《黄帝内经》中“主明则下安”的理论探析

文章信息/Info

• Title:《黄帝内经》中“主明则下安”的理论探析

• 卷期:2024年22卷15期

• 作者:胡依凡1，*田相同2

• 1山东中医药大学第一临床医学院，山东济南，250014；2临沂市中心医院 院长办公室，山东临沂，276401

• Author(s):Hu Yifan1,Tian Xiangtong2

• 1. The First Clinical Medical College of Shandong University of Traditional Chinese Medicine，Jinan City, Shandong Province；2. Linyi Central HospitalLINYI Central Hospital，office of the director，Linyi City，Shandong Province

• 关键词黄帝内经；心；神明；经脉；五脏六腑

• Keywords:Huangdi Neijing;heart; Shen Ming; Meridian vessel;internal organs

• 摘要:《黄帝内经》中“心”被赋予了君主之官的地位，但在现代中医临床中更注重脾、肾的治疗及保健，忽视了心统领人体生命活动的作用。古人对心功能性的认识是在解剖层面的基础上，通过取象比类等方法并结合临床实践不断修正得出的，可依据《内经》概括为主神明及主血脉，二者相互影响，是其统领脏腑、主宰全身的根基。本文以《内经》中心藏象的内容为基础，展开阐述心藏象的功能性，并列举文献中“心”对五脏六腑的生理病理影响，以期论述“主明”在中医临床诊疗及养生保健中的重要性。                                                                                                                                                                                

• Abstract In Huangdi Neijing, the "heart" has been given the position of monarch, but in modern TCM clinic, it pays more attention to the treatment and health care of spleen and kidney, ignoring the role of the heart in guiding human life activities. On the basis of anatomy, ancient people's understanding of heart function was constantly revised by taking images and comparing categories and other methods combined with clinical practice. It can be summarized as the main spirit and the main blood vessel according to the Internal Classic, and their mutual influence is the foundation of their command of viscera and the whole body. Based on the contents of the central visceral manifestation in Neijing, this paper expounds the functions of the visceral manifestation, and enumerates the physiological and pathological effects of the "heart" on the internal organs in the literature, so as to discuss the importance of "ruling the light" in clinical diagnosis and treatment of traditional Chinese medicine and health care.

  “主明则下安”出自《素问·灵兰秘典论》：“故主明则下安，以此养生则寿，殁世不殆，以为天下则大昌。主不明则十二官危，使道闭塞而不通，形乃大伤，以此养生则殃。”[1]突出了君主之官“心”对脏腑的统治及影响作用。“心”不仅仅是现代医学解剖层面的概念，而是在古代哲学的影响下，通过对天地、自然及社会制度的取象比类，采用仿象臆测的思辨方法，并结合生活观察，在不断探析、总结临床实践的基础上，理性地思考和分析综合，逐渐使“心”的概念脱离其实体,演变为了功能化之“心”，形成了中医心藏象理论。“主明而下安”的论点，对认识人体生理、病理、防病保健，以致临床实践都具有指导意义。