中医杂志

认为膜原的位置，除周身之间隙外，在《黄帝内经》基础上发展出的中医各家学说中尚存在两种主要传统别说，一是脾胃肠，二是膈膜。膜原脾胃肠说的实质是脾胃肠间隙的膜原，而不是脾胃肠；膜原膈膜说的实质可以分为狭义和广义，狭义是指从胸中到膈下之间隙的膜原，广义是指周身隔膜及所包罗间隙的膜原，但都不是膈膜；膜原脾胃肠说和狭义膜原膈膜说可以类比于现代医学的腹膜腔、肠系膜间隙、膈下间隙等。脾胃肠膈一体，滋养周身膜原且可从隔膜治疗膜原。基于对上述关系的研究，可开阔膜原病证的脉诊思路，开辟脾胃肠膈用药的膜原治法，为临床疑难病症的诊治提供参考。

Regarding the location of membrane source, in addition to the interstitial spaces throughout the body, there are two major traditional alternative theories in the various schools of traditional Chinese medicine(TCM) thoughts developed from the Inner Canon of Yellow Emperor （《黄帝内经》）, one refering to the spleen, stomach, and intestines, the other to the diaphragmatic membrane. The essence of the "membrane source as spleen-stomach-intestines" theory lies in the membrane source in the interstitial spaces of the spleen, stomach, and intestines, rather than the spleen, stomach, and intestines themselves. The essence of the "membrane source as spleen-stomach-intestines" theory can be divided into narrow and broad senses: in the narrow sense, it refers to the membrane source in the interstitial space from the chest to below the diaphragm; in the broad sense, it refers to the membrane source in the diaphragmatic membranes throughout the body and the enclosed interstitial spaces—but neither refers to the diaphragmatic membrane itself. The "membrane source as spleen-stomach-intestines" theory and the narrow-sense "membrane source as diaphragmatic membrane" theory can be analogous to the peritoneal cavity, mesenteric space, subdiaphragmatic space, etc., in modern medicine. The spleen, stomach, intestines, and diaphragm form an integrated unit, which nourishes the membrane source throughout the body, and membrane source-related conditions can be treated through the diaphragmatic membrane. Based on the study of the above relationships, this paper expands the thinking of pulse diagnosis for membrane source-related diseases, develops membrane source-targeted treatment methods using drugs that act on the spleen, stomach, intestines, and diaphragm, and provides a reference for the diagnosis and treatment of difficult and complicated clinical diseases.