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1、第4期李梦琳等从《黄帝内经》“心部于表”刍议心与表的关系273第42卷第4期2019年4月北京中医药大学学报Vol.42No.4Apr.2019JournalofBeijingUniversityofTraditionalChineseMedicine•理论研究•从《黄帝内经》“心部于表”刍议心与表的关系李梦琳,女,在读博士生#通信作者:翟双庆,男,博士,教授,博士生导师,研究方向:《黄帝内经》中医基础理论研究,E-mail:zsq2098@163.com国家中医药管理局科研基金项目(No.2016009)李梦琳席
2、崇程刘珍珠张宁田栋黄薰莹刘金涛陈敬文王维广陈子杰翟双庆#(北京中医药大学中医学院北京100029)摘要:“心部于表”之说首见于《黄帝内经》,一方面指心气布达于体表,另一方面亦指心主宰皮毛肌腠等体表组织的功能活动,并支配人体视听言动等外在活动。心为阳脏,其气象火,有向外运动之趋势;心主血脉,滋养脏腑百骸及皮表;心藏神任物,乃君主之官,五脏六腑之大主。心与表在生理上相互关联,在病理上亦相互影响,因此治疗皮肤病时,可予“泻心火’“调心柿’“行心血”之法,治疗心系疾患时,亦可配合辛温解表之品以行散寒通阳之功。此外《黄帝内经
3、》亦有“肺主皮毛”理论以及后世引申之“太阳主表”理论,这3种主表理论在理论基础与认识角度等方面均有不同,各自有其适用范围,需细察详审以用之。关键词:黄帝内经;心;表;心为君主之官doi:10.3969/j.issn.1006-2157.2019.04.001中图分类号:R221.1Relationshipbetweenheartandexteriorfromtheperspectiveof“heartcommandingtheexterior”inHuangdiNeijing*LiMenglin,XiChongch
4、eng,LiuZhenzhu,ZhangNing,TianDong,HuangXunying,LiuJintao,ChenJingwen,WangWeiguang,ChenZijie,ZhaiShuangqing#(SchoolofChineseMedicine,BeijingUniversityofChineseMedicine,Beijing100029,China)AbstractIThestatementaheartcommandingtheexterior”wasfirstfoundintheHuangd
5、iNeijing(YellowEmperor,sInternalClassic).Accordingtothistheory,heartqispreadstotheexterior,andheartregulatesthefunctionsandactivitiesofskin,hair,muscle,andinterstitialtissues,determiningexternalactivitiesincludingseeing,hearing,speakingandmoving.Therationaleo
6、fthistheoryinvolvsssevsralaspects.First,heartischaracterizedbyfirewiththenatureofyang,withatrendtowardstheexterior.Heartalsoregulatesthebloodvsssels,nourishingalloftheinternalvisceraandtheexternalskin.Moreovsr,heartgovernsthemindandcontrolsthefunctionofthewhol
7、ebodyasthekeyorganlikeamonarch.Thus,heartandexteriorcanaffectandcorrelatewitheachotherinphysiologicalandpathologicalmanners.Thiskindofconnectionprovidesnewapproachandconceptforthetreatmentofmanyrelateddiseases,suchasapplyingthemethodof“purgingfireofhear”,“adju
8、stingthemindandspirit”or^promotingbloodcirculation”fortreatingskindiseases,oradministratingpungent-warmdiaphoreticagentstodissipatecoldandactivateyyangforheart—'elateddiseases.Add