《黄帝内经》之“肾治于里”理论探赜

“肾治于里”一词首见于《黄帝内经》，常理解为“肾位置在里，主治于里”或“肾主水，其气内治于里”。然而，众医者对其含义认识仍有分歧，在指导临床实践时亦有困惑。从“肾治于里”的文义、理论意义及临床价值方面进行探赜，“肾治于里”的文义可从肾的位置、肾的功能、肾与易学三方面解读，其理论意义及临床价值可从“肾为至阴，五行主水”“肾与冬应，藏精，主蛰守位”“肾内寓真阴真阳、为脏腑阴阳之本”“肾之经脉属少阴”四方面阐释。虽然众医者对“肾治于里”理论的诠释不同，呈现出各家学说的特点，但本质上均是对《黄帝内经》“肾治于里”理论的传承创新。因此，医者在临床应用时要灵活运用，为“肾治于里”的临床运用提供理论支撑。

Exploration of the Theory of "Kidney Governs the Interior" from Huang Di Nei Jing

Abstract： The term "kidney governs the interior" first appeared in the Huang Di Nei Jing (The YellowEmperor''s Inner Classic)， often understood as "the kidneys are located in the interior and govern in theinterior" or "the kidney governs water，and their qi governs internally in the interior". However，there are stilldifferences in the understanding of its meaning and confusion in guiding clinical practice. From the "kidneygoverns the interior" of the text，theoretical significance and clinical value to explore，"kidney governs theinterior" of the text can be interpreted from the kidney location， kidney function， kidney and Yi JingKnowledge three aspects，its theoretical significance and clinical value can be illustrated from "the kidneypertains to the beginning of yin，governing water in five elements" "kidney corresponds to winter，storingessence，hiding and storing” "kidney contains true yin and true yang，is the root of zang-fu yin and yang"and "the meridians of the kidney belong to shaoyin" are explained in four aspects. Although doctors havedifferent interpretations of the theory of " kidney governs the interior"，showing the characteristics of eachtheory，they are essentially inheriting and innovating the theory of "kidney treatment in the interior" of the Huang Di Nei Jing. Therefore， the practitioners should use it flexibly in clinical application， which alsoprovides theoretical support for the clinical application of "kidney governs the interior".