《灵枢·九针十二原》之四关与五脏*

作者：王葭琪，王玉芳

单位：山东中医药大学中医学院，山东 济南 250355

引用：引用：王葭琪,王玉芳.《灵枢·九针十二原》之四关与五脏[J].中医药导报,2025,31(10):226-229.

DOI：10.13862/j.cn43-1446/r.2025.10.042

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摘要：

《灵枢·九针十二原》中“四关主治五脏”是指导针灸治疗的重要原则，后世医家对此理论阐发见仁见智，多落脚于取穴以及针刺的应用，虽对临床施治具有重要意义，但从《黄帝内经》理论的宏扩性而言，未能完全揭示经典的深刻内涵，在医理的阐释与研究上具有一定的局限性。本文基于《黄帝内经》的核心理念，结合历代之注，认为四关指人体肘膝关节及以下部位，是腧穴及所在部位的整体，与五脏密切相关。四关既是五脏生理病理的外在体现，也与五脏神机内外络属。“四关主治五脏”是中医学形神共治理论的重要体现，既在针刺外治这一领域颇有指导意义，在导引按蹻等中医特色疗法及养生防病领域也具有重要的应用价值。

关键词：四关；五脏；《黄帝内经》；形神理论

Abstract：

The theory "the Siguan governed the Five Zang-Organs" recorded in Lingshu: Nine Needles and Twelve Yuan-Source Points is an important principle guiding acupuncture treatment. Medical experts from later generations have different explanations in their interpretations of this theory, and their views mostly focus on application of acupoint selection and acupuncture. Although it is of great significance for clinical treatment, from the perspective of the macro expansion of the theory of Huangdi Neijing, it fails to fully reveal the profound connotation of the classic, which has certain limitations in the interpretation and research of medical theory. Based on the core concept of Huangdi Neijing and combined with the notes from previous medical experts, this article holds that the Siguan refers to areas of the human elbow and knee joint and below. They are the whole of acupoints and the corresponding parts, which are closely related to the five zang-organs. It is not only the external manifestation of the physiology and pathology of the five zang-organs, but also the internal and external collaterals of the the transforming mechanism of Shen (Spirit) of the five zang-organs. The theory of "siguan governed the five zang-organs" is an important embodiment of the theory of combination of body and spirit in tradtional Chinese medicine (TCM). It not only has significant guiding significance in the field of external treatment such as acupuncture, but also possesses important application value in TCM characteristic therapies like guiding exercise and massage manipulation, as well as in the fields of health preservation and disease prevention.

Key words：siguan; five zang-organs; Huangdi Neijing; theory of body and spirit

发布时间：2026-01-08

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