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“根、溜、注、入”理论的研究
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摘要
“根、溜、注、入”理论出现在《灵枢·根结》篇中,内容涉及手足六阳经的“根”、“溜”、“注”、“入”四类腧穴,其中“入”穴又分为上、下两种,共30个腧穴。这些腧穴不仅有鲜明的分布规律,而且具有由四肢末端流注上行的特点。但在后世的经络腧穴理论研究中,对“根、溜、注、入”的专题研究十分匮乏,既缺乏对“根、溜、注、入”本义的探讨,又没有系统和完善的理论认识。同时相关文献的比较研究也不丰富,出现了“根、溜、注、入”与五输穴等内容的混淆情况。这与其在《内经》中鲜明的理论特点并不相称。因此,对“根、溜、注、入”的深入研究具有重要的学术价值。
     本选题对“根、溜、注、入”的研究集中在三个方面。首先从研究背景着眼,对相关的古代文献和近五十年研究文献进行整理和归纳,梳理出相应的认识和观点,发掘其中的参考价值;其次结合语言学、文献学方法,在《内经》理论研究的背景下,从局部到整体对“根、溜、注、入”进行深入细致的分析研究,点面结合,归纳其理论内涵与意义;第三,运用比较研究的方法,将“根、溜、注、入”与根结、标本、五输穴等相关内容进行比较,进一步加深对“根、溜、注、入”含义的认识,探究其理论根源,同时辨明混淆内容,力求在经络理论的层面上,突显“根、溜、注、入”独特的理论内涵,必将对针灸经典理论的研究与临床发展产生一定的指导意义。
     1.“根、溜、注、入”的文献研究概况
     《内经》之后的历代针灸专著中,晋代皇甫谧不仅在《针灸甲乙经》中保留了《内经》“根、溜、注、入”的文献记载,还提出自身的学术观点。唐宋时期是“根、溜、注、入”记载的空白期,针灸文献的研究以完善腧穴理论为主,鲜有对经络理论的深入探讨。至金元时期窦汉卿在《标幽赋》中提出“四根三结”,注家对其进行注解时再次提到“根、溜、注、入”的内容,但认识较为混乱。从文献记载的情况可以看出“根、溜、注、入”与经络理论的发展息息相关。
     《内经》注家对“根、溜、注、入”的注解,提供了重要的观点。主要有杨上善、马莳、张介宾、张志聪等,他们对“根、溜、注、入”的认识大体上比较一致,肯定了从“根”流注上行的特点,强调与“络”的密切关系,并明确指出与五输穴的不同。同时对是否只涉及阳经,以及个别腧穴的归经方面存在分歧。这些认识为“根、溜、注、入”的理论研究提供了平台。
     现代文献对“根、溜、注、入”的专题研究是空白,只在经脉流注、类穴、根结、五输穴的研究中涉及到“根、溜、注、入”的内容。“根、溜、注、入”出现在这些相关文献中,一方面说明其与这些理论的关系密切,另一方面也反映出自身的理论特点:经脉有上行单向流注的特点;所包括的腧穴具备类穴的规律;与根结理论密不可分;与五输穴有类似之处。这些相关文献为“根、溜、注、入”研究提供了思路。
     2.“根、溜、注、入”内涵的探讨与认识
     从文字本身的含义、《内经》中相关文字的意义以及相应腧穴的应用研究三个方面对“根”、“溜”、“注”、“入”各类腧穴进行探讨。总结认为“根”穴分布在四肢末端,是经络之气“始发”的部位,蕴涵着“生”的含义,体现出对整体的决定性作用,并延续根结理论的内涵,强调人体四肢末端对头胸等上部的重大影响力。“溜”穴分布在腕踝关节,与原气有关,是阳气充盛的部位,可用于诊察脉气的盛衰,与早期经脉学说对人体腕踝关节部位的重视相一致。“注”穴有规律地分布在腕踝关节、近腕踝关节1/4处、肘膝关节,多数与脉动有关,是经气正盛的部位。“入”穴分为上“入”与下“入”穴两种,上“入”是位于颈部的经穴,下“入”是络穴,联系络脉。上“入”与下“入”指出了从“根”流注上行有经脉与络脉两种途径,并且这两种途径终结的部位都在头胸等人体的上部,与“根”相呼应,体现出人体通过经络纵向联系的整体性。上、下“入”穴的部位表浅,与经脉与络脉的诊察相关。位于颈部的上“入”穴联系邻近部位,体现近治的作用,而位于肘膝以下的下“入”穴,联系远隔部位,体现远治作用。
     结合各类腧穴的探讨,从文字含义、腧穴分布、与脉诊的关系以及治疗特点等各方面,对“根、溜、注、入”进行整体研究。研究发现,“根、溜、注、入”通过腧穴上下分布的规律特点,不仅直接表现出人体上、下部位纵向的密切联系,还强调了四肢远端的重要性,突出颈部腧穴的作用,呈现出循经远近配穴的基本模式。“根、溜、注、入”的应用与脉诊相关,腧穴多为诊脉点,治疗的范围是外邪入中经络的外感病症,表现为阳经的实证、表证。治疗的方法采用泻实的方法,包括放血疗法。
     3.“根、溜、注、入”与相关理论的比较研究
     通过对“根、溜、注、入”与根结理论、标本理论以及早期经脉学说的比较研究,清晰地看到这些理论对经络以四肢为本上下纵向密切联系的认识具有同源性,体现出《内经》所强调的关于“终始”、“本末”的重要性。“根、溜、注、入”理论通过腧穴的运用表现出经络理论的内涵,是对经络理论的进一步发挥。
     “根、溜、注、入”与五输穴涉及一些共同的文字和腧穴,流注方向也大致相同,有着相似的特点,但在出处、内容、意义以及应用等方面的比较中发现二者之间在本义上存在很大的区别,所强调的理论重点不同。“根、溜、注、入”是通过腧穴体现经络理论的应用,而五输穴是体现腧穴自身的特异性,二者有各自的特点,不可掺杂在一起,否则会造成内容混淆,误解“根、溜、注、入”的含义。
     “根、溜、注、入”作为《内经》理论之一,融合了《内经》的哲学思想,通过人体自身上下联系的整体性,反映出自然界人与天地相参的整体观念。
     4.结论与讨论
     “根、溜、注、入”是经络与腧穴相结合的理论,以经络为体,腧穴为用,具有经络并重,上下相应、重在四末,诊治结合,诊脉为先等特点。
     综合全文,可以得出如下几个结论:
     (1)通过本文多方面的研究,对“根、溜、注、入”理论有了基本的认识:“根、溜、注、入”具有丰富的理论内涵和鲜明的学术特点。
     (2)“根、溜、注、入”理论与临床实践活动紧密结合,是早期经络理论的应用和发挥,是经络理论和腧穴理论过渡的产物。
     (3)比较研究中发现,“根、溜、注、入”与五输穴有着不同的理论内涵,同时与根结、标本以及早期经脉学说有同源性。
     (4)从历史上看,随着脏腑理论、腧穴理论占据中医针灸理论的主导地位,《内经》经络理论的丰富内涵在后世未被发扬,“根、溜、注、入”理论为深入开展《内经》经络理论研究提供了新的依据。
     本选题创新点主要体现在如下几个方面:
     第一,通过本义探讨,填补了“根、溜、注、入”理论的研究空白。
     第二,通过与《内经》相关理论的比较研究,明确“根、溜、注、入”理论的意义,辨明与五输穴混淆的内容。
     第三,为深入研究经络理论提供新线索。
     第四,为针灸临床工作提供新的诊疗思路。
Study on Genliu Infusion Theory
     The integrated content of the theory of Genliu infusion is from Linshu·Genjie,including 30 acupoints in total with four kinds of‘Gen',' Liu','Zhu','Ru'divided into upper‘Ru' and lower‘Ru'.These acupoints distribute with obvious characteristic,running from the ends of the four extremities to the top.But there is almost no particular study of Genliu infusion now,lack of probing into the original meaning of Genliu infusion, and without systematical and complete theory structure.At the same time, comparing study of relative article is insufficient and there is disturbing recognition between Genliu infusion and Wushu points.The situations can not match the significant feature of Genliu infusion in the classic of Huangdi Neijing.Therefore,deep study of the theory of the Genliu infusion possess important value.
     The topics of the‘Genliu infusion' study focused on three aspects.First, from the research background focusing on the ancient literature and related research literature in recent years,collate and summarize the corresponding knowledge and explore the reference value.Second,followed by combination of linguistics,literature methods,in the background of 'Neijing' theoretical research,conduct an in-depth analysis and detailed research of Genliu infusion from the local to the whole and summary up its meaning and significance of the theory.Third,with the comparative study method,compare Genliu infusion with root and knot,manifestation and root cause,Five-shu Points and other related content,understand the meaning of Genliu infusion further deeply and explore the root causes of its theory.Meanwhile solve some problems with theory confusion.Based on the knowledge of channel theory,form unique theoretical system of Genliu infusion,significantly guide the classical theory of acupuncture research and clinical development.
     1.Literatural summarization of Genliu infusion study
     In the history of acupuncture monographs after Neijing,Huangfu Mi kept the record of Genliu infusion in his classic of Zhenjiu Jiayijin in Jin Dynasty and give his own opinion.Tang and Song Dynasties was the window period of Genliu infusion recorded,aupuncture research literature in order to perfect the theory of the main acupoints,few of the meridian theory in depth. Until Jin and Yuan Dynasties,Dou Hanqing put forward the saying of Sigen Sanjie in his classic of Biaoyou Fu.During noting Sigen Sanjie,people referred to the content of Genliu infusion again.But there was still more confusion of understanding.From the literature,it is can be seen that Genliu infusion is closely related to the development of the theory of meridians.
     People who noting Neijing,Yang Shangshan,Ma Shi,Zhang Jiebin, ZhangZhicong and so on,gave their own opinion of Genliu infusion.They had a more consistent understanding of the whole,affirm the characteristics of flowing from the Gen up to highlight,stress the close relationship with Luo, and clearly pointed out the difference with the Five-shu Points.At the same time,they had different opinion that if the Genliu infusion just refer to yang meridians as well as the several acupoints pertaining to which meridians.These views provide platform of theoretical Study of Genliu infusion.
     Modern literature on the study of the Genliu infusion topic is empty,the content of Genliu infusiont just can be seen in the study of the meridians flowing and infusion,type acupoints,root and knot,Five-shu points and so on.Genliu infusion appear in the relevant literature,on the one hand,it shows close relationship with these theories;on the other hand,it reflects the characteristics of its own theory:meridians has the characteristics of one-way flowing up in whole,acupoints included conform to the law of type acupoints similar to Five-shu Points,the theory closely linked with the root and knot. The relevant literature provide the ideas and means to the study of Genliu infusion.
     2.Explore and understand the meaning of Genliu infusion.
     Explore every type of acupoints of Gen,Liu,Zhu,Ru in three aspects:the meaning of text itself,the meaning of the related text appeared in Neijing and the application of corresponding acupoints.It is concluded that the Gen points locating in the end of limbs is beginning of the meridian qi implying‘live' means,reflecting the overall decisive to the whole body,and extend the connotation of the root and knot theory,emphasizing the ends of human limbs have a major influence to the upper head and chest.Liu points locating in the wrist-ankle joints relate to original qi.It is the portion with Yang qi flourishing and can be used for examination for the strong and weak of meridian qi.It is the same with the early theory of meridians which focus on the parts of wrist and ankle in human body.Zhu points regularly distribute in the wrist ankle,nearly 1/4 to wrist ankle,elbow knee.Most of them has relationship with pulse and they are the sites with Jing qi frorishing.Ru points are divided into two kinds of upper Ru and lower Ru.The upper Ru is acupoints located in neck and lower Ru is the Luo-connecting points related to collaterals.Upper and lower Ru point out Genliu infusion flowing up in two ways of meridian and collacteral.Both of them teminate at the upper part of body as head and chest concert with Gen point.It shows that human body keep the whole through the meridians of the overall vertical linkages.Upper and lower Ru points locate in superficial part associated with the examination of meridian and collacteral. Upper Ru located in the neck contacts with adjacent part,reflecting local effect. Lower Ru located just below the elbow and knee contact with remote part, reflecting remote effect.
     Acupoint combination of various types of Genliu infusion conduct a comprehensive study of various aspects,including text meaning,acupoints distribution,and the relationship with pulse diagnosis,and treatment characteristics.The study found that the Genliu infusion directly manifest the close vertical relationship between upper and lower part of the human body through the distribution of acupoints.The theory focus on the importance of distal limbs and influence to the head and chest.Applications is related to the pulse diagnosis combined with treatment.The indications is exogenous syndromes due to external pathogenic evil attacking to meridians with manifestation of excess and exterior syndrome.Treatment method is reducing method,including blood-letting therapy.
     3.Comparative study between Genliu infusion and relative theory
     Through the comparative study between Genliu infusion and theory of root and knot,manifestation and root,early channel,it is clear to be seen these theory have the same opinion of meridian theory taking the four limbs as root and stress the important meaning of‘end and beginning ',‘root and tip' written in Neijing.The theory of Genliu infusion further develop the application of meridian theory through expressing the true meaning of meridians with acupoints.
     Genliu infusion and Five-shu points have similar feature with several same words and acupoints,general same direction of flowing and infusing.But they are very different in true meaning with comparing in the aspects of source, content,meaning and application and focus on different point of theory.Genliu infusion focus on meridian theory,Five-shu points focus on acupoints themselves. They have different characters.We'd better not to mixture them and avoid theoretical confusion.
     As one theory of Neijing,Genliu infusion imply philosophy thoughts in Neijing.It reflect the whole conception of close relationship between human being and heaven and earth in nature through the connection with upper and lower part of the human body.
     4.Conclusion and discussion
     Genliu infusion is the theory combining meridians and acupoints together with application of acupoints based on meridians theory.The theory has such characteristic as stressing meridians and collaterals at the same time,lower part corresponding to the upper,combine disgnosis and treatment,and so on.
     The following conclusions can be drawn according to the whole text:
     (1)With a wide range of research In this paper,comb out the characteristics of Genliu infusion theory,establishment the basic theoretical system of Genliu infusion and show its rich academic connotations.
     (2)Genliu infusion theory is closely linked with the early clinical application with distinct characteristics.It is the application and development of the meridians theory and can be seen as a transitional theory from the meridians to acupoints.
     (3)Comparative study shows that the Genliu infusion has different theoretical meaning with Five-Shu Points and same source with the theory of root and knot,manifestation and root,early channel.
     (4)Historically,the theory of the Zang-fu organs and acupoints holds the leading position in the acupuncture theory.The rich connotation of the meridian theory in Neijing was not developed after the period.Genliu infusion provides a new basis to carry out further study of the meridian theory in Neijing.
     The main topics of innovation embodied in the following aspects:
     Firstly,explore the adoption of the original meaning,to fill the research empty of Genliu infusion theory.
     Secondly,with the comparative study with related theory,form a perfect theoretical system of Genliu infusion,solve the current confusion with Five-shu points.
     Thirdly,apply new clues to further study of meridian theory.
     Fourthly,provide a new idea of diagnosis and treatment in clinical practice of acupuncture.
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