中醫腎臟模組重劃 — 解剖與功能結構關連

Redescription of Zang Kidney Model--Anatomico-Functional Tie

本文是以現代醫學家能了解的層面去描繪傳統中醫學說中的[ 腎] 臟。傳統中醫學以臟象學說演譯臟腑。而現代研究中醫[ 腎] 臟理論時發現，它與現代醫學的神經、內分泌及免疫系統的功能有著密切的關係，提出把下丘腦─垂體─靶腺軸及免疫網路功能來演譯[ 腎] 臟，但是[ 腎] 臟反視為一組相互關聯的結構而不是獨立之[ 器官]，功能不與一塊解剖結構關連。本文復審研究，由這個層面深入，加上肌肉及其有關的反射反應機能，可具體把中醫[ 腎] 臟的結構與功能互相匹配上。將人體末端一塊整體功能結構，即腹腔腹膜以後及以下的組織，包括腎上腺、腎及泌尿器官、生殖器官、卵巢、盤腔肌肉及下背筋腱肌肉，視為“居於內”的[ 腎] 臟；而這身體末端─組結構的功能，包括水液代謝、膀胱功能、求偶、性交、交配、生殖、和生命的應付等，以及協調這組結構的腦神經及荷爾蒙的互動緊密機制、其影響生命的動力、啟動成志及伎巧等機能，則視為“觀於外”的[ 腎] 臟臟象。這[ 腎] 臟範例與中醫學的腎臟本質意義相距不遠，亦比過去的模式更為貼切，能成全主流基本要求標準，包括解剖與生理的密切關連。所以這模型比起過去的理論模型，較易為現代科學上的同儕所認受。本文亦介紹以古籍及現代研究複證的方法，此範例有助於中西醫學發展，其好處在於獨特而有啟導性的意義。Traditional Chinese Medicine (TCM) conventionally described Zang organs according to the Zangfu manifestation theory. Current TCM studies showed that the hypothalamic-endocrine-immunological axis may represent the Zang Kidney. Zang is described as a set of interrelated parts rather than an anatomical organ. This paper reviewed how the Zang Kidney could mean the same anatomical organ but with added dimension. Re-inclusion of musculature with its related reflexive functions helped restoring the anatomical functional tie. The one retro-infra-peritoneal organ mass of adrenal, kidney and bladder, ovary, reproductive structures, and the pelvic and back musculature may be taken as the Zang Kidney “situated internally”. Zang Xiang “external manifestations” may be expressed as functional features of that one structure as it serves for controlling water and fluid metabolism, related bladder function, sexual behaviour, reproduction and functions for life, and also functional features of the intricate interrelationship between that structure with neuro-endocrine mechanisms in mating, craftsmanship and in life. These correspond well with Zang Kidney described, and meet its essential meaning more closely than previous models. This anatomico-functional model can better interpret TCM literature and be easily understood by current science.