论正胰腺脏位 还十二指肠腑名

长期以来,大凡认真研读过《黄帝内经》(以下简称《内经》)脏腑理论的中医学者,都会因文中既提"十二藏",又述"五藏六府",以及将一个不具备"藏而不泄"之"脏"功能的"心包"列于脏位。将无"满而不能实","传化物而不藏"之"腑"功能的"三焦"给以腑名,而时有困惑。近年来,随着糖尿病患者,胰腺癌患者及十二指肠球部溃疡等患者的大量涌现。胰腺和十二指肠作为脏腑功能的显现,越来越受到重视。笔者根据《内经》,关于脏与腑功能的界定标准,及现代解剖学,生化学所见,结合长期的临床实践之需求,提出了将人体"胰腺"取代无脏功能的"心包"以正其脏位。并将与胰腺有密切生理关系的十二指肠取代三焦,作为与胰腺相表里的腑。这样就将"五藏六府",正式升级为"六脏六腑"。即:肺与大肠、胰与十二指肠、心与小肠、脾与胃、肝与胆、肾与膀胱,以合《内经》"十二藏"之说。经过如此传承精华与守正创新,则可使《内经》的脏腑理论得以进一步完善。既符合了人体内客观真实的脏腑生理结构状况,而且对中医临床的脏腑辨证论治,提供了理论依据。

On the Position of the Pancreas and the Name of the Duodenum

For a long time, scholars of traditional Chinese medicine who have carefully studied the theory of viscera in inner path would mention "twelve organs", "five organs" and "six organs", as well as "pericardium", which do not have the function of "internal organs". The "three jiao", which is not "full but not real", "conveying but not hiding", is sometimes confused. In recent years, with the emergence of diabetes, pancreatic cancer and duodenal bulb ulcer patients arise. As the manifestation of viscera function,pancreas and duodenum have been paid more and more attention.According to the definition criteria of viscera and viscera functions in Neijing, modern anatomy and biochemistry, and the needs of long-term clinical practice, the author proposed to replace "pancreas" of human body with "pericardium" without viscera to correct its viscera.The duodenum, which has a close physiological relationship with the pancreas, replaced the trifocal organ as the internal organs inside and outside the pancreas.This will be the "five viscera",the official upgrade to "six viscera". Namely: lung and large intestine, pancreas and duodenum, heart and small intestine, spleen and stomach, liver and bile, kidney and bladder, in accordance with the "twelve organs" theory of the inner Canon. Through such inheritance of essence and innovation, the theory of viscera in huangdi neijing can be further improved.It not only conforms to the objective and true physiological structure of zang-fu organs in human body, but also provides theoretical basis for the dialectical treatment of zang-fu organs in TCM clinic.