刘清国——内经十原本义探析.docVIP

《内经》十二原本义探析 赵文麟1谢晓佳纪智1朱华超1 郭文1 刘清国＃ (北京中医药大学针灸推拿学院，北京 100029) [摘要] 本文旨在溯本求源,对“十二原”这一名词术语从出处沿革、与三焦原气的关系、与五脏六腑的联系方式以及临床诊疗等方面对其本义进行探讨，以促其规范化、标准化,从而更好地传承经典理论并用之指导临床实践。研究认为“十二原”的本义是五脏之气直接输注的部位，可以反映和主治五脏病症；五脏原穴“所出为原”，与五脏之气直接相通应，是五脏的代表穴，与《内经》中“十二原”本义相符；而经后世发挥从经脉所过角度提出的六腑原穴与六腑之气并非直接相通，且其主病亦不是以腑病而是以外经病变为主，故经《难经·六十六难》发挥而来的六腑之原与“十二原”本义不符，最早出于《灵枢》的“十二原”指的是五脏原穴和膏之原、肓之原，共计7个穴，认为原穴的本义是五脏之气直接输注的部位,是五脏的代表穴，可以反映和主治五脏病症，而经后世发展至今的十二个经脉原穴与《内经》中“十二原”虽数目相同，但实指各异，二者常被混淆，不可不辨。“十二原”作为针灸学中的规范术语，其内涵仍需进一步的挖掘，为加深针刺理论的认识和提高临床疗效提供依据。 [关键词] 内经；十二原；原气；规范术语； Study on The Original Meaning of Twelve Source Points [Abstract] In order to promote the standardization of the twelve source points , this paper aimed to trace the original meaning of the twelve source points in terms of their history ,the relationship with triple burner and original qi ,and the ways connecting with organs. Results find that the original meaning of the twelve source points is that they are the infusion sites of five Zang qi and can reflect really physiologic function and pathological changes of the five Zang-organs,and can be used for treatment of diseases corresponding to five Zang-organs. There is closely correlative specifisity among the source points of the five Zang-organs and the five Zang,However, the source points of the six Fu-organs which are mainly used to treat meridians disorders indirectly associated with the six fu-organs through the branches of twelve channels. There is no significant correlative specifisity between the source points of the six Fu-organs and the six Fu-organs.Therefore,it is questionable that the sourse points of the six Fu-organs are regarded as representative points of the six Fu-organs. [Key words] the Internal Canon of Medicine；Twelve Source Points；Standard terms “十二原”首载于《灵枢·九针十二原》，是《内经》中一个重要名词术语。然考其历史沿革,变义甚多,其名称、数目、含义均经历了不同时代的演变,故时至今日,仍有诸多学者对“十二原”本义的理解有较多含混不清，未尽经旨之处。如《内经》中“十二原”为7个穴，而目前公认的“十二原穴”却是12个穴，又比如五脏之原如太冲，毫无疑义即可称为肝之原，又可称为肝经之原，而对于六阳经之原穴如合谷,究竟称大肠原穴还是大肠经原穴则产生分歧。鉴于此种疑惑在现今诸多针灸著作及教学临床中存在的现