發(fā)布時間：2017-12-30 18:10

  本文關鍵詞：水腫的古代文獻研究與學術源流探討　出處：《北京中醫(yī)藥大學》2016年博士論文　論文類型：學位論文

  更多相關文章： 辨證 病因 病機 文獻研究 水腫 治療

【摘要】：目的水腫是臨床常見病證。中醫(yī)學對水腫的認識有悠久的歷史,對水腫的治療有優(yōu)勢與特色。水腫理論發(fā)展至今,一方面,概念的內涵難免變遷,而一些治法方藥亦可埋沒；另一方面,建國以后,中醫(yī)學對水腫的研究主要有專著、學位論文、期刊文獻的形式,或因篇幅所限,失之全面；或為文獻匯編,缺乏分析；或從理法方藥橫向研究。因此系統(tǒng)地整理水腫的古代文獻,梳理水腫的學術源流,對于理論和實踐均有重要的意義。方法本文運用文獻學、邏輯學等方法,對水腫古代文獻進行研究。其具體方法為：①機檢與手檢相結合收集資料。利用《中華醫(yī)典》初步篩選相關資料,結合《中國中醫(yī)古籍總目》與《中醫(yī)文獻學》,確定最終選用的醫(yī)籍及版本。以此來獲取古代文獻�，F代文獻：主要指國內外于1949-2014年間公開發(fā)表的中醫(yī)藥學位論文、期刊文獻、會議文獻。通過機檢中國生物醫(yī)學文獻數據庫、中國中醫(yī)藥期刊文獻數據庫獲取題錄,之后通過相關期刊論文全文下載的方式獲得文獻。②按不同歷史時期對資料進行匯總,并按病因、病機、治療、預后等分類。③采用縱橫比較的方法,對于同一歷史時期的資料,結合當時醫(yī)學發(fā)展概況對相關資料進行橫向比較,理清不同醫(yī)家之間學術觀點的異同,整理總結出這一時期中醫(yī)學對水腫的總體認識和各個醫(yī)家的學術特點；再將不同時期、不同醫(yī)家縱向比較,理出歷代醫(yī)家在學術觀點上的繼承和發(fā)展,從而得出中醫(yī)對水腫認識發(fā)展的脈絡。結果本文分為九節(jié)。第一節(jié)介紹了水腫的定義、范圍,并對相關病名進行概述。第二節(jié)至第八節(jié),是本文的主要部分。以歷史發(fā)展為主線,以斷代史的方法,分將水腫發(fā)展史分為七個時期：先秦兩漢、三國魏晉南北朝、隋唐五代、兩宋、金元、明、清。通過各時期醫(yī)家及主要醫(yī)學著作中對水腫的記載,從病名、病因、病機、診斷、治療和方面來概括其學術發(fā)展情況。通過以上研究,第九節(jié)則提出了一些相關問題,并進行了初步探討。結論①首次全面系統(tǒng)地整理了水腫的古代文獻。按水腫的學術發(fā)展進程,將歷史劃分為七個不同的發(fā)展階段：先秦兩漢、三國魏晉南北朝、隋唐五代、兩宋、金元、明、清。先秦兩漢是水腫理論發(fā)展的創(chuàng)始期,《黃帝內經》對水腫病因、病機、治療、預防的認識,為后世的研究奠定了基礎；漢代張仲景《金匱要略》的雜病臟腑辨證為后世水腫辨治的理法方藥奠定了法度。三國魏晉南北朝時期對水腫的認識主要體現在診斷學和針灸學方面,代表作是《脈經》和《針灸甲乙經》,另有大量方書,存世不多,可從《肘后備急方》與《小品方》中窺見一斑。隋唐時期主要是文獻的收集和整理,《諸病源候論》詳于證候的記載和病機的闡發(fā),孫氏二書及《外臺秘要》在論述病因病機時均引錄《病源》,收錄前代方藥。兩宋時期,北宋時大型官修方書收集與整理文獻資料,而南宋則在此基礎上由博返約,突出體現在水腫的陰陽分類上。金元時期,學術爭鳴,劉完素對濕熱進行闡述,張從正對汗吐下法重新認識,朱丹溪提出的有關水腫病機、治療方面的理論得到了后世醫(yī)家的廣泛認同。明代,水腫辨證論治體系基本確立,并在前代的基礎上,有所提升和發(fā)揮。清代是水腫辨治理論更為成熟與完善的階段,醫(yī)家從各個方面對水腫理論予以補充。②對水腫分類、水腫與痰飲的鑒別、汗法治療水腫、腎氣丸考等理論進行探討。通過對歷代醫(yī)書中水腫歸屬及水腫分類的總結,水腫是一個病因病機復雜,多臟腑相關的疾病,將其簡單分入腎系疾病下是不全面的,將其作為氣血津液病更為合理。痰飲與水腫均是水液代謝異常、在體內停聚為患的疾病；臨床有相似之處,且易相兼發(fā)生,故相辨別。汗法是八法之一,應用廣泛,現將其治療水腫專題以述。腎氣丸始載于《金匱要略》,初不為水腫所設,至薛己、趙獻可、張景岳始治水腫,現辨此源流。
[Abstract]:The purpose of edema is a common clinical disease. The TCM understanding of edema has a long history, treatment of edema have advantages and characteristics. The theory of edema development so far, on the one hand, the connotation of the concept of inevitable change, and some herbs can also be buried; the other hand, after the study of the traditional Chinese medicine mainly edema there are books, theses, journals, or because of the limited space, not comprehensive; or for documentation, or the lack of analysis; cross-sectional study in prescription. Therefore systematic edema of the ancient literature, the academic research on the origin and development of edema, to have important theoretical and practical significance of this method. By using literature, logic and other methods to study the edema ancient literatures. The specific methods are: machine inspection and manual inspection combined to collect data. Using the data related to the preliminary screening of traditional Chinese medicine combined with < >, < Chinese ancient Chinese medicine total Order "and" Chinese Literature ", medical books and determine the final selection version. In order to obtain the ancient literature. Modern literature mainly refers to both at home and abroad in 1949-2014 years published medical dissertations, journal articles, conference papers. Check through the machine China biomedical literature database, China medicine journal literature database acquisition bibliography get through the way of literature, after downloading Chinese full-text periodicals database. According to the different historical periods of data were collected, and according to the etiology, pathogenesis, treatment, prognosis and classification. The method of comparison, for the same period, combined with the medical development compared to the related data, to clarify the similarities and differences between different physicians between the academic point of view, we summarize this period of Chinese medicine overall cognition and various physicians on the edema of the academic characteristic of the time period, Different doctors in the longitudinal comparison, a medical history of inheritance and development in the academic view, so that the traditional Chinese medicine on the understanding of the context of development. Edema results in this paper is divided into nine sections. The first section introduces the definition of the scope of edema, and an overview of the related problems. The second section to the eighth section is the main part of this paper. Based on the historical development as the main line, with the method of the dynastic history, the history of the development of edema is divided into seven periods: Pre Qin Dynasty and Han Dynasty, the Wei Jin Southern and Northern Dynasties, Sui and Tang Dynasty and Five Dynasties, two song, Jin, Ming and Qing period. The doctors and medical writings on water swelling records, from the name of disease, etiology the pathogenesis, diagnosis, treatment, and to summarize its academic development. Through the above research, the ninth section proposes some relevant issues and discussed. Conclusion the first comprehensive collation of ancient literature. According to the academic development of edema and swelling of the water, The history is divided into seven stages: the pre Qin Dynasty and Han Dynasty, the Wei Jin Southern and Northern Dynasties, Sui and Tang Dynasty and Five Dynasties, two song, Jin, Ming and Qing. Qin and Han Dynasty is a founding period of edema in the development of the theory, "Huangdi Neijing > on the etiology, pathogenesis, treatment and prevention awareness, laid the foundation for later on; Zhang Zhongjing of the Han Dynasty" Jinkui yaolue > viscera and laid the testimonies for miscellaneous prescription in treating edema. The three generations of the Wei and Jin Dynasties of edema is mainly reflected in the field of diagnostics and acupuncture, is representative of the < > and < > zhenjiujiayijing, while a large number of books. There is not much, can get a glimpse from the "zhouhoubeijifang > and < >. Prescriptions in the Sui and Tang Dynasties is mainly literature collection and collation, analysis based on detailed records < and > syndrome pathogenesis, sun Shier books and" waitai miyao "in the discussion of etiology and pathogenesis are quotation < > source The previous generation, included prescription. The two Song period, when the Northern Song Dynasty, Xiufang book collection and collation of large documents, and on the basis of the Southern Song Dynasty embodied in Yin and Yang from abundance back to limitation, the classification of edema. The Jin and Yuan Dynasties, academic contend, Liu Wansu elaborates on Zhang Congzheng on the damp heat, sweat vomit purgation reconsidered, related to edema Zhu Danxi's disease treatment, the theory has been widely recognized by later generations. In Ming Dynasty, edema syndrome differentiation system is established, and on the basis of former generations, to improve and play. The Qing Dynasty is edema differentiation theory more mature and perfect stage, doctors from the aspects of edema theory to be added. The classification of edema, edema and differentiation of phlegm, perspiration treating edema of Shenqi Pill test theory. Based on the classification and classification of edema edema in the summary of previous books, edema is a complex etiology and pathogenesis, Many viscera related diseases, will be divided into the simple kidney disease is not comprehensive, as a disease of Qi blood and body fluid is more reasonable. Phlegm and edema are water metabolism abnormal, stop poly diseases in vivo; clinical similarities, and easy combination, so the phase discrimination. Sweating method is widely used, one of the eight methods, the treatment of edema in the subject. Shenqi Pill was contained in the "Golden Chamber", the beginning is not set to edema, Xue Ji, Zhao Xian, Zhang Jingyue began to treat edema, is this differentiation origin.

【學位授予單位】：北京中醫(yī)藥大學
【學位級別】：博士
【學位授予年份】：2016
【分類號】：R256.51
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本文編號：1355860