the main theory The Inner Canon to discuss the links between yin-yang, four seasons and five viscera. It has become a feature of Chinese medicine theory of viscera, laying the foundation of knowledge about five viscera, and also the rules that Chinese medical research of the human body has always followed. Simple Questions said that "five viscera regularly communicated with each other", while in common the regular is "four seasons and five elements". Simple Questions has also said that "twelve viscera employed with each other", and used the relationship between monarch and his subjects to discuss the relationship between viscera. The ancient physicians in China have raised "five viscera bypass", "five viscera cross", "five viscera store in each other", "five viscera have effects on each other", and so on. Such theories laid a theoretical foundation for the creation of the wu-zang-connected doctrine.
The development of Zang-fu theories in Chinese medicine is accompanied by the research of disease pathogenesis and lessons learned of drugs in the clinical practice. The research of ancient physicians in China obout the wu-zang pathological machine has shown the following characteristics:①Doctors had different emphases on their study about five viscera, and even engendered academic schools; there were also physicians begin clinical study about the disease pathogenesis while more than one viscera had been lesion;②The advance of theoretical pathogenesis research was closely related to that of symptoms and sings of disease; while the theoretical research advance of both the zang-fu pathogenesis and Chinese medicine were inseparable;③Philosophical reasoning by the five elements has gradually being replaced by the pathogenesis study of concrete viscera and the accumulation of clinical experience.
The five viscera in Chinese medicine have different functional distribution, and have effects on each other meanwhile. The effects, both mutual promotion and restriction, complement each other in fact. So wu-zang in Chinese medicine can be systematized, but could not be separated. The wu-zang pathological machine is the core of pathogenesis study in TCM, and is the key to syndrome differentiation. The meridian tropism theory in Chinese medicine has carry out the targeted therapies on wu-zang, and got rid of the dependency on the five elements theory. It means that priority of Chinese medical practice has been established.
3.2 The wu-zang-correlation doctrine put forward by DENG Tietao
In Chinese medicine, the thought that five viscera are associated with each other goes back to ancient times, but as a doctrine was founded by Professor Deng Tietao.50-60 years of the 20th century, there were a academic debate about "the core of the theoretical system of Chinese medicine". In the paper How to Study and Sort Out and Select from Chinese medicine Heritage, published in 1961, professor Deng put forward "wu-zang-correlation doctrine". Since then several representative monographs have been published to clarify the definition of the doctrine, its value and main content.
Research about wu-zang-correlation doctrine was found in many other writings of Professor DENG, such as the induction of the pathological mechanism relationship between five viscera, the advice that wu-zang-correlation doctrine can be taken as guidance to the syndrome differentiation of miscellaneous diseases. The clinical application of wu-zang-correlation doctrine by Professor DENG is mainly reflected in the prevention and treatment of modern disease those common, frequently-occurring, difficult, complicated and critically, such as coronary heart disease, hypertension, myasthenia gravis, and so on.
The research of wu-zang-correlation doctrine has gone through the creation stage, incubation stage. Included in the National Basic Research Program (973 Program) in July 2005, it entered "the heritage and innovative research of wu-zang-correlation theory" stage.
3.3 Theoretical connotation of wu-zang-correlation doctrine
Those five concepts, liver, heart, spleen, lung and kidney in Chinese medicine were classified the overall function present on human life processes. They are five functional subsystems of the human body. Wu-zang-correlation, means multi-dimensional links within subsystem, between subsystems, to form five viscera an organic whole, and could not be mechanically separated. It also means correlation between body and the natural and social environment, namely "correspondence between man and universe". It gives prominence to the overall concept and system-associated idea in TCM, embodied the functional systems view, zang-fu associated idea and the whole concept of man and universe of modern Chinese medical about life.
The patterns of wu-zang-correlation can be called the N-system-related patterns. Five viscera as a whole, can be systematized into five functional subsystems, that is quinary system related model. Combined with modern systematics, according to system-to-system, intra-system and exo-system, wu-zang-correlation can be systematized into three levels, namely ternary system related model. When activities of qi were considered, the five systems can be re-combination, spleen-stomach, liver-lung and heart-kidney, a ternary system. On the analogy of this, five viscera can be systematized into a certain number of associated systems, when the physiological contact, pathological impact, therapeutic synergy effect, etc are taken into account.
The mechanism of wu-zang-correlation includes:①functional coordination, effect of activities of qi;②meridian communication, yin-yang gasification;③vital energy communicate human body and universe, and each kind to act in unison. Wu-zang-correlation is nonlinear, because the factors are diversity and its dynamic, openness characteristics.
3.4 Methodology meaning of wu-zang-correlation doctrine
The characteristics of our country's spectrum of disease nowadays: multi-factor disease that life, spirit, environment and other factors caused have become major disease spectrum; cardiovascular and cerebrovascular diseases, cancer, old age diseases, etc are the major disease which have done serious harm to people's health, and furthermore, difficult and complicated diseases, emotional illness is increasing.
Results of the clinical research on 39 cases of myasthenia gravis: According to the wu-zang pathogenesis attribution, system distribution of the 39 symptoms in the case group were spleen and stomach system 12, lung system 8, renal system 7, liver system 7, heart system 5; of the 321 times symptoms appeared in total, spleen and stomach symptoms had appeared 158 times (49.2%), and heart system symptoms 52 (16.2%), pulmonary system 43 (13.4%), renal system 34 (10.6%), liver system 34 (10.6%). The result suggested that the zang-fu pathogenesis of the disease firstly located in the spleen and stomach system, and with other 4 system closely related. It corresponded to the summarization of Professor Deng to the basic pathogenesis of myasthenia gravis "asthenic and consumptive of the spleen and stomach, as well as five viscera system correlated".
The wu-zang-correlation is a thinking pattern of clinical medicine, contains a Chinese and western integrative medicine research direction, that may combine western methods to identify disease and the syndrome differentiation in Chinese medical. The wu-zang-correlation doctrine can guide the pathogenesis research on modern diseases, and devising treatment programs according to the new understanding of the diseases. In this study, the diagnosis and treatment procedures related to the wu-zang-correlation doctrine are:①illness diagnosis,②ocate wu-zang pathogenesis attribution,③correlation analysis,④legislation and treatment.
4 Conclusion
The concept and theory of wu-zang-correlation, is the highly condensed summary of the complexity of zang-fu pathogenesis of modern disease, and develop a new methodology for the study of this phenomenon as well.
The wu-zang-correlation doctrine has inherited and developed the core theories in Chinese medical, such as zang-fu and pathogenesis. Under the academic background of the modern disease spectrum, the wu-zang-correlation doctrine contains an integrative medicine research direction to combine the disease identify and the syndrome differentiation.
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