本文選題：傷寒　切入點(diǎn)：診斷　出處：《遼寧中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：傷寒的應(yīng)用理論是數(shù)千年來(lái),無(wú)數(shù)醫(yī)家站在巨人的肩膀上,閱讀臨床,凝練而成的中醫(yī)傷寒學(xué)方法論,是中醫(yī)學(xué)的臨證精華,它并非某個(gè)學(xué)術(shù)理論,也不是某個(gè)單純的辨證體系,它是連接中醫(yī)理論與中醫(yī)臨證的橋梁。本次研究是運(yùn)用起源于社會(huì)學(xué)的“框架”理論將中醫(yī)學(xué)中有關(guān)傷寒臨證的方法論呈現(xiàn)出來(lái),將中醫(yī)傷寒學(xué)中,那些學(xué)術(shù)理論具體指導(dǎo)臨床辨證的過程,層次性更清晰地展示出來(lái)。“框架”理論的形成尚不足半個(gè)世紀(jì),因其所涵蓋的理論較完整地鏈接了理論與實(shí)踐的關(guān)系,故近三十年內(nèi),其被植入多個(gè)學(xué)科,用其升華學(xué)術(shù)理論和指導(dǎo)工作實(shí)踐。本次研究分為兩個(gè)主要部分,一是通過文獻(xiàn)的梳理,進(jìn)行概念的界定,二是通過文獻(xiàn)中臨床經(jīng)驗(yàn)的歸納和演繹,推導(dǎo)出各概念間的關(guān)聯(lián)性,并構(gòu)建框架。在對(duì)文獻(xiàn)的整理中,本次研究采取了時(shí)間、空間雙向進(jìn)行的研究方法,以時(shí)間維度為軸,梳理出傷寒學(xué)發(fā)展的歷史脈絡(luò),以空間維度為軸,整理出中醫(yī)診療傷寒的共性理論和個(gè)性化經(jīng)驗(yàn)。通過研究,傷寒應(yīng)用理論的形成發(fā)展大致可分為三個(gè)主要的歷史階段:一為奠基期,在這個(gè)階段,《五十二病方》、《黃帝內(nèi)經(jīng)》、《黃帝八十一難經(jīng)》三書奠定了學(xué)術(shù)基礎(chǔ),從疾病范圍、發(fā)病條件、發(fā)病機(jī)理、治則治法等多個(gè)概念進(jìn)行了詳細(xì)的理論闡述,但各概念之間關(guān)系較割裂,并沒有規(guī)律的聯(lián)系。二為形成期,《傷寒雜病論》一書承先人之精華,合臨證之詣要,將前人之臨床經(jīng)驗(yàn)進(jìn)行較系統(tǒng)、較完整的理論升華,形成六經(jīng)辨證體系,其中潛藏之辨證論治之理,成為了傷寒應(yīng)用理論框架的核心價(jià)值,其所蘊(yùn)含的病邪傳變之機(jī)要,詮釋了傷寒所獨(dú)有的方法論特點(diǎn),另,華佗之六部三法、巢元方這癥候辨治等都在理論向臨床的過渡上,起到了重要的推動(dòng)作用,成不朽之偉業(yè)。三為發(fā)展期,自秦漢至明清,傷寒之發(fā)展尋源而有序,自《黃帝內(nèi)經(jīng)》奠定了學(xué)術(shù)之基調(diào),《傷寒雜病論》樹立了臨證之標(biāo)尺,后世諸醫(yī)家均以此兩部經(jīng)典為治學(xué)之圭臬,晉代王叔和考天地氣候之短長(zhǎng),立以氣候條件參考治療之法,后世龐安時(shí)等醫(yī)家遂從之。唐代孫思邈深諳人體生、長(zhǎng)、化、收、藏的生命特點(diǎn),據(jù)患者所處的生理階段進(jìn)行治療方案的確立,并著重養(yǎng)生之道,重論日常飲食、房室禁忌,病后調(diào)護(hù)等養(yǎng)生之法,以助針?biāo)幹委焸�。宋代諸醫(yī)家創(chuàng)“證候”之說(shuō),以陰陽(yáng)、表里、寒熱、虛實(shí)八個(gè)綱目進(jìn)行相應(yīng)的病機(jī)分析,將傷寒之不同階段以證候之詞一而統(tǒng)之。證候的出現(xiàn)對(duì)中醫(yī)學(xué)治法的甄選有著革命性的作用,據(jù)證候立治法的論治方法已被延用至今。時(shí)至宋后,中醫(yī)界百家爭(zhēng)鳴,金元四有,溫病一派接踵而至,雖其所專不為傷寒,但其于傷寒的造詣可見一斑,劉完素越宋而追古,崇病機(jī),創(chuàng)立了一套以遏止病機(jī)為主的治療方法,李東垣、朱丹溪追同藥王孫思邈,以體質(zhì)論為主,從體質(zhì)特點(diǎn)作為用藥的主要參考因素,張子和重視病位,提出了以法為先的治療思路,柯韻伯提出六經(jīng)橫縱論,單以病位羅列治法的治療思路,又如王好古、敖氏等將臟腑辨證參入傷寒的診療當(dāng)中等等。時(shí)至清末,傷寒之診療方式眾多,但皆不出《傷寒雜病論》六經(jīng)辨證之大綱,中醫(yī)傷寒學(xué)形成了一套以脈癥、病機(jī)為核心,傳變、病位為主要特點(diǎn)的應(yīng)用理論框架。
[Abstract]:The application of the theory of typhoid fever is thousands of years, countless doctors standing on the shoulders of giants, reading on clinical, a concise method of traditional Chinese medicine and typhoid fever, is the traditional Chinese medicine clinical essence, it is not an academic theory, nor is it a simple dialectical system, it is connected with TCM theory and clinic for the bridge. This study is the use of origin in sociology "framework" theory in traditional Chinese medicine on typhoid clinical methodology presented, TCM febrile disease, the academic theory of specific guidance for clinical diagnosis, level more clearly displayed. "Frame" theory is still insufficient for half a century, because it covers the theory of a complete link between theory and practice, so in the past thirty years, the implantation of multiple disciplines, the sublimation of academic theory and guide practice. This research is divided into two main parts, one is Through literature review, the definition of the concept, two is through the clinical experience in the literature induction and deduction, derived the relevance between concepts, and building the framework. In the literature, this research adopts the research method of space time, two-way, taking the time dimension to the shaft, comb the history of the development of typhoid fever, with the space dimension axis, sorting out the TCM diagnosis and treatment of typhoid fever and common theories and personalized experience. Through the research, the formation of application of the theory of typhoid development can be roughly divided into three main stages: one is the foundation period, at this stage, < fifty-two > < Huangdi's internal disease. The < >, eighty-one > 3 Nanjing emperor laid the academic basis, from the range of disease, disease conditions, pathogenesis, therapeutic methods and many other concepts are described with the theory, but the relationship between the concepts is fragmented, there is no law of the contact. The formation period, "Shanghanzabinglun" a Book of the ancestors of the essence of combined clinical go to clinical experience, previous systematic, complete theoretical sublimation, the formation of the system of the six, including the treatment of hidden dialectical reason, has become the core value of the theoretical framework of the application value of typhoid fever, the confidential contains the pathogen, interpretation of the unique characteristics of the method of typhoid fever, on the other, six of Hua Tuozhi's three law, the symptoms are in the treatment of pharmaceutical research to clinical transition, has played an important role in promoting, become immortal. Albert three development period, from the Qin and Han Dynasty to the Ming and Qing Dynasties. The search for the source of development of typhoid and orderly, since < Neijing lays > academic tone, < Shanghanzabinglun > set scale near card later, the doctors are taking two classic as research model, the Jin Dynasty Wang Shuhe admitted in the world long climate, climate reference therapy, later When the doctors then from Ann Pang. Sun Simiao of the Tang Dynasty, well versed in human life, and life, characteristics of reservoir, according to the established physiological stage patients of the treatment plan, and focus on heavy diet, a way of keeping good health, AV taboo, nursing and other health law after the disease, in order to help the acupuncture and medicine treatment in the Song Dynasty. The doctors "typhoid fever syndrome", on the table, cold and heat, deficiency of yin and Yang, eight class analysis pathogenesis of the different syndromes of typhoid in word and the EC. There syndromes of traditional Chinese medicine treatment on the selection of a revolutionary role, according to stand on the treatment of syndrome treatment methods have been used so far. Even after Song Dynasty, traditional Chinese medicine have a febrile disease Jinyuan, contention of a hundred schools of thought, sent followed, although its not designed for typhoid, but its remarkable attainments in typhoid fever, the Song Dynasty and ancient Liu Wansu's chase, Chong pathogenesis, created a set of to prevent disease the treatment of machines. Li Dongyuan, Zhu Danxi, chase with Sun Simiao manual, mainly from the theory of constitution, constitutional characteristics as the main factor influencing medication, Zhang Zi disease and attention, put forward ideas for the treatment of Ephraim, Ke Yunbo proposed six on the cross, to disease treatment and treatment list of ideas, such as Wang Haogu, Ao Shi the diagnosis and treatment of viscera and incorporation of typhoid fever and so on. At the end of the Qing Dynasty, many of the diagnosis and treatment of typhoid, but they are not < Shanghanzabinglun > Outline six, TCM febrile disease formed a set of symptoms, pathogenesis as the core, transmission, application of the theoretical framework for the main features of the disease.

【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R222.2

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