基于象思维及系统思维对肾藏象理论科学内涵的研究
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摘要
本文首先对肾藏精的源流进行了梳理,中医学对精的定义,无论是广义之精还是狭义之精都是指精微物质而言,在这一点上与“精”字的本义有关。对于古代哲学“精气学说”的形成,笔者认为首先应是源于中医学“精气学说”的建立,或者至少应受古人对自身“精、气”的观察与思考的影响,如“男女媾精,万物化生”,指出“精”在人体生命形成的重要作用。古代哲学的“精气学说”虽然基于中医学的“精气学说”,但其内涵和外延又不局限于此,尤其是作为哲学层次的方法论,对其理论的完善具有了更深刻的指导意义。精在结构层次上分四个级别：古代哲学之“精”是宇宙本原,是抽象的概念,在“精”的结构层次中位于整个结构层次的最顶端；由古代哲学之精产生的具体的人体之精位于第二层级；构成人体之精的“先天之精”和“后天之精”为第三层次；人体之精分布于人体各部而形成的人体各部之精位于第四层级。古代哲学“精水合一”的思想是构建肾藏象理论“肾藏精”与“肾主水”理论的哲学基础。因此,该理论源于最原始的生理解剖,统一于中国古代哲学思想,成为医学与哲学在中医学中完美结合的典范。
古代哲学所强调的精或精气原本就存在于宇宙之中,是抽象的。人类作为生物学上的一个物种,与生俱来就禀受了宇宙之精气,在繁衍生息过程中不断更新,不断进化。因此,我们有理由相信人体是由存在于宇宙之中的无形而运动不息的精气或气所化生而来的。从精的来源可分为“先天之精”和“后天之精”。先天之精是秉承于父母的生殖之精,是构成胚胎发育的原始物质,主要闭藏于肾,既包括父母的生殖之精,又包括脱离母体后个体的生殖之精。先天之精是决定个体先天禀赋的重要因素,也是先天正气。具有促进人体各项生理机能,促进机体生长、发育的功能,当这种精气充盈到一定程度,形成“天癸”,还直接影响人的衰老过程。中医学将人体出生后所获得的呼吸之精和水谷之精合称为“后天之精”。《内经》在五脏皆藏精的前提下又单独提出肾藏精,在于强调肾藏之精与其他脏腑之藏精不同,特别是生殖之精,是肾藏精的立论依据。传统认为“肾所藏之精”以先天为主,兼有部分后天之精,而其它四脏所藏之精主要为后天之精。肾精和五脏六腑之精在贮藏、转输、相互调节方面是动态的、多向性的,有赖于此既保障了肾所藏之精的充足,又促进了全身各脏腑之精的贮藏和调节,肾精仅是五脏之精的一部分,虽在人体生命活动中发挥着重要作用,但不能替代脏腑之精或一身之精。肾藏脏腑之精的含义有二：一方面说明肾本脏功能要依靠它脏功能的正常得到保障,另一方面又说明肾藏精对它脏功能发挥重要调节作用。肾主骨、生髓的生理功能,实际就是肾中精气功能的重要组成部分,即促进机体的生长和发育。肾精充盈则骨髓生化有源,骨骼得到骨髓的滋养而坚固有力。肾精所化之髓,可分为骨髓、脊髓和脑髓。肾中精气的盛衰,还影响着脊髓和脑髓的充盈和发育。脊髓上通于脑,髓聚而成脑,故有“脑为髓海”之说。因此,肾中精气充盈,则髓海得养,脑的发育就健全,就能发挥“精明之府”的生理功能。肾藏精属阴,藏精而起亟,能应激、应变,强调肾具有调节机体与内、外界环境之间的平衡,维护机体健康的功能。机体的这种应变能力就是我们所说的正气,与精气盛衰密切相关。
通过实验研究表明肾藏精与干细胞研究的密切联系,以及对脑研究、男子不育女子不孕的研究、对贫血研究的作用；通过有关“肾藏精”的临床研究,发现应用“从肾论治”的原则和“补肾填精”方法,对免疫功能障碍性疾病、老年性痴呆、不育、不孕症、慢性再生障碍性贫血及骨质疏松症都有显著的治疗功效。
象思维源于古人观物取象的自然选择过程,此时的“象”是通过一种事物或卦爻等抽象的符号或数字系统来表现事物的特征,形成“效天下之动者”之象,以达到推测宇宙变化,揭示事物联系之目的。具有形象性、意象性、属向性、多媒性、普遍性及规律性的特征。近年来,对“象思维”的释义归纳为如下几种：象数思维、形象思维、形象逻辑思维、取象思维、意象思维及象征思维等。古人通过象思维创建了“阴阳模型”“五行模型”和“八卦模型”,成为分析、归纳各种事物和现象的属性及研究各类事物内部相互联系的一种认识论和方法论。“象思维”的构建综合使用了观象、立象、取象、意象、想象和联想等方法,这些方法不能孤立存在,而是有机结合,密切联系,甚至会有所叠加,具有动态流动性和层层深入性。象思维作为一种典型的东方思维,以象形文字为思维载体,以意象为基本要素,以主体、对象和观念的三维混同为其特殊机制,在感性直观的基础上,主要以自我体验的模式解释外部客观世界,并通过类比互渗、想象与联想将意象整合为一种有序的整体系统的一种思维方式,具有形象性、意象性、动态整体性、潜逻辑性等特征。现代认知心理学从认知领域的“黑箱、白箱”理论充分肯定了象思维的科学性和先进性。
象思维在中医理论中的应用表现在象思维方法及象思维模型的具体应用上。中医学通过象思维方法建构了以《黄帝内经》为代表的中医理论体系。通过六气之象、脏腑之象、病证之象、四诊之象及理法方药之象的研究,凸显了据“象”归类、取“象”比类的整体、动态的象思维方法,成功将古代哲学中的“象思维模型”引入中医理论的构建中,创建了中医理论的“阴阳模型”、“五行模型”和“八卦模型”,成为中医生临床诊疗所依据的“象识别模型”
本文侧重从象思维的角度对肾藏象的科学内涵进行了研究。古代文献从数量、重量、在身体的部位、形状、颜色等诸方面描述了肾的解剖之象。《内经》采用了当时国家管理机构中主要官位的职能之象对脏腑功能加以类比说明,将肾描述为“肾者,作强之官,伎巧出焉。”肾属阴,具有“藏而不泻”的功能特点,是其阴阳之象。《内经》说明了肾在五行属水,在五方与“北”相应,从而建立起以五行为纽带的肾的空间之象。“肾之象”因“年、月、时辰”在时间上的不同变化而有所改变,表现为不同的时间之象,使人体呈现不同的生理病理状态,为养生保健提供了“四时养生”的依据,体现了中医学“天人相应”的特点。通过肾与它脏的关系解释了肾的八卦之象。肾与它脏的联系之象表现为：心肾二脏的水火既济；肝肾二脏的乙癸同源；脾肾二脏的先后天互生；肺肾二脏的金水相生。象思维的特点之一就是强调整体功能动态,基于象思维探讨肾的功能作用,就要将肾放在机体整体的生理活动功能关系上研究,肾的功能正常,机体就会呈现一派健旺之象,可以表现为生长发育正常、生殖机能旺盛；水液代谢通畅；呼吸调匀；骨骼坚固、髓海有余；生命力旺盛；血液充盈。当肾的功能失常时,机体就会呈现出病理之象,即腰疼、腰脊不举；耳鸣、耳聋；口热舌干、不能言；目下肿、目无所见、目盳盳如无所见、视歧；齿槁、齿脱；发堕、发鬓颁白、发去；骨痿、骨痹、骨极、骨枯；遗尿、癃闭、大便秘结、五更泄；遗精、早泄、滑脱、不育、早产、不孕；胕肿；面色黧黑；石脉无力；呼多吸少、动则益甚。通过肾系疾病之肾虚证和肾实证的象表现,归纳了肾的诊断之象。肾的治疗之象着重探讨了壮水之主,以制阳光；益火之源,以消阴翳；泻南补北及金水相生的象思维原理。
系统科学是现代科学总体系中与自然科学、社会科学等并列的另一大学科门类。“复杂性”实际是开放的复杂巨系统的动力学,或开放的复杂巨系统学,复杂性是开放的复杂巨系统的一种很重要的特性。系统思维是系统学与思维学交叉融合的产物,应包含两个层面上的含义。第一,从系统学出发,把认识对象作为系统加以理解和把握。第二,从思维学出发,把认识主体的大脑思维活动作为系统来规范和运作。系统思维要求将认识对象系统化,考察问题注重整体性,综合运用整体思维和分析思维,同时把握系统的内在规定性及外在规定性,并且始终重视系统的整体涌现性。因为人们总会在无意识中经常地使用非系统思维,所以强调系统思维要通过自觉的修炼来获得。
系统思维最突出的特点之一就是从整体上认识对象和解决问题。在生理上,用系统思维把人体看作是由各组成部分构成的一个整体,这些组分在结构上不可分割,功能上相互协调,病理上相互作用。同时,把人体放到宇宙的大系统中去,这与系统的本质是一致的,表现在生理上,即“天人相应”的中医理论。由于内外环境,即指“七情”(喜怒忧思悲恐惊)和“六淫”(风寒暑湿燥火)作用于人体这一系统,导致系统的某些方面失衡,结果致病。中医的诊断学就是以把握人体系统整体涌现性为目标而建立的,通过望闻问切四诊所获得的信息都是有关人体整体涌现特性的信息。这些信息被整合形成具有动态性的“证”,表征整个病变过程中正邪斗争相互消长的连续性和传变顺序,从而掌握整个病变过程中“证”的动态演变规律。系统思维还要求认知的主体要把思维活动作为系统来规范和运作。中药是一个庞大的、多层次多维的复杂系统,无论是单味药还是经过配伍而成的方剂,都是系统整体涌现的典范。中医的处方用药最能体现系统思维的整体涌现性特性。中医诊疗疾病注重系统对象的自我调节,将治病看成他组织与自组织相结合的过程。人体是最高级最发达的自组织系统,自愈应是医学自组织理论的核心概念之一。
要创造性地进行中医基础理论的研究必须要有系统的观念,将考察的对象放在系统当中,用系统思维探讨系统复杂性问题。根据系统的层级性特点,任何一个系统都可以分为母系统、子系统和分系统,如肾的各个层面都可看作是肾这一母系统的子系统。系统包括构成要素(组分)即其相互作用而产生的关系,其间存在着物质、能量、信息的交换,如一个人体的五脏系统(包括体、华、窍、合、液等),五脏和六腑之间以及五脏之间就存在各种信息的交换关系,各系统有边界和外界联系。中医通过辨证论治旨在调整系统间的关系,系统内部各要素之间的关系,以期恢复系统内外的平衡稳态,保证人体的健康长寿。肾系统作为人体五大功能系统之一,其主要包括肾、膀胱、骨、髓、脑、发、耳、二阴、志、恐(惊)等组成要素。因为任何一个系统所呈现的功能状态都不可能是某一构成要素作用的结果,它必须是组分间通过物质、能量、信息的交互作用所共同产生的系统整体涌现性。所以,我们将肾藏象系统分为“天人合一系统”、“形神合一系统”及“体用合一系统”,分析肾藏精对天人关系系统、形体官窍系统以及生命物质系统的调节。
Firstly, the origins of the kidney essence combing traditional Chinese medicine on a refined definition, whether it is the essence of broadly or narrowly the essence subtle substance with the intent of the word "essence" at this point. For the formation of ancient philosophy "essence doctrine", I believe that the first is from the medicine,"the doctrine of the essence" to establish, or at least should be subject to the ancients of the observation and thinking of their own "essence, qi". Men and women married, the formation of people, pointed out that the "essence" is an important role in the formation of human life. Ancient philosophy of "the doctrine of the essence" doctrine in medicine essence, but its connotation and extension without limitation, especially as the methodology of the philosophical level, improving the theory has a more profound meaning of guidance. Essence points in the hierarchy of four levels: the "essence" of the ancient philosophy of the universe primitive is an abstract concept in the entire hierarchy of the top of a hierarchy of " essence " by the ancient philosophy of the essence produce specific the body of the essence in the second level; constitute the essence of the human body's innate essence and acquired essence of the third level; essence of the human body are distributed in the ministries of human ministries of human sperm in the fourth level. Ancient philosophy, the essence water one idea is to build the renal phenomenological theory "kidney essence" and the philosophical basis of the theory of the kidney water. Therefore, the theory comes from the most primitive anatomy and physiology, are united in the ancient Chinese philosophy, a perfect combination of a model of Medicine and Philosophy in Traditional Chinese Medicine.
Emphasized by the ancient philosophy of essence or essence gas already exist in the universe is abstract. Human beings as a biological species, inherent intrinsic subject of the essence of the universe, thrive, constantly updated, evolving. Therefore, we have reason to believe that the human body is the perpetual movements exist in the universe, invisible essence or gas metaplasia. From the source of the essence can be divided into congenital essence and acquired essence. Congenital essence is adhering to the parents'reproductive essence, constitute the raw material of embryonic development, mainly closed Tibet in the kidney, both parents'reproductive's essence, but also from the mother of the essence of the individual's reproductive. Congenital essence is the important factors that determine individual Congenital and innate righteousness. Has to promote the body of the physiological function, and promote the body's growth and development of functional, to a certain extent, when this essence gas filling, the formation of "menstruation", and also a direct impact on the aging process. In Chinese medicine, the essence of breathing after the birth of the human body and Mizutani Precision collectively referred to as "acquired essence". The Neijingsingled out under the premise of the five internal organs are the essence and kidney essence, is to emphasize the essence of the kidney and other organs of the essence, especially reproductive essence of kidney essence of the argument basis. Kidney essence and internal organs of sperm in storage, transshipment, the mutual adjustment of dynamic, multidirectional, depends not only ensures adequate renal possession fine, but also promotes the storage of the various organs of the body essence and adjustment, only the kidney essence is part of the essence of the five internal organs, play an important role in the activities of human life, but can not replace the essence of the organs or the essence of the body. The renal organs of the essence of the meaning are two folds:on the one hand description of this viscera function of the kidney to rely on viscera function be guaranteed, on the other hand the description of the kidney essence it viscera play an important regulatory role. The kidney dominates the bones, manufactures the marrow to replenish the brain,of physiological functions, is in fact an important part of the function of kidney essence, that is to promote the body's growth and development. Kidney essence filling the bone marrow biochemical active, the nourishment of the bones to get bone marrow solid and strong. Kidney essence of the pulp can be divided into the bone marrow, spinal cord and brain. The Rise and Fall of the kidney essence, but also affect the filling and development of the spinal cord and brain. Spinal cord through the brain, marrow and poly from the brain, it is called as the reservoir of the marrowTherefore, the kidney essence filling, marrow support, the development of the brain sound, you can play a physiological functions of the "smart house". Kidney essence is overcast sky urgent essence, can stress, strain, emphasizing the kidney to regulate the body and the balance between the external environment, maintaining the health of the body. The people's ability of this strain is closely related to what we call the righteousness, and the Rise and Fall of the essence.
Experimental studies have shown the kidney essence and the close contact of the stem cell research, as well as research on brain and male infertility, female infertility, anemia research."Kidney essence" of clinical research, found that application of the principles and Supplementary kidney essence method from kidney, immune function disorders, senile dementia, infertility, chronic regeneration anemia and osteoporosis has significant therapeutic efficacy.
jiangthinking stems from the ancient concept of taking in images of natural selection process, as a thing or hexagrams, and other abstract symbols or digital systems to express the characteristics of things. The formation of the dynamic of xiang, and speculated that the universe in order to achieve change, revealing the purpose of the contact of things. Has the characteristics of the image, image is isotropic, multi-media nature, universality, and regularity. In recent years, the induction of " xiang thinking" interpretation of the following categories: Number Thinking, thinking in images, the image of logical thinking to take thinking like thinking, imagery and symbolic thinking. Interlinked by the ancient property and research within the various things xiang thinking to create the "yin and yang Model" and "Five Elements Model" analysis, summarized a variety of things and phenomena of an epistemology and methodology." xiang thinking " to build the integrated use of the xiang to stand like taking in images, image, imagination, and Lenovo and other methods. These methods do not exist in isolation, but organic combination of close contact, and may even be superimposed, with the dynamic mobility and layers of depth. As a typical oriental thinking xiang thinking, hieroglyphics carrier of thinking, its special mechanism to confuse the subject, object, and the concept of3D images as basic elements, on the basis of intuition, self-experience model explain the objective external world, mutual infiltration, by analogy, imagine the system as a whole Lenovo image integration in an orderly way of thinking, image, image, dynamic integrity, potential logical characteristics. Modern cognitive psychology from the cognitive domain of the "black box, white box" theory fully affirmed the scientific and advanced to xiang thinking.
xiang thinking in traditional Chinese medicine theory performance in specific applications like way of thinking and as thinking model. Chinese medicine through the construction of the "Yellow Emperor" became Chinese medicine theory of the way of xiang thinking. Through the xiang of the organs, the xiang of the six elements, the signs of the disease and syndrome, the signs of four diagnostic and hair cut prescriptions as the study highlights the classified as analogizing from the similarity of their appearances, dynamic way of thinking successfully the ancient philosophy of " xiang thinking model" into the construction of traditional Chinese medicine theory, created the TCM theory of " yin and yang model" and "Five Elements model " to doctors based on clinical diagnosis and treatment xiang recognition model.
This article focuses on the scientific content of the kidney as studied from the point of view xiang thinking. Ancient literature from the quantity, weight, location, shape, color and other aspects of the body described as kidney anatomy. The Neijing with the functions of the main official position of the national regulatory agencies like the organs function to analog. The kidney viscera preserve the vital essence (and mind) instead of discharging (them) it unduly. The Neijing Description kidney belong to the element of water, in the corresponding five parties, and "North" in order to establish a link with the five acts of the signs of kidney space. Kidney due to year, month, hour in different variations on the time change, showing a different time as the human body to show different physiological and pathological conditions,"seasons health " based on health care, reflects the Chinese medicine "Heaven corresponding characteristics". Like the performance of the viscera contact of the kidney and it is:the heart and kidney water and fire both the economy; homologous B capric the hepatorenaltwo visceras; splenorenal two visceras successively days alternate; lung and kidney two visceras Goldwater Aioi. As one of the characteristics of the thinking is the emphasis on the overall function of dynamic, xiang thinking renal function of the kidney should be on the body's overall functional relationship between physical activity research, normal renal function, the body will be healthy, Can be expressed in normal growth and development, reproductive function is strong; smooth water metabolism; breathing and mix thoroughly; sturdy bones, more than a sea of marrow; great vitality; blood filling. When kidney dysfunction, the body will be showing the signs of the pathology, namely, back pain, tinnitus, deafness; mouth hot, dry tongue can not speak; heads swollen, and the eyes can not see, the teeth off; gray hair, hair loss; frequent urination, urinary urgency or incontinence; edema; swarthy; pulse delay weakness; respiratory disorders. Performance from kidney diseases, summed up the diagnosis of kidney. The strong water of the main focuses on the treatment of kidney, to the system of the sun; the source of the fire, in order to eliminate the shadow; diarrhea South to fill the North and Goldwater each other generate as thinking principle.
Well-known scientist Qian_xuesen thinks that Systems Science is an integral part of modern science and technology system, which belongs neither to the natural sciences, does not belong to the social sciences, but in the parallel system of modern science and the natural sciences, social sciences, such as another major disciplines. He believes that the "complexity" is actually the dynamics of open complex giant system, or open complex giant system science, complexity is a very important characteristic of the open complex giant system. Systems thinking are a system of learning and thinking school cross product of fusion, should contain two levels of meaning. First, learn from the system starting to recognize the object as a system to understand and grasp. Second, learn from the thinking, understanding of the main brain thinking activities as a system specification and operation. Systems thinking will recognize the object systematic inspection problems holistic, integrated use of the overall thinking and analytical thinking, and grasp the internal regulations and external requirements, and has always attached importance to the system as a whole emerge. Because there will always be often unconscious use of non-systems thinking, so emphasis on systems thinking to get through the conscious practice.
One of the most prominent features of systems thinking is the whole object of knowledge and problem-solving. Physical, systems thinking, the human body as a whole is constituted by the part of these components is indivisible in the structure, function coordination, pathological interactions. At the same time, into the human system of the universe, this is consistent with the nature of the system, manifested in the physical, namely "Heaven corresponding" theory of Chinese medicine. Due to internal and external environmental effects on these systems of the human body, leading to imbalances of certain aspects of the systems. Chinese medicine diagnostics is to grasp the human system as a whole emerged as the goal established, the information obtained through the four clinics of the look and smell are the characteristics of information emerged about the body as a whole. Information is integrated to form a dynamic "Symptoms", the characterization of good and evil and the struggle of mutual growth and decline throughout the lesion in continuity and mass change order in order to grasp the dynamic evolution of the entire disease process "Symptoms" Systems thinking are also the principal should require cognitive thinking as a system specification and operation. Chinese medicine is a huge, multi-level multi-dimensional complex system, whether it is the emerging model of a single herb or compatibility from the prescription, the system as a whole. The prescription of Chinese medicine can best embody the whole emergence of systems thinking characteristics. Chinese medical diseases to focus on self-regulation system objects, and will treat as he organized and self-organization process of combining. The human body is the most advanced and most developed self-organizing system, self-healing should be one of the medicine of the core concepts from organization theory.
To creatively Basic Theory of TCM research must have a system of concepts, and will examine the object on the system of system complexity, systems thinking. According to the system-level features of any system can be divided into the parent system, subsystem, and subsystems, such as the various levels of the kidney can be seen as subsystems of the parent system of the kidney. The system includes elements of its interaction arising from the relationship, during which the existence of matter, energy, information exchange, such as the five internal organs of a human body system, the five organs and six fu and five internal organs between there are all kinds of information exchange between various system boundary and the outside world. Chinese medicine through the diagnosis and treatment aims to adjust the relationship between the system and the relationship between the various elements of the system internal to restoring the balance of the system inside and outside the steady-state, to ensure the health and longevity of the human body. The renal system as a human body system, one of the five functions including kidney, bladder, bone, marrow, brain, hair, ears, genitalia and anus, Chi and other elements. Functional status are presented by any system is the result of certain elements of the role, it must be material, energy, information interaction between the components co-produced the whole system emergent property. Therefore, based on systems thinking, analysis of kidney essence of living matter systems, regulation of body officer awakened, and Heaven relations system.
古代哲学所强调的精或精气原本就存在于宇宙之中,是抽象的。人类作为生物学上的一个物种,与生俱来就禀受了宇宙之精气,在繁衍生息过程中不断更新,不断进化。因此,我们有理由相信人体是由存在于宇宙之中的无形而运动不息的精气或气所化生而来的。从精的来源可分为“先天之精”和“后天之精”。先天之精是秉承于父母的生殖之精,是构成胚胎发育的原始物质,主要闭藏于肾,既包括父母的生殖之精,又包括脱离母体后个体的生殖之精。先天之精是决定个体先天禀赋的重要因素,也是先天正气。具有促进人体各项生理机能,促进机体生长、发育的功能,当这种精气充盈到一定程度,形成“天癸”,还直接影响人的衰老过程。中医学将人体出生后所获得的呼吸之精和水谷之精合称为“后天之精”。《内经》在五脏皆藏精的前提下又单独提出肾藏精,在于强调肾藏之精与其他脏腑之藏精不同,特别是生殖之精,是肾藏精的立论依据。传统认为“肾所藏之精”以先天为主,兼有部分后天之精,而其它四脏所藏之精主要为后天之精。肾精和五脏六腑之精在贮藏、转输、相互调节方面是动态的、多向性的,有赖于此既保障了肾所藏之精的充足,又促进了全身各脏腑之精的贮藏和调节,肾精仅是五脏之精的一部分,虽在人体生命活动中发挥着重要作用,但不能替代脏腑之精或一身之精。肾藏脏腑之精的含义有二：一方面说明肾本脏功能要依靠它脏功能的正常得到保障,另一方面又说明肾藏精对它脏功能发挥重要调节作用。肾主骨、生髓的生理功能,实际就是肾中精气功能的重要组成部分,即促进机体的生长和发育。肾精充盈则骨髓生化有源,骨骼得到骨髓的滋养而坚固有力。肾精所化之髓,可分为骨髓、脊髓和脑髓。肾中精气的盛衰,还影响着脊髓和脑髓的充盈和发育。脊髓上通于脑,髓聚而成脑,故有“脑为髓海”之说。因此,肾中精气充盈,则髓海得养,脑的发育就健全,就能发挥“精明之府”的生理功能。肾藏精属阴,藏精而起亟,能应激、应变,强调肾具有调节机体与内、外界环境之间的平衡,维护机体健康的功能。机体的这种应变能力就是我们所说的正气,与精气盛衰密切相关。
通过实验研究表明肾藏精与干细胞研究的密切联系,以及对脑研究、男子不育女子不孕的研究、对贫血研究的作用；通过有关“肾藏精”的临床研究,发现应用“从肾论治”的原则和“补肾填精”方法,对免疫功能障碍性疾病、老年性痴呆、不育、不孕症、慢性再生障碍性贫血及骨质疏松症都有显著的治疗功效。
象思维源于古人观物取象的自然选择过程,此时的“象”是通过一种事物或卦爻等抽象的符号或数字系统来表现事物的特征,形成“效天下之动者”之象,以达到推测宇宙变化,揭示事物联系之目的。具有形象性、意象性、属向性、多媒性、普遍性及规律性的特征。近年来,对“象思维”的释义归纳为如下几种：象数思维、形象思维、形象逻辑思维、取象思维、意象思维及象征思维等。古人通过象思维创建了“阴阳模型”“五行模型”和“八卦模型”,成为分析、归纳各种事物和现象的属性及研究各类事物内部相互联系的一种认识论和方法论。“象思维”的构建综合使用了观象、立象、取象、意象、想象和联想等方法,这些方法不能孤立存在,而是有机结合,密切联系,甚至会有所叠加,具有动态流动性和层层深入性。象思维作为一种典型的东方思维,以象形文字为思维载体,以意象为基本要素,以主体、对象和观念的三维混同为其特殊机制,在感性直观的基础上,主要以自我体验的模式解释外部客观世界,并通过类比互渗、想象与联想将意象整合为一种有序的整体系统的一种思维方式,具有形象性、意象性、动态整体性、潜逻辑性等特征。现代认知心理学从认知领域的“黑箱、白箱”理论充分肯定了象思维的科学性和先进性。
象思维在中医理论中的应用表现在象思维方法及象思维模型的具体应用上。中医学通过象思维方法建构了以《黄帝内经》为代表的中医理论体系。通过六气之象、脏腑之象、病证之象、四诊之象及理法方药之象的研究,凸显了据“象”归类、取“象”比类的整体、动态的象思维方法,成功将古代哲学中的“象思维模型”引入中医理论的构建中,创建了中医理论的“阴阳模型”、“五行模型”和“八卦模型”,成为中医生临床诊疗所依据的“象识别模型”
本文侧重从象思维的角度对肾藏象的科学内涵进行了研究。古代文献从数量、重量、在身体的部位、形状、颜色等诸方面描述了肾的解剖之象。《内经》采用了当时国家管理机构中主要官位的职能之象对脏腑功能加以类比说明,将肾描述为“肾者,作强之官,伎巧出焉。”肾属阴,具有“藏而不泻”的功能特点,是其阴阳之象。《内经》说明了肾在五行属水,在五方与“北”相应,从而建立起以五行为纽带的肾的空间之象。“肾之象”因“年、月、时辰”在时间上的不同变化而有所改变,表现为不同的时间之象,使人体呈现不同的生理病理状态,为养生保健提供了“四时养生”的依据,体现了中医学“天人相应”的特点。通过肾与它脏的关系解释了肾的八卦之象。肾与它脏的联系之象表现为：心肾二脏的水火既济；肝肾二脏的乙癸同源；脾肾二脏的先后天互生；肺肾二脏的金水相生。象思维的特点之一就是强调整体功能动态,基于象思维探讨肾的功能作用,就要将肾放在机体整体的生理活动功能关系上研究,肾的功能正常,机体就会呈现一派健旺之象,可以表现为生长发育正常、生殖机能旺盛；水液代谢通畅；呼吸调匀；骨骼坚固、髓海有余；生命力旺盛；血液充盈。当肾的功能失常时,机体就会呈现出病理之象,即腰疼、腰脊不举；耳鸣、耳聋；口热舌干、不能言；目下肿、目无所见、目盳盳如无所见、视歧；齿槁、齿脱；发堕、发鬓颁白、发去；骨痿、骨痹、骨极、骨枯；遗尿、癃闭、大便秘结、五更泄；遗精、早泄、滑脱、不育、早产、不孕；胕肿；面色黧黑；石脉无力；呼多吸少、动则益甚。通过肾系疾病之肾虚证和肾实证的象表现,归纳了肾的诊断之象。肾的治疗之象着重探讨了壮水之主,以制阳光；益火之源,以消阴翳；泻南补北及金水相生的象思维原理。
系统科学是现代科学总体系中与自然科学、社会科学等并列的另一大学科门类。“复杂性”实际是开放的复杂巨系统的动力学,或开放的复杂巨系统学,复杂性是开放的复杂巨系统的一种很重要的特性。系统思维是系统学与思维学交叉融合的产物,应包含两个层面上的含义。第一,从系统学出发,把认识对象作为系统加以理解和把握。第二,从思维学出发,把认识主体的大脑思维活动作为系统来规范和运作。系统思维要求将认识对象系统化,考察问题注重整体性,综合运用整体思维和分析思维,同时把握系统的内在规定性及外在规定性,并且始终重视系统的整体涌现性。因为人们总会在无意识中经常地使用非系统思维,所以强调系统思维要通过自觉的修炼来获得。
系统思维最突出的特点之一就是从整体上认识对象和解决问题。在生理上,用系统思维把人体看作是由各组成部分构成的一个整体,这些组分在结构上不可分割,功能上相互协调,病理上相互作用。同时,把人体放到宇宙的大系统中去,这与系统的本质是一致的,表现在生理上,即“天人相应”的中医理论。由于内外环境,即指“七情”(喜怒忧思悲恐惊)和“六淫”(风寒暑湿燥火)作用于人体这一系统,导致系统的某些方面失衡,结果致病。中医的诊断学就是以把握人体系统整体涌现性为目标而建立的,通过望闻问切四诊所获得的信息都是有关人体整体涌现特性的信息。这些信息被整合形成具有动态性的“证”,表征整个病变过程中正邪斗争相互消长的连续性和传变顺序,从而掌握整个病变过程中“证”的动态演变规律。系统思维还要求认知的主体要把思维活动作为系统来规范和运作。中药是一个庞大的、多层次多维的复杂系统,无论是单味药还是经过配伍而成的方剂,都是系统整体涌现的典范。中医的处方用药最能体现系统思维的整体涌现性特性。中医诊疗疾病注重系统对象的自我调节,将治病看成他组织与自组织相结合的过程。人体是最高级最发达的自组织系统,自愈应是医学自组织理论的核心概念之一。
要创造性地进行中医基础理论的研究必须要有系统的观念,将考察的对象放在系统当中,用系统思维探讨系统复杂性问题。根据系统的层级性特点,任何一个系统都可以分为母系统、子系统和分系统,如肾的各个层面都可看作是肾这一母系统的子系统。系统包括构成要素(组分)即其相互作用而产生的关系,其间存在着物质、能量、信息的交换,如一个人体的五脏系统(包括体、华、窍、合、液等),五脏和六腑之间以及五脏之间就存在各种信息的交换关系,各系统有边界和外界联系。中医通过辨证论治旨在调整系统间的关系,系统内部各要素之间的关系,以期恢复系统内外的平衡稳态,保证人体的健康长寿。肾系统作为人体五大功能系统之一,其主要包括肾、膀胱、骨、髓、脑、发、耳、二阴、志、恐(惊)等组成要素。因为任何一个系统所呈现的功能状态都不可能是某一构成要素作用的结果,它必须是组分间通过物质、能量、信息的交互作用所共同产生的系统整体涌现性。所以,我们将肾藏象系统分为“天人合一系统”、“形神合一系统”及“体用合一系统”,分析肾藏精对天人关系系统、形体官窍系统以及生命物质系统的调节。
Firstly, the origins of the kidney essence combing traditional Chinese medicine on a refined definition, whether it is the essence of broadly or narrowly the essence subtle substance with the intent of the word "essence" at this point. For the formation of ancient philosophy "essence doctrine", I believe that the first is from the medicine,"the doctrine of the essence" to establish, or at least should be subject to the ancients of the observation and thinking of their own "essence, qi". Men and women married, the formation of people, pointed out that the "essence" is an important role in the formation of human life. Ancient philosophy of "the doctrine of the essence" doctrine in medicine essence, but its connotation and extension without limitation, especially as the methodology of the philosophical level, improving the theory has a more profound meaning of guidance. Essence points in the hierarchy of four levels: the "essence" of the ancient philosophy of the universe primitive is an abstract concept in the entire hierarchy of the top of a hierarchy of " essence " by the ancient philosophy of the essence produce specific the body of the essence in the second level; constitute the essence of the human body's innate essence and acquired essence of the third level; essence of the human body are distributed in the ministries of human ministries of human sperm in the fourth level. Ancient philosophy, the essence water one idea is to build the renal phenomenological theory "kidney essence" and the philosophical basis of the theory of the kidney water. Therefore, the theory comes from the most primitive anatomy and physiology, are united in the ancient Chinese philosophy, a perfect combination of a model of Medicine and Philosophy in Traditional Chinese Medicine.
Emphasized by the ancient philosophy of essence or essence gas already exist in the universe is abstract. Human beings as a biological species, inherent intrinsic subject of the essence of the universe, thrive, constantly updated, evolving. Therefore, we have reason to believe that the human body is the perpetual movements exist in the universe, invisible essence or gas metaplasia. From the source of the essence can be divided into congenital essence and acquired essence. Congenital essence is adhering to the parents'reproductive essence, constitute the raw material of embryonic development, mainly closed Tibet in the kidney, both parents'reproductive's essence, but also from the mother of the essence of the individual's reproductive. Congenital essence is the important factors that determine individual Congenital and innate righteousness. Has to promote the body of the physiological function, and promote the body's growth and development of functional, to a certain extent, when this essence gas filling, the formation of "menstruation", and also a direct impact on the aging process. In Chinese medicine, the essence of breathing after the birth of the human body and Mizutani Precision collectively referred to as "acquired essence". The Neijingsingled out under the premise of the five internal organs are the essence and kidney essence, is to emphasize the essence of the kidney and other organs of the essence, especially reproductive essence of kidney essence of the argument basis. Kidney essence and internal organs of sperm in storage, transshipment, the mutual adjustment of dynamic, multidirectional, depends not only ensures adequate renal possession fine, but also promotes the storage of the various organs of the body essence and adjustment, only the kidney essence is part of the essence of the five internal organs, play an important role in the activities of human life, but can not replace the essence of the organs or the essence of the body. The renal organs of the essence of the meaning are two folds:on the one hand description of this viscera function of the kidney to rely on viscera function be guaranteed, on the other hand the description of the kidney essence it viscera play an important regulatory role. The kidney dominates the bones, manufactures the marrow to replenish the brain,of physiological functions, is in fact an important part of the function of kidney essence, that is to promote the body's growth and development. Kidney essence filling the bone marrow biochemical active, the nourishment of the bones to get bone marrow solid and strong. Kidney essence of the pulp can be divided into the bone marrow, spinal cord and brain. The Rise and Fall of the kidney essence, but also affect the filling and development of the spinal cord and brain. Spinal cord through the brain, marrow and poly from the brain, it is called as the reservoir of the marrowTherefore, the kidney essence filling, marrow support, the development of the brain sound, you can play a physiological functions of the "smart house". Kidney essence is overcast sky urgent essence, can stress, strain, emphasizing the kidney to regulate the body and the balance between the external environment, maintaining the health of the body. The people's ability of this strain is closely related to what we call the righteousness, and the Rise and Fall of the essence.
Experimental studies have shown the kidney essence and the close contact of the stem cell research, as well as research on brain and male infertility, female infertility, anemia research."Kidney essence" of clinical research, found that application of the principles and Supplementary kidney essence method from kidney, immune function disorders, senile dementia, infertility, chronic regeneration anemia and osteoporosis has significant therapeutic efficacy.
jiangthinking stems from the ancient concept of taking in images of natural selection process, as a thing or hexagrams, and other abstract symbols or digital systems to express the characteristics of things. The formation of the dynamic of xiang, and speculated that the universe in order to achieve change, revealing the purpose of the contact of things. Has the characteristics of the image, image is isotropic, multi-media nature, universality, and regularity. In recent years, the induction of " xiang thinking" interpretation of the following categories: Number Thinking, thinking in images, the image of logical thinking to take thinking like thinking, imagery and symbolic thinking. Interlinked by the ancient property and research within the various things xiang thinking to create the "yin and yang Model" and "Five Elements Model" analysis, summarized a variety of things and phenomena of an epistemology and methodology." xiang thinking " to build the integrated use of the xiang to stand like taking in images, image, imagination, and Lenovo and other methods. These methods do not exist in isolation, but organic combination of close contact, and may even be superimposed, with the dynamic mobility and layers of depth. As a typical oriental thinking xiang thinking, hieroglyphics carrier of thinking, its special mechanism to confuse the subject, object, and the concept of3D images as basic elements, on the basis of intuition, self-experience model explain the objective external world, mutual infiltration, by analogy, imagine the system as a whole Lenovo image integration in an orderly way of thinking, image, image, dynamic integrity, potential logical characteristics. Modern cognitive psychology from the cognitive domain of the "black box, white box" theory fully affirmed the scientific and advanced to xiang thinking.
xiang thinking in traditional Chinese medicine theory performance in specific applications like way of thinking and as thinking model. Chinese medicine through the construction of the "Yellow Emperor" became Chinese medicine theory of the way of xiang thinking. Through the xiang of the organs, the xiang of the six elements, the signs of the disease and syndrome, the signs of four diagnostic and hair cut prescriptions as the study highlights the classified as analogizing from the similarity of their appearances, dynamic way of thinking successfully the ancient philosophy of " xiang thinking model" into the construction of traditional Chinese medicine theory, created the TCM theory of " yin and yang model" and "Five Elements model " to doctors based on clinical diagnosis and treatment xiang recognition model.
This article focuses on the scientific content of the kidney as studied from the point of view xiang thinking. Ancient literature from the quantity, weight, location, shape, color and other aspects of the body described as kidney anatomy. The Neijing with the functions of the main official position of the national regulatory agencies like the organs function to analog. The kidney viscera preserve the vital essence (and mind) instead of discharging (them) it unduly. The Neijing Description kidney belong to the element of water, in the corresponding five parties, and "North" in order to establish a link with the five acts of the signs of kidney space. Kidney due to year, month, hour in different variations on the time change, showing a different time as the human body to show different physiological and pathological conditions,"seasons health " based on health care, reflects the Chinese medicine "Heaven corresponding characteristics". Like the performance of the viscera contact of the kidney and it is:the heart and kidney water and fire both the economy; homologous B capric the hepatorenaltwo visceras; splenorenal two visceras successively days alternate; lung and kidney two visceras Goldwater Aioi. As one of the characteristics of the thinking is the emphasis on the overall function of dynamic, xiang thinking renal function of the kidney should be on the body's overall functional relationship between physical activity research, normal renal function, the body will be healthy, Can be expressed in normal growth and development, reproductive function is strong; smooth water metabolism; breathing and mix thoroughly; sturdy bones, more than a sea of marrow; great vitality; blood filling. When kidney dysfunction, the body will be showing the signs of the pathology, namely, back pain, tinnitus, deafness; mouth hot, dry tongue can not speak; heads swollen, and the eyes can not see, the teeth off; gray hair, hair loss; frequent urination, urinary urgency or incontinence; edema; swarthy; pulse delay weakness; respiratory disorders. Performance from kidney diseases, summed up the diagnosis of kidney. The strong water of the main focuses on the treatment of kidney, to the system of the sun; the source of the fire, in order to eliminate the shadow; diarrhea South to fill the North and Goldwater each other generate as thinking principle.
Well-known scientist Qian_xuesen thinks that Systems Science is an integral part of modern science and technology system, which belongs neither to the natural sciences, does not belong to the social sciences, but in the parallel system of modern science and the natural sciences, social sciences, such as another major disciplines. He believes that the "complexity" is actually the dynamics of open complex giant system, or open complex giant system science, complexity is a very important characteristic of the open complex giant system. Systems thinking are a system of learning and thinking school cross product of fusion, should contain two levels of meaning. First, learn from the system starting to recognize the object as a system to understand and grasp. Second, learn from the thinking, understanding of the main brain thinking activities as a system specification and operation. Systems thinking will recognize the object systematic inspection problems holistic, integrated use of the overall thinking and analytical thinking, and grasp the internal regulations and external requirements, and has always attached importance to the system as a whole emerge. Because there will always be often unconscious use of non-systems thinking, so emphasis on systems thinking to get through the conscious practice.
One of the most prominent features of systems thinking is the whole object of knowledge and problem-solving. Physical, systems thinking, the human body as a whole is constituted by the part of these components is indivisible in the structure, function coordination, pathological interactions. At the same time, into the human system of the universe, this is consistent with the nature of the system, manifested in the physical, namely "Heaven corresponding" theory of Chinese medicine. Due to internal and external environmental effects on these systems of the human body, leading to imbalances of certain aspects of the systems. Chinese medicine diagnostics is to grasp the human system as a whole emerged as the goal established, the information obtained through the four clinics of the look and smell are the characteristics of information emerged about the body as a whole. Information is integrated to form a dynamic "Symptoms", the characterization of good and evil and the struggle of mutual growth and decline throughout the lesion in continuity and mass change order in order to grasp the dynamic evolution of the entire disease process "Symptoms" Systems thinking are also the principal should require cognitive thinking as a system specification and operation. Chinese medicine is a huge, multi-level multi-dimensional complex system, whether it is the emerging model of a single herb or compatibility from the prescription, the system as a whole. The prescription of Chinese medicine can best embody the whole emergence of systems thinking characteristics. Chinese medical diseases to focus on self-regulation system objects, and will treat as he organized and self-organization process of combining. The human body is the most advanced and most developed self-organizing system, self-healing should be one of the medicine of the core concepts from organization theory.
To creatively Basic Theory of TCM research must have a system of concepts, and will examine the object on the system of system complexity, systems thinking. According to the system-level features of any system can be divided into the parent system, subsystem, and subsystems, such as the various levels of the kidney can be seen as subsystems of the parent system of the kidney. The system includes elements of its interaction arising from the relationship, during which the existence of matter, energy, information exchange, such as the five internal organs of a human body system, the five organs and six fu and five internal organs between there are all kinds of information exchange between various system boundary and the outside world. Chinese medicine through the diagnosis and treatment aims to adjust the relationship between the system and the relationship between the various elements of the system internal to restoring the balance of the system inside and outside the steady-state, to ensure the health and longevity of the human body. The renal system as a human body system, one of the five functions including kidney, bladder, bone, marrow, brain, hair, ears, genitalia and anus, Chi and other elements. Functional status are presented by any system is the result of certain elements of the role, it must be material, energy, information interaction between the components co-produced the whole system emergent property. Therefore, based on systems thinking, analysis of kidney essence of living matter systems, regulation of body officer awakened, and Heaven relations system.
引文
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