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基于《黄帝内经》营卫理论及现代 医学论六经辨证本质
Based on the "Huangdi Neijing"and modern medicine interpret the Essence of Six-meridian syndrome differentiation
摘要
目的:基于《黄帝内经》营卫理论及现代医学讨论六经辨证本质,方法:在现代中西医学指导下，解读《黄帝内经》营卫的生成过程与功能，分析各脏腑在此过程中的作用，总结卫气病理与治则；在此基础上，分析六经辨证的前身《黄帝内经》六经分证及《伤寒论》六经辨证的本质。结果:营卫为五脏精气合后天水谷精微及自然界清气生成，营卫气包含现代医学多种物质成分，外感病卫气为抗邪主导，卫气病病机为卫气失常，可分为卫气虚证及卫气郁闭证、卫气阻滞证、卫气内伐证、卫气过亢证等实证，以及虚实夹杂的卫气紊乱（失衡）证。卫气受邪，疾病沿经络脏腑传变可以分为六经病。在太阳病期，邪毒多与卫气相争于肺、胃肠黏膜，邪毒侵入肺系、肠胃黏膜下淋巴组织，与散行卫气相搏，为阳明证，卫气进入独行通道淋巴管，在淋巴结与独行卫气相搏，影响胆、胃功能，出现口苦、喜呕、胁肋疼痛等症状，则为少阳证。太阳病为卫分证，阳明证、少阳证为气分证。因感受寒邪伤及营血症状多不明显，故仲景没有研究营血证。太阳病、阳明病、少阳病邪卫相争，伤及脏腑之气，致五脏气虚、气化郁滞，卫气乏源，或有邪毒内侵则发生三阴病，三阴病正邪俱衰者，为虚证，太阴病为肺脾虚并卫气虚，少阴病为心肾虚并卫气虚，厥阴病为肝虚并卫气虚，治疗重在救里。三阴病若邪毒内传于三阴，或病理产物堆积，则发生实证或虚实夹杂证，治在祛邪或扶正祛邪。结论:六经辨证与现代医学可以互通。
Abstract
Under the guidance of modern Chinese and Western medicine, this paper interprets and summarizes the theories of Ying Qi and Wei Qi in the Huangdi Neijing. It is proposed that Ying and Wei Qi are formed by the combination of essential qi from the five zang organs, refined substances from dietary intake, and clear qi from nature. Ying and Wei Qi encompass multiple components in modern medical terms. In external pathogenic diseases, Wei Qi plays a dominant role in resisting pathogens; disorders of Wei Qi arise from its dysfunction and can be classified into deficiency syndromes (Wei Qi deficiency) and various excess syndromes—such as stagnation, blockage, internal invasion, or overactivity of Wei Qi—as well as mixed syndromes involving both deficiency and excess due to Wei Qi imbalance. When Wei Qi is invaded by pathogens, disease transmission along meridians and internal organs follows the six-meridian pattern. During Taiyang stage, pathogenic factors primarily contend with Wei Qi in the lungs and gastrointestinal mucosa. As toxins invade the lymphatic tissues beneath the pulmonary and gastrointestinal mucosa and interact with diffusely circulating Wei Qi, Yangming syndrome develops. When Wei Qi enters the solitary pathway—the lymphatic vessels—and confronts the solitary Wei Qi within lymph nodes, affecting gallbladder and stomach functions, symptoms such as bitter taste, nausea, and胁肋 pain emerge, indicating Shaoyang syndrome. Taiyang syndrome corresponds to the Wei layer, while Yangming and Shaoyang syndromes belong to the Qi layer. Since cold pathogenic invasion often damages Ying and blood without obvious symptoms, Zhang Zhongjing did not systematically study Ying and blood syndromes. The three stages—Taiyang, Yangming, and Shaoyang—represent conflicts between pathogens and Wei Qi, damaging organ qi, leading to deficiency of the five zang organs, stagnation of qi transformation, and depletion of Wei Qi sources. If pathogens further invade internally, San Yin syndromes develop. In San Yin syndromes where both body resistance and pathogenic factors are weakened, deficiency syndromes occur: Taiyin syndrome involves lung and spleen deficiency combined with Wei Qi deficiency; Shaoyin syndrome involves heart and kidney deficiency with Wei Qi deficiency; Jueyin syndrome involves liver deficiency with Wei Qi deficiency. Treatment focuses on rescuing the interior. If pathogenic toxins spread inward into the San Yin region or pathological byproducts accumulate, excess or mixed syndromes may arise, requiring treatment aimed at eliminating pathogens or supporting the body's defenses while expelling pathogens.关键词
中医营卫理论/六经辨证/本质/Key words
Traditional Chinese Medicine's theory of Ying and Wei/ Six-meridian syndrome differentiation/ essence/引用本文复制引用
陈吉全,陈瑞祺.基于《黄帝内经》营卫理论及现代 医学论六经辨证本质[EB/OL].(2026-10-09)[2026-10-11].https://sinoxiv.napstic.cn/article/26332010.学科分类
中医学基金
河南省高等学校重点科研项目计划 张仲景、张锡纯大气理论在重大慢性病治疗中的应用研究( 26B360021 )