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1.中国中医科学院 广安门医院,北京 100053
2.陕西中医药大学,陕西 咸阳 712046
金雨静,在读硕士,从事中医药防治老年疾病、脑病的临床研究,E-mail:wuhejyj@163.com
黄世敬,博士,研究员、博士生导师,从事中医药防治老年病、脑病的临床研究,E-mail:gamhsj@126.com
纸质出版日期:2022-09-20,
网络出版日期:2022-06-30,
收稿日期:2022-04-03,
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金雨静,翟吴剑文,杨芮等.“三焦营卫闭环”理论的构想[J].中国实验方剂学杂志,2022,28(18):213-224.
JIN Yujing,ZHAIWU Jianwen,YANG Rui,et al.Preliminary Conception of Theory of Triple Energizer-nutrient-defense Loop[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(18):213-224.
金雨静,翟吴剑文,杨芮等.“三焦营卫闭环”理论的构想[J].中国实验方剂学杂志,2022,28(18):213-224. DOI: 10.13422/j.cnki.syfjx.20221822.
JIN Yujing,ZHAIWU Jianwen,YANG Rui,et al.Preliminary Conception of Theory of Triple Energizer-nutrient-defense Loop[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(18):213-224. DOI: 10.13422/j.cnki.syfjx.20221822.
三焦实质的研究尚未形成统一观点,现有对三焦的认识与古典三焦在结构和功能上的对应仍然有限。传统营卫理论中,营卫以经络为主要循环系统,但未阐明营卫在三焦中的运行情况。由于三焦的实体结构尚未阐明,三焦在多数情况下作为其他脏腑功能的集合并未得到重视。解剖学新的进展为研究三焦实质提供了更多可能性,三焦的功能和结构与“间充质”、界面液体流动高度相似,为三焦的宏观和微观结构提供了新的认识。三焦分布于全身,组成包括焦膜、腠理,物质结构包括纤维支架、胶原纤维、间充质干细胞及其组织细胞和周细胞、组织间液等。三焦的功能包括通行津液、运行营卫、敷布元气、传变邪气等。据现有对三焦实质的认识,提出“纵横三焦”概念,指出三焦具有独立结构和脏腑属性,并对其空间分布做出初步界定。经络与三焦的关系在探讨营卫运行问题中至关重要,远细胞Telocyte(Tc)及其Telopod(Tp)在功能和结构上具备经络特征,Tc及Tp所分布的结缔组织与“组织液界面流动网络”的基本结构、间充质的纤维骨架属于同一物质,明确经络和三焦具有物质共性的证据。从营卫运行通道问题出发,发现经络可能是浸泡、依附于三焦的一种特殊通道,提出“经络浸附三焦模型”。将营卫的循环与“纵横三焦”结合,以完整描述营卫在经络、三焦中生成、运输、代谢的过程,构建“三焦营卫闭环”理论,为今后研究疾病表里传变提供可行的理论模型。
The research on the essence of triple energizer has not reached a consensus. The correspondence between the existing understanding and the classical theory of triple energizer is still limited in terms of structure and function. According to the traditional theory, nutrient-defense takes channels as the main circulatory system, while the operation of nutrient-defense in the triple energizer remains unclear. Since little is known about the physical structure of the triple energizer, the role of triple energizer as a collection of other Zang-fu organs has been ignored in most cases. The new progress in anatomy paves the way for the research on the essence of triple energizer. The function and structure of triple energizer are similar to those of interstitium and interfacial fluid flow, which enriches our understanding of the macro and micro structures of triple energizer. The triple energizer is distributed throughout the body and composed of membrane and interstitial space. The material structure of triple energizer includes fiber scaffold, collagen fiber, mesenchymal stem cells, histiocytes, pericytes, and interstitial fluid. The functions of triple energizer include passing body fluids, operating nutrient-defense, distributing original Qi, and transmitting and changing pathogenic Qi. According to the available theories and research achievements, we put forward the concept of vertical and horizontal triple energizer, pointed out that triple energizer had independent structure and the features of Zang-fu organs, and preliminarily defined the spatial distribution of triple energizer. The relationship between channels and triple energizer is essential for discussing the operation of nutrient-defense. Telocyte (Tc) and telopod (Tp) has the characteristics of channels in function and structure. The connective tissue with the distribution of Tc and Tp belongs to the same material as the basic structure of interstitial/interfacial fluid flow system and the fibrous skeleton of interstitium. It is clear that channels and triple energizer have material commonality. From the operation paths of nutrient-defense, we proposed that channels may be soaked and attached in triple energizer and put forward the model of channels soaked and attached in triple energizer. By combining the circulation of nutrient-defense with the vertical and horizontal triple energize, we developed the theory of triple energizer-nutrient-defense loop to comprehensively describe the generation, transport, and metabolism of nutrient-defense in channels and triple energizer, aiming to provide a theoretical model for future studies of disease transmission and change from exterior to interior.
三焦营卫经络界面液体流动间充质
triple energizernutrient-defensechannelsinterfacial fluid flowinterstitium
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