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三阴三阳经脉气血多少理论源流考辨OA

Origin and evolution of the theory on the quantity of qi and blood in the three yin and three yang channels

中文摘要英文摘要

三阴三阳经脉气血多少系《黄帝内经》经脉理论的重要内容之一,并成为后世医家补泻治疗的重要依据.但三阴三阳经脉气血多少在《黄帝内经》中存在不同观点,其实质尚未有令人信服的阐释.本文对《黄帝内经》原文及相关传世、出土文献进行考证,认为《黄帝内经》三种三阴三阳经脉气血多少观点源自不同时期的医学实践活动.《灵枢·九针论》依据对足经刺静脉放血及对标本脉脉动的候测提出三阴三阳经脉气血多少的观点;《素问·血气形志篇》基于手太阴肺经为寸口,对三阴三阳经脉气血多少进行了修改;后因刺分间调气法作为针刺主要方式的兴起,三阴三阳经脉气血多少逐步失去其实质性内涵;《灵枢·五音五味》依据体表毛发特点对其进行了引申阐述.因此在临床针刺出气出血的医疗实践中,刺足经当从《灵枢·九针论》之观点,刺手经当从《素问·血气形志篇》之观点.

The theory on the quantity of qi and blood in the three yin and three yang channels is a significant component of the channel theory in Huangdi Neijing and is an essential basis for supplementation and drainage treatments among later physicians.However,different viewpoints on this theory exist within Huangdi Neijing,and no convincing interpretation of its essence has been established.Through a philological analysis of the original text of Huangdi Neijing alongside related transmitted and unearthed documents,this paper argues that the three perspectives on the quantity of qi and blood in the three yin and three yang channels originated from different periods and practical contexts.The Jiuzhen Lun of Lingshu initially proposed the concept based on venipuncture for blood letting in the foot channels and the observation of the biao(branch-distal)and ben(root-proximal)pulses in the foot channels.The Xueqi Xingzhi of Suwen revised the theory by incorporating the idea that the Taiyin Lung Channel of Hand corresponds to the cunkou pulse.Subsequently,with the increase of needling to regulate qi in the intermuscular layers as a primary needling method,the theory on the quantity of qi and blood in the three yin and three yang channels gradually lost its substantive connotation.The Wuyin Wuwei of Lingshu provided an extended explanation based on the characteristics of body hair.Therefore,in the clinical practice of needling for discharging qi or blood,the foot meridians should be treated according to the perspective of Jiuzhen Lun of Lingshu,whereas the hand meridians should be treated according to the perspective of Xueqi Xingzhi of Suwen.

姜树诚;杨佩诗;贺娟

北京中医药大学中医学院 北京 100029北京中医药大学中医学院 北京 100029北京中医药大学中医学院 北京 100029

医药卫生

气血多少《黄帝内经》《天回医简》经脉理论放血疗法理论演变

quantity of qi and bloodHuangdi NeijingTianhui Medical Bamboo Slipschannels theoryblood letting therapytheoretical evolution

《北京中医药大学学报》 2026 (7)

908-914,7

国家社会科学基金重大项目(No.21&ZD349) National Social Science Foundation of China(No.21&ZD349)

10.3969/j.issn.1006-2157.2026.07.004

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