基于张锡纯“宗气为枢”理论论治
重大慢性病合并病经验
Treatment of Major Chronic Diseases and Their Comorbidities Based on Zhang Xichun's Theory of "Zongqi as the Pivot"
陈吉全 1陈瑞祺2
作者信息
- 1. 南阳医学高等专科学校
- 2. 广州中医药大学
- 折叠
摘要
目的：基于张锡纯“宗气为枢”理论讨论重大慢性病的共性病机，介绍治疗合并病经验。方法:研究张锡纯“宗气为枢”理论内涵及传承创新；总结基于“宗气为枢”理论认识重大慢性病合并病共同病机，并制定治则方药论治的经验。结果：当代社会重大慢性病具有复合型特点，多属虚实夹杂，气机失调的多脏腑合并病。笔者传承创新张锡纯“宗气为枢”学术思想，认为肾精化生元气，元气化生营卫，营卫于胸中合成宗气，宗气以胸中为枢纽以营卫形式周流全身，发挥温煦、濡养、护卫功能，元气亦可借宗气通道周流于三焦，元阴即元精、命水，发挥化生、修复功能，元阳即命火、龙雷之火，发挥推动、激发等功能，宗气周流，保合神明，神气通过自主神经以及通过君火-命火-相火轴调控元气及脏腑之气，火气（元阳）周流全身，宗气是一身气化的物质基础与保证，为一身之气之纲领与统摄。元气、宗气、神气诸气之间互生互制，诸气及其关系失常，疾病发生。结论：诸多重大慢性病及其合并病病机共性病机多为以宗气虚滞为基础病机的宗气失调，其治宜调补宗气。
Abstract
Objective: Based on Zhang Xichun's theory that "Zong Qi serves as the pivot," this study discusses the common pathogenesis of comorbidities in major chronic diseases and introduces clinical experience in treating these comorbidities. Methods: The study examines the connotations and the inheritance and innovation of Zhang Xichun's theory that "Zong Qi serves as the pivot"; summarizes the understanding of the common pathogenesis of comorbidities in major chronic diseases based on this theory; and formulates principles for treatment, as well as empirical experience in prescribing formulas and medications. Results: In contemporary society, major chronic diseases exhibit a complex nature, often manifesting as comorbidities involving multiple organs characterized by a mixture of deficiency and excess and a disruption in Qi dynamics. The author inherits and innovates upon Zhang Xichun's academic thought that "Zong Qi serves as the pivot," positing that Kidney essence gives rise to Yuan Qi; Yuan Qi gives rise to Ying Qi and Wei Qi; Ying Qi and Wei Qi combine in the chest to form Zong Qi; Zong Qi uses the chest as its hub to circulate throughout the body in the form of Ying Qi and Wei Qi, thereby performing functions of warming, nourishing, and protection; Yuan Qi can also circulate throughout the three burners via the Zong Qi pathway; Yuan Yin—namely, Yuan Essence or "Life Water" —performs functions of transformation and repair; and Yuan Yang—namely, "Life Fire" or "Dragon-Thunder Fire" —performs functions of propulsion and stimulation. The circulation of Zong Qi preserves and harmonizes the spirit; spirit and Qi regulate Yuan Qi and the Qi of the Zang-Fu organs through the autonomic nervous system and via the "Jun Fire–Life Fire–Xiang Fire" axis; Fire Qi (Yuan Yang) circulates throughout the body; Zong Qi provides the material foundation and guarantee for the transformation of Qi throughout the body, serving as the guiding principle and overarching regulator of all Qi in the body. Among Yuan Qi, Zong Qi, and Spirit Qi, there is mutual generation and mutual restraint; when the balance among these Qi and their relationships is disrupted, disease occurs. Conclusion: The common pathogenesis of many major chronic diseases and their comorbidities is primarily Zong Qi dysregulation, which is based on Zong Qi deficiency and stagnation. Therefore, treatment should focus on regulating and tonifying Zong Qi.关键词
宗气/元气/神气/宗气周流/营卫生会/火气运行/君火-命火-相火轴Key words
yuanqi/shenqi/Zongqi circulation/ying-wei convergence/fire qi circulation/junn huo–ming huo–xiang huo axis引用本文复制引用
陈吉全,陈瑞祺.基于张锡纯“宗气为枢”理论论治
重大慢性病合并病经验[EB/OL].(2026-10-27)[2026-10-29].https://www.biomedrxiv.org.cn/article/doi/10.12201/bmr.202610.00061.学科分类
中医学
