本文選題：交通心腎 + 心腎相關(guān)�。� 參考：《北京中醫(yī)藥大學(xué)》2016年博士論文

【摘要】：研究目的“交通心腎”治法是在“心腎相關(guān)”理論指導(dǎo)下的中醫(yī)臨床常用重要治法之一,“心腎相關(guān)”理論自先秦兩漢時(shí)期萌芽,經(jīng)歷代醫(yī)家從臨床實(shí)踐中的總結(jié)、提煉和升華,逐漸發(fā)展完善,“交通心腎”治法亦隨之經(jīng)歷了發(fā)展和變化。本研究側(cè)重歷代相關(guān)重要中醫(yī)古籍和醫(yī)家學(xué)術(shù)思想,以中醫(yī)基礎(chǔ)理論、中醫(yī)內(nèi)科學(xué)以及相關(guān)醫(yī)案類(lèi)文獻(xiàn)為主要研究對(duì)象,對(duì)“交通心腎”治法相關(guān)古今文獻(xiàn)進(jìn)行研究,以期勾勒該治法的歷史發(fā)展脈絡(luò)和古今臨床應(yīng)用的規(guī)律和特點(diǎn)。研究方法本研究將主要分為三篇進(jìn)行闡述：上篇以“交通心腎”治法歷史源流研究為主要內(nèi)容。通過(guò)檢索《中華醫(yī)典》里“醫(yī)經(jīng)類(lèi)”“內(nèi)科類(lèi)”“綜合醫(yī)書(shū)類(lèi)”類(lèi)目中相關(guān)內(nèi)容,結(jié)合《中國(guó)醫(yī)學(xué)史》《中醫(yī)各家學(xué)說(shuō)》和《中國(guó)中醫(yī)古籍總目》,篩選出各個(gè)歷史時(shí)期比較有影響力的文獻(xiàn)著作,以計(jì)算機(jī)檢索和手檢結(jié)合的方式,收集與“交通心腎”治法和“心腎相關(guān)”理論相關(guān)的原始資料。按照先秦兩漢時(shí)期、兩晉至五代時(shí)期、宋金元時(shí)期、明代、清代和現(xiàn)代等六個(gè)不同歷史階段對(duì)檢索資料進(jìn)行分期,應(yīng)用文獻(xiàn)學(xué)一般研究方法,結(jié)合各個(gè)歷史時(shí)期的社會(huì)背景及醫(yī)學(xué)發(fā)展特點(diǎn)、主要醫(yī)家學(xué)術(shù)觀點(diǎn)、中醫(yī)教材相關(guān)內(nèi)容等,對(duì)資料進(jìn)行系統(tǒng)整理與分析,探討治法和相關(guān)理論源流。中篇基于文獻(xiàn)研究?jī)?nèi)容需求,設(shè)計(jì)開(kāi)發(fā)“名醫(yī)名方中醫(yī)藥傳承平臺(tái)(V1.0)”,該平臺(tái)通過(guò)對(duì)醫(yī)療信息進(jìn)行采集、提取特征、綜合管理和數(shù)據(jù)挖掘,可將中醫(yī)病案獨(dú)立分離的理、法、方、藥等信息集成一個(gè)相互關(guān)聯(lián)、完整和協(xié)調(diào)的綜合系統(tǒng)。通過(guò)對(duì)中醫(yī)臨證診療中的四診、處方等信息進(jìn)行采集和儲(chǔ)存,運(yùn)用數(shù)據(jù)挖掘方法對(duì)相關(guān)信息進(jìn)行深入挖掘分析,促進(jìn)中醫(yī)臨證和傳承中“隱性知識(shí)”的顯性化。下篇主要從古代和現(xiàn)代相關(guān)醫(yī)案入手,研究古今醫(yī)案中該治法的臨床應(yīng)用特點(diǎn)與規(guī)律。在古代醫(yī)案研究中,應(yīng)用關(guān)鍵詞檢索古代醫(yī)案數(shù)據(jù)庫(kù),從127本中醫(yī)醫(yī)案類(lèi)古籍中,檢索主要應(yīng)用“交通心腎”治法治療疾病的相關(guān)醫(yī)案,嚴(yán)格納入和排除標(biāo)準(zhǔn),篩選出相關(guān)醫(yī)案70篇,借助“名醫(yī)名方中醫(yī)藥傳承平臺(tái)(V1.0)”建立古代醫(yī)案數(shù)據(jù)庫(kù)。基于古代醫(yī)案數(shù)據(jù)庫(kù),對(duì)醫(yī)案中出現(xiàn)的疾病和用藥進(jìn)行統(tǒng)計(jì)；應(yīng)用數(shù)據(jù)挖掘技術(shù),對(duì)用藥內(nèi)容進(jìn)行關(guān)聯(lián)規(guī)則分析,探討總結(jié)古代醫(yī)家在應(yīng)用“交通心腎”治法中常見(jiàn)疾病分布和用藥特點(diǎn)。現(xiàn)代醫(yī)案研究部分主要從相關(guān)期刊論文、萬(wàn)方數(shù)據(jù)知識(shí)服務(wù)平臺(tái)、中文科技期刊數(shù)據(jù)庫(kù)等3個(gè)網(wǎng)絡(luò)文獻(xiàn)資料數(shù)據(jù)庫(kù)中,檢索近30年應(yīng)用“交通心腎”治法治療疾病的相關(guān)醫(yī)案,嚴(yán)格納入和排除標(biāo)準(zhǔn),篩選出相關(guān)醫(yī)案344篇,借助“名醫(yī)名方中醫(yī)藥傳承平臺(tái)(V1.0)”建立現(xiàn)代醫(yī)案數(shù)據(jù)庫(kù)�；诂F(xiàn)代醫(yī)案數(shù)據(jù)庫(kù),對(duì)于醫(yī)案中出現(xiàn)的疾病、癥狀、藥物等內(nèi)容進(jìn)行統(tǒng)計(jì)；對(duì)癥狀、藥物內(nèi)容進(jìn)行關(guān)聯(lián)規(guī)則分析、因子分析；參考網(wǎng)絡(luò)藥理學(xué)研究方法,對(duì)相關(guān)方劑進(jìn)行網(wǎng)絡(luò)藥理學(xué)分析,探討現(xiàn)代臨床在應(yīng)用“交通心腎”治法的疾病、癥狀和用藥特點(diǎn)。討論部分主要從古今對(duì)“心”“腎”的認(rèn)識(shí)演變和差異,以及“心腎交通”的途徑和方式等方面內(nèi)容入手,分析探討“交通心腎”治法的內(nèi)涵；探討“心”“腎”概念的現(xiàn)代內(nèi)涵；探討古今應(yīng)用“交通心腎”治法在臨床上治療的常見(jiàn)疾病、辨證、癥狀以及處方用藥的特點(diǎn)與規(guī)律,并試從現(xiàn)行《中醫(yī)診斷學(xué)》教材和相關(guān)“國(guó)標(biāo)”的定義中出發(fā),探討古今臨床處方用藥差異的原因。研究結(jié)果1古代中醫(yī)應(yīng)用“交通心腎”治法以治療腎系疾病、心系疾病、氣血津液病證等系統(tǒng)疾病為主,常用于治療遺精、不寐、心悸等病證。2古代中醫(yī)應(yīng)用“交通心腎”治法主要采用安神藥、補(bǔ)虛藥、清熱藥、收澀藥等四大類(lèi)藥物；常用藥物有茯神、酸棗仁、遠(yuǎn)志、麥冬、地黃等；常用藥對(duì)有茯神-酸棗仁,酸棗仁-遠(yuǎn)志,茯神-遠(yuǎn)志等；常用藥物的藥性以平、溫、寒為主,藥味以甘、苦為主,歸經(jīng)以腎、心兩經(jīng)為主。3現(xiàn)代中醫(yī)應(yīng)用“交通心腎”治法以治療心系疾病與腎系疾病為主,常用于治療不寐、經(jīng)斷前后諸證、心悸、遺精等疾��；西醫(yī)疾病以失眠、更年期綜合征、病理性遺精、遺尿等疾病為主。4現(xiàn)代中醫(yī)臨床常見(jiàn)心腎不交證的癥狀有不寐、心悸、頭暈、夢(mèng)多、口干等；常見(jiàn)舌色以紅色和淡紅色為主,舌尖紅為心腎不交證特異性舌色：常見(jiàn)苔質(zhì)為薄苔和少苔；常見(jiàn)脈象為細(xì)數(shù)脈。5現(xiàn)代中醫(yī)應(yīng)用“交通心腎”治法主要采用補(bǔ)虛藥、安神藥、清熱藥、收澀藥等四大類(lèi)藥物；常用藥物有黃連、酸棗仁、地黃、肉桂、遠(yuǎn)志等；常用藥對(duì)有黃連-肉桂、黃連-酸棗仁、地黃-黃連等；常用藥物藥性以平、寒、溫為主,藥味以甘、苦為主；歸經(jīng)以心、腎、肝經(jīng)為主；6應(yīng)用“交通心腎”治法時(shí),在補(bǔ)益藥的應(yīng)用上,古代臨床以補(bǔ)氣和補(bǔ)陽(yáng)藥物的使用為主,現(xiàn)代臨床以補(bǔ)陰和補(bǔ)血藥物的使用為重。7現(xiàn)代中醫(yī)臨床治療心腎不交證常用方劑有交泰丸、六味地黃丸、黃連阿膠湯、天王補(bǔ)心丹等4首,常在方劑中加入“龍骨、牡蠣”“地黃、牡丹皮、知母”等藥物組合。研究結(jié)論1“心”“腎”的概念內(nèi)涵豐富,中醫(yī)在“心”“腎”的認(rèn)識(shí)經(jīng)歷了從解剖意義上“心”“腎”到功能上的“心”“腎”的發(fā)展過(guò)程。目前,“心腎相關(guān)”理論中所指的“心”“腎”,主要代表“精神神經(jīng)系統(tǒng)”、“生殖系統(tǒng)”和“內(nèi)分泌系統(tǒng)”等的生理功能；心腎不交證常見(jiàn)于現(xiàn)代醫(yī)學(xué)“精神和行為障礙”和“泌尿生殖系統(tǒng)”疾病中。2“交通心腎”及其相關(guān)理論在形成初期,深受古代哲學(xué)思想和道家丹道學(xué)說(shuō)思想的影響,但在其后來(lái)發(fā)展過(guò)程中因中醫(yī)和道家道教發(fā)展目標(biāo)、理論體系以及研究與應(yīng)用手段方法不同,自明清已降,“交通心腎”治法僅用于少部分疾病的治療中。3心腎之間交通方式主要依靠心腎陰陽(yáng)交感、經(jīng)絡(luò)、脾胃、肝膽、胞胎、三焦等,臨床治療心腎不交證常從“心腎陰陽(yáng)失調(diào)”與“脾胃”兩方面入手。4高等院�！吨嗅t(yī)診斷學(xué)》教材與《中華人民共和國(guó)國(guó)家標(biāo)準(zhǔn)·中醫(yī)臨床診療術(shù)語(yǔ)·證候部分》(GB/T 16751.2-1997),均將心腎不交證等同于心腎陰虛[陽(yáng)亢]證；且《中醫(yī)臨床診療術(shù)語(yǔ)·治法部分》(GB/T 16751.3-1997)則僅提出滋陰潛陽(yáng)之法以“交通心腎”�，F(xiàn)行教材和“國(guó)標(biāo)”并未對(duì)“心腎不交”內(nèi)涵進(jìn)行全面的分析和闡述,使得“交通心腎”治法在臨床上應(yīng)用范圍較為局限。5數(shù)據(jù)挖掘技術(shù)可以有效的應(yīng)用于中醫(yī)醫(yī)案的研究中,輔助挖掘潛在的、不易察覺(jué)的、有價(jià)值的癥狀和用藥信息。
[Abstract]:This study focuses on the study of the historical development of TCM ancient books and traditional Chinese traditional Chinese medicine , which is based on the basic theory of traditional Chinese medicine , the contents of TCM teaching materials and so on . Through collecting and storing medical information , the platform collects and stores information such as four diagnostic , prescription and other information in the medical record of Chinese medicine .
Based on the database of Chinese periodical full - text database , universal data knowledge service platform and Chinese sci - tech periodicals database , the author searches for the related medical cases , which is based on the database of modern medical records , and makes statistics on the diseases , symptoms and drugs in medical cases .
The correlation rule analysis and factor analysis of the symptom and drug content are carried out .
With reference to the method of network pharmacology research , the related prescriptions are analyzed by network pharmacology , and the characteristics of diseases , symptoms and medication of modern clinical practice in the application of " traffic centers and kidneys " are discussed . The discussion is mainly based on the understanding and difference of " heart " and " kidney " in modern clinic , and the ways and ways of " heart and kidney transportation " .
To explore the modern connotation of " heart " " kidney " concept ;
This paper discusses the causes of common diseases , syndrome differentiation , symptoms and prescription drugs of traditional Chinese medicine in the treatment of common diseases , symptoms , symptoms and prescription drugs .
Common medicines include Poria , Semen Ziziphi Spinosae , Cortex et Radix Polygalae , Radix Ophiopogonis , Radix Rehmanniae , and the like ;
The common medicine is prepared from Poria , Semen Ziziphi Spinosae , Semen Ziziphi Spinosae , Cortex et Radix Polygalae , Poria , Radix Polygalae , and the like ;
The traditional Chinese medicine is mainly used for treating cardiovascular diseases and renal diseases , which are commonly used for treating insomnia , pre - and post - menopausal syndrome , palpitation , spermatorrhea , etc .
Western medicine diseases are mainly diseases such as insomnia , climacteric syndrome , pathological nocturnal emission , nocturnal urine , etc . The symptoms of the clinical common heart and kidney syndrome in modern Chinese medicine are insomnia , palpitation , dizziness , dream , mouth and dry , etc .
The common tongue color is mainly red and light red , and the tongue tip is red as the specific tongue color of the heart and kidney .
The common pulse is the fine pulse . The modern Chinese medicine is mainly applied to four drugs such as tonifying deficiency medicine , tranquilizing medicine , clearing away heat and astringent , etc .
commonly used medicines are coptis , wild jujube seed , rehmannia root , cinnamon , polygala root and the like ;
The common drug is prepared from Coptidis Rhizoma , Cortex Cinnamomi , Coptidis Rhizoma , Semen Ziziphi Spinosae , Radix Rehmanniae , Rhizoma Coptidis , and the like ;
Common drug resistance is mainly flat , cold and warm , and the medicine taste is mainly sweet and bitter ;
It is classified as heart , kidney and liver meridian ;
6 . In the application of " heart - kidney " method , the traditional Chinese medicine is mainly used for tonifying qi and tonifying yang , and the modern clinic is mainly used for tonifying yin and enriching the blood . The research conclusion is that the concept of " heart " kidney is rich , and the traditional Chinese medicine has experienced the development process of " heart " and " kidney " in the meaning of " heart " .
Heart and kidney syndrome is common in modern medicine " spirit and behavior disorder " and " urinary reproductive system " disease . " Traffic center kidney " and its related theory are influenced by ancient philosophy thought and Taoist Dandao theory thought in the early stage of formation .
Traditional Chinese medicine and GB / T 16751 . 3 - 1997 only put forward the method of nourishing yin and yang . The present teaching material and the national standard do not comprehensively analyze and expound the connotation of " heart and kidney " . The data mining technology can be applied to the research of traditional Chinese medicine to help excavate the latent , difficult , valuable symptom and medication information .

【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R242
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本文編號(hào)：1815928