从“轴运轮行，轮运轴灵”到“中轴不灵，轮运不畅”探讨颈椎病的诊治*
作者：宁辉丽，许金海，陈舟扬，徐一白，薛瑞瑞，王国栋，叶 洁，莫 文
单位：上海中医药大学附属龙华医院，上海 200032
引用：引用：宁辉丽，许金海，陈舟扬，徐一白，薛瑞瑞，王国栋，叶洁，莫文.从“轴运轮行，轮运轴灵”到“中轴不灵，轮运不畅”探讨颈椎病的诊治[J].中医药导报,2026,32(1):136-139.
DOI：10.13862/j.cn43-1446/r.2026.01.023
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摘要：
颈椎病是骨伤科常见病和多发病，本文基于黄元御《四圣心源》“一气周流，土枢四象，四象轮旋”和彭子益“中土脾胃为轴，肝心肺肾为轮”的“圆运动”轴轮整体观探讨颈椎病的诊治。阐述“一气周流，土枢四象，四象轮旋”理论的具体内涵，生理状态下“轴运轮行，轮运轴灵”，中土作为气机升降枢纽和全身气化源泉，通过升降浮沉聚散带动四轮之气循环往复。病理状态下“中轴不灵，轮运不畅”，气不周流，诸脏失衡，治疗以固护中土脾胃，推动左右升降旋转为主，恢复肝胆肺肾气之运转，使轴轮并运，气能周流，以平颈椎病诸症。
关键词：颈椎病；一气周流；黄元御；轴轮理论；圆运动；气一元论
Abstract：
Cervical spondylosis is a common and frequently occurring disease in orthopedics and traumatology. This article explores its diagnosis and treatment based on the "circular movement" axis-wheel holistic view derived from Huang Yuanyu's theory of "One Qi Circulates, Earth Governs the Four Elements, and the Four Elements Rotate" (from Four Sages' Source of the Heart) and Peng Ziyi's concept of "Central Earth (Spleen and Stomach) as the Axis, and the Liver, Heart, Lungs, and Kidneys as the Wheels". It elaborates on the specific connotations of the theory "One Qi Circulates, Earth Governs the Four Elements, and the Four Elements Rotate". Under physiological conditions, "the axle rotates the wheels, and the wheels make the axle flexible". Central Earth, as the hub of qi movement and the source of qi transformation throughout the body, drives the circulation of qi in the four wheels (representing the liver, heart, lungs, and kidneys) through ascending, descending, floating, sinking, gathering, and dispersing. Under pathological conditions, "the central axis is not flexible, and the wheels do not rotate smoothly", leading to impaired qi circulation and imbalance among the organs. Treatment should focus on strengthening the spleen and stomach (the Central Earth), promoting the ascending and descending rotation on both sides, and restoring the movement of qi in the liver/gallbladder and lungs/kidneys, thereby enabling the simultaneous movement of the axis and wheels, ensuring smooth qi circulation, and alleviating the various symptoms of cervical spondylosis.
Key words：cervical spondylosis; one qi circulation; Huang Yuanyu; axis and wheel theory; circular movement; qi monism
发布时间：2026-01-30
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