命门学说理论框架变迁及其原因的历史考察

考察命门学说的历史,分析命门学说理论结构,探讨命门学说兴衰原因,进一步探讨中医临床实践对中医理论发展的影响。命门学说兴于明代,衰于清代,在现代统编教材《中医基础理论》中处于边缘地位。其兴起源于对阐述生命原动力及动力机制的需求,并以宋明理学为核心基础构建;其衰落的主要原因是命门学说自身的存在缺少实证基础。现代处于边缘位置,主要是有两个特点:第一,在介绍命门学说的章节中,缺少命门学说原本的理论框架;第二,出现了以命门学说理论框架部分结构构建的新概念,即以"动力—肝、心、脾、肺、肾"这一结构重新构建新的概念。这种现象主要体现在肝主疏泄的理论构建上,其原因主要有两个:第一,主流思想的改变,使命门学说的核心结构与核心理论的结构存在差异,相互排斥,使得命门学说原本的问题被放大;第二,对生命动力及原动力的解释是中医理论不可缺少的部分。厘清这一点,对中医脏象理论研究和中医临床实践都有积极的意义。

Theoretical framework changes of Life Gate Doctrine

To study the influence of TCMclinical practice on the development of TCMtheories by the way of studying “Life Gate (mingmen)Doctrine”,including its history,its theoretical framework and the rea-son for its vicissitude .The rise was in Ming Dynasty and fall was in Qing Dynasty,and decentralization in Foundamental Theory ofTraditional Chinese Medicine,a unified compiled teaching book.In Ming Dy-nasty,Life Gate Doctrine originated from the requirement of interpreting the life-propelling force and the force mechanism,and was established with Neo-Confucianism as its central foundation.But for the reason of lacking practical ground,the doctrine declined in Qing Dynasty.In Foundamental Theory ofTradition-al Chinese Medicine,the theoretical framework of Life Gate Doctrine was not original,but a new one based on parts of the original framework of “life-propelling force-liver,heart,spleen,lung,kidney vis-cera-organ”.The changes reflected the theoretical construction of “liver controlling dipersion”due to two causes:the changes of mainstream thoughts induced the difference of central structure and central theo-ries,which were mutually exclusive in Life Gate Doctrine whose inherent problems were magnified;throughout,the interpretation of “life-propelling force”was indispensable for TCMtheory.In a word,it is undoubtedly significant to study TCMViscera-Organ Theory and improve clinical practice based on un-derstanding the changes of Life Gate Doctrine.