本文旨在突破传统中医对目、脑关系之宏观思辨范式,首次以现代神经解剖学中具象的动眼神经与视交叉为核心结构枢纽,系统构建一个融合“形-神-气”三位一体观的“目-脑轴”理论新体系。文章深植于《内经》以降的经典医籍,掘发“目系”“脑为元神之府”“精明之府”等理论的深层意涵,并将其与动眼神经的运动、自主神经功能及视交叉的空间信息整合特性相参互证,阐发“目-脑轴”作为维系人体内外信息交换、调控神明出入、斡旋气机升降之核心枢机的重要地位。本文提出“目-脑轴”非仅为视觉上传之径路,实为脑神外显之牖户、心神下达之机括、阴阳气血交汇之冲要。通过剖析动眼神经麻痹、视交叉病变及相关神志、眩晕疾患,系统论述“轴枢失运”“窍络闭阻”“神光不展”等病机,并创新性提出“调枢以启神机”“通络以利玄府”“察象以断气机”3大临床诊疗纲要。进而衍生出融合精准针刺(眼区深刺调枢法、颅底骨孔通窍法)、目脑导引术(九宫眼动调气法)、药物归经引达(通巅达络方药体系)等具有鲜明中医特色且直指临床的整合干预策略。“目-脑轴”之构建不仅为中医“目脑相关”及“中医电学”原创思维赋予了坚实的现代神经生物学“形质”基础,实现了“形神互诠”,亦为众多疑难脑病、眼病及心身疾患的诊治,开辟了一条汇通中西、执简驭繁的创新路径,兼具重大学术价值与临床实践意义。

This paper aims to transcend the macro-speculative paradigm of traditional Chinese medicine (TCM) regarding the relationship between the eyes and the brain. For the first time, it takes the concrete modern neuroanatomical structures of the oculomotor nerve and the optic chiasm as the core structural hubs to systematically construct a novel theoretical system of the "Eye-Brain Axis," which integrates the TCM trinity concept of "Form-Spirit-Qi." Deeply rooted in classical medical texts from the Inner Canon onward, the paper excavates the profound implications of theories such as the "ocular connectors," "the brain is the mansion of the primordial spirit," and "the head is the mansion of acuity." These are corroborated with the motor and autonomic functions of the oculomotor nerve and the spatial information integration characteristics of the optic chiasm, elucidating the pivotal role of the "Eye-Brain Axis" as a core mechanism for maintaining internal-external information exchange, regulating the ingress and egress of spirit, and mediating the ascent and descent of Qi dynamics. This paper posits that the "Eye-Brain Axis" is not merely a pathway for visual upload; it serves as the window for the external manifestation of brain-spirit, the trigger for the downward command of heart-spirit, and the crucial confluence for the interplay of Yin-Yang, Qi, and Blood. By analyzing pathologies such as oculomotor nerve palsy, optic chiasm lesions, and related mental and vertigo disorders, the paper systematically discusses disease mechanisms like "axis-pivot dysfunction," "orifice-network obstruction," and "failure of spirit-light to radiate." It innovatively proposes three core clinical diagnostic and therapeutic principles: "Regulating the Pivot to Activate the Spirit Mechanism," "Dredging the Collaterals to Facilitate the Mysterious Offices," and "Observing Manifestations to Determine Qi Dynamics." Furthermore, it derives integrated intervention strategies with distinct TCM characteristics and direct clinical relevance, combining precise acupuncture (e.g., Deep Periocular Needling for Pivot Regulation, Cranial Base Foramen Needling for Orifice Opening), eye-brain guidance techniques (e.g., Nine-Palace Eye Movement for Qi Regulation), and herbal medicine guided by channel tropism (e.g., the Ascend-to-Crown and Unblock-Collaterals herbal formula system). The construction of the "Eye-Brain Axis" not only provides a solid modern neurobiological "formal" basis for the original TCM concepts of "eye-brain correlation" and "TCM Electrology," achieving "mutual interpretation of form and spirit," but also opens an innovative path integrating Chinese and Western medicine, simplifying complexity for the diagnosis and treatment of numerous refractory encephalopathies, eye diseases, and psychosomatic disorders. It holds significant academic value and practical clinical significance.<br />Keywords: Eye-Brain Axis; Oculomotor Nerve; Optic Chiasm; Unity of Form and Spirit; Pivot Theory; TCM Electrology

国家自然科学(82474569)；国家中医药管理局第七批全国老中医药专家学术经验继承工作项目(国中医药人教函[2022]76号)；2023年度河南省中医学“双一流”创建科学研究专项课题项目(HSRP-DFCTCM-2023-05-08)