本文選題：催瀉療法 + 特點�。� 參考：《北京中醫(yī)藥大學(xué)》2016年博士論文

【摘要】：藏醫(yī)催瀉療法是藏醫(yī)五療之一,是一個具有悠久歷史的治療方法,據(jù)現(xiàn)存藏醫(yī)古籍記載該療法可以追隨到遠(yuǎn)古象雄時期。在吐蕃贊普時期,為當(dāng)時醫(yī)學(xué)的發(fā)展前后多次聘請印度、漢地等其它地區(qū)的醫(yī)師,翻譯和編寫了各派醫(yī)學(xué)著作,完善和豐富了藏醫(yī)催瀉療法的理論,使藏醫(yī)催瀉療法的實踐操作趨于統(tǒng)一化和條理化,從而形成了先行準(zhǔn)備、正行施治、術(shù)后調(diào)養(yǎng)的理論框架。在此基礎(chǔ)上搜集和整理了歷代各醫(yī)家對催瀉療法的理論見解及實踐經(jīng)驗,促成了《四部醫(yī)典》中記載的催瀉療章節(jié)。目的：從《四部醫(yī)典》中記載的催瀉療法內(nèi)容來看,可用來治療任何年齡階段的各種疾病,尤其藏醫(yī)治則中指出了“欲病者平之,已病者瀉之”的治療宗旨,可想而知催瀉療法在藏醫(yī)臨床治療中有著不可缺少和無與倫比的地位。但由于種種原因該療法在臨床治療中未得到廣泛的應(yīng)用,致使對各種疾病的治療面臨困境。因此我認(rèn)為研究藏醫(yī)催瀉療法即符合臨床治療的需求,更符合提高傳統(tǒng)醫(yī)學(xué)服務(wù)能力和促進傳統(tǒng)醫(yī)學(xué)的傳承與發(fā)展的政策趨勢。本文通過分析藏醫(yī)藥歷史與各藏醫(yī)古籍文獻中記載的催瀉療法內(nèi)容,進一步探討藏醫(yī)催瀉療法的演變、發(fā)展、成熟的過程;著重提出藏醫(yī)催瀉療法的治療特點；收集和分析治療常見病的瀉方,尋找其組方規(guī)律；了解目前臨床治療中催瀉療法應(yīng)用的情況,提出后期研究方向等方面深入的研究,為進一步的臨床治療和科學(xué)研究奠定基礎(chǔ)。方法：(1)對比和分析《敦煌本吐蕃醫(yī)學(xué)文獻》、《比其黃色經(jīng)函》、《當(dāng)許醫(yī)文殘卷》、《月王藥診》等吐蕃時期的藏醫(yī)文獻,探討吐蕃時期催瀉療法的發(fā)展情況與理論體系的形成。(2)依據(jù)藏醫(yī)古籍中記載的催瀉療法內(nèi)容提出其治療特點；結(jié)合自己的觀點分析和論述了對催瀉療法的遠(yuǎn)近期先行準(zhǔn)備、正行施治、術(shù)后調(diào)養(yǎng)等內(nèi)容；(3)對赤巴、肝、胃、瘤、痛風(fēng)、疼痛等臨床常見病的瀉方進行歸類和分析。(4)以走訪、詢問、實地考察等方式了解目前臨床中催瀉療法的應(yīng)用情況。結(jié)果：(1)藏醫(yī)催瀉療法具有悠久的歷史,至少有1300多年的文字記載史,是在固有的藏醫(yī)催瀉療法內(nèi)容基礎(chǔ)上汲取周邊民族的相關(guān)知識和經(jīng)驗而形成了先行、正行、術(shù)后三個階段的理論體系。(2)提出了藏醫(yī)催瀉療法有九大治療特點；古籍記載可瀉之病58個,不可瀉病30個,經(jīng)梳理和分析確定了可瀉之病11個,不可瀉病4個。(3)根據(jù)古籍中記載的催瀉完成程度內(nèi)容,新制定了積分式催瀉完成程度的評價表。(4)探討了治療赤巴、肝、胃、痛風(fēng)、瘤、疼痛等六種病型催瀉方劑的組方規(guī)律,提出了每種病型的催瀉方劑主藥及輔藥。(5)以走訪、詢問、實地考察等方式了解到目前臨床中常用的催瀉方劑只有三個。結(jié)論：(1)在古籍文獻《十萬拳》中有“伏藏膿瀉法源自苯教”的記載、《宇妥傳》里記載“象雄有使疾病瀉下的催瀉療法”、《藏多醫(yī)學(xué)札記》中記載“肝瀉與脾血瀉源自《無畏的武器》”等內(nèi)容來看,催瀉療法是個古老療法,可以肯定至少有一千三百多年的文字記載史。從《醫(yī)療精匯》中印度瀉方“哈布夏“和漢地瀉方“麻細(xì)黃”的記載；贊普時期《瀉療銀杯》、《內(nèi)科療法珍寶瀉》等的翻譯和編寫可以看出藏醫(yī)催瀉療法的發(fā)展始終遵循了傳承固有、汲取他派之精的學(xué)術(shù)氣氛。(2)藏醫(yī)催瀉療法的內(nèi)容有遠(yuǎn)期準(zhǔn)備、近期準(zhǔn)備、峻瀉、緩瀉、藥物炮制、服法、促劑、出量、術(shù)后調(diào)理等完整的理論體系和條理性的實踐步驟。(3)藏醫(yī)催瀉療法具有九大治療特點：治療范圍廣、治赤巴病的優(yōu)選、根除疾病、凈化管腔、增升胃火、鎮(zhèn)止疼痛、平衡三因、療效快、防病保健等的作用。(4)通過對常見病類的催瀉方分析得出催瀉方劑的主藥為平衡三因藥(訶子)和寒熱共瀉藥(白狼毒),在此基礎(chǔ)上可以根據(jù)疾病性質(zhì)和病情、患者的體質(zhì)加以輔藥的規(guī)律,為研制催瀉新方提供了思路及依據(jù)。(5)對經(jīng)典古籍中記載的可否催瀉病進行統(tǒng)計和分析得出結(jié)論：可催瀉的病為浮腫、水腫、麻風(fēng)、昏花眼疾、類風(fēng)濕性關(guān)節(jié)炎、絳蟲病、熟期熱疫、中毒、瘤等,不可瀉的為孕婦疾病、胃火衰弱、外傷、肛疾。(6)目前臨床中使用的催瀉方劑為“阿如賽瀉”、“十味緩瀉”、“米同根均”。“阿如賽瀉”主要用于治療黃疸病,“十味緩瀉”主要用于治療培赤病、“米同根均”主要用于治療早期普瓦木布病�？傊�,通過此次研究對藏醫(yī)催瀉療法有了新的認(rèn)識和新的發(fā)現(xiàn),并對該療法的臨床運用和深層次的研究打下了堅定基礎(chǔ)。也盼望本文對藏醫(yī)臨床服務(wù)能力提升和發(fā)展起到促進作用。
[Abstract]:The medicine of Tibetan medicine is one of the five treatments of Tibetan medicine. It is a method of treatment with a long history. According to the existing ancient books of Tibetan medicine, it is recorded that the therapy can follow the period of ancient elephant male. During the period of Tubo zantian, doctors of other areas, such as India, Han and other regions, had been employed to translate and compile various medical works for the period of the development of the Tibetan medicine. And enriches the theory of the Tibetan medicine purgative therapy, which makes the practice of the Tibetan medicine purgative therapy tend to be unified and organized, thus forming a theoretical framework of preparation, treatment and post operation. On the basis of this, the theoretical views and practical experiences of various medical practitioners in the past dynasties have been collected and arranged, which contributed to the records of the four medical codes. Objective: from the contents of the purgative therapy recorded in the "four medical codes", it can be used to treat all kinds of diseases of the age stage, especially in the Tibetan medical treatment, which points out the treatment aim of "the sick person is flat, the sick person purges", and it is conceivable that the purgative therapy is indispensable and unparalleled in the clinical treatment of the Tibetan medicine. But for a variety of reasons, the therapy has not been widely used in clinical treatment, which leads to the difficulties in the treatment of various diseases. Therefore, I think that the study of Tibetan medicine purgative therapy is in line with the needs of clinical treatment, which is more in line with the policy trend of improving the traditional medical service ability and promoting the inheritance and development of traditional medicine. Analysis of the history of Tibetan medicine and the contents of purging therapy recorded in the ancient books of Tibetan medicine, further discuss the evolution, development and maturity of the Tibetan medicine, and focus on the characteristics of the treatment of the Tibetan medicine, collecting and analyzing the prescriptions of the common diseases, looking for the rules of the prescription, and understanding the application of the current therapy in the clinical treatment. In order to lay the foundation for further clinical treatment and scientific research, methods: (1) comparison and analysis of the Tibetan medicine literature of Dunhuang Tubo, < than its yellow classics >, < Xu medical literature >, < Yue Wang Medicine > and other Tibetan medical literature, to explore the development of the Tubo Period. The formation of the situation and theoretical system. (2) according to the contents of the treatment of the ancient Tibetan medicine, the characteristics of the treatment were put forward, and in combination with his own viewpoint, the far near preparation, treatment and postoperative care were analyzed and discussed, and (3) the classification of clinical common diseases such as Cheb, liver, stomach, tumor, gout, and pain were classified. And analysis. (4) by visiting, inquiring, field investigation and other ways to understand the application of the current clinical therapy of diarrhea. Results: (1) Tibetan medicine diarrhea therapy has a long history, at least 1300 years of history of written records, is based on the content of the inherent Tibetan medicine to absorb the related knowledge and experience of the surrounding ethnic groups formed the first, The theory system of the three stages after the operation. (2) it is proposed that there are nine characteristics of the treatment of Tibetan medicine for diarrhea; 58 of the ancient books can be diarrhoea, and 30 are diarrhoea, and 11 diarrhoea and 4 diseases are determined by combing and analysis. (3) the completion degree of the integral type of diarrhea is newly developed according to the content of the completion degree recorded in the ancient books. The evaluation table. (4) to discuss the prescription rules of six kinds of prescriptions for the treatment of Chek, liver, stomach, gout, tumor, pain and so on, and put forward the main and auxiliary drugs for each type of diarrhea prescription. (5) there are only three commonly used diarrhea prescriptions in clinic by visiting, inquiring and field investigation. Conclusion: (1) there are one hundred thousand boxing in ancient books. The records of "the source of purpur and diarrhoea from the origin of benzene" are recorded in the legend of "Xiang Xiong", "Xiang Xiong has diarrhea and diarrhea therapy", and the contents of "liver diarrhoea and spleen blood diarrhea originating in the fearless weapon >", and so on, are an ancient therapy, which can be affirmed for less than more than 1300 years of written history. The records of "Hun Bu Xia" in India Xie Fang and the decoction of Han and Chinese diarrhoea, the translation and compilation of the Zan Pu period < Xie therapy silver cup > < internal medicine therapy treasure diarrhea > can be seen that the development of the Tibetan medicine purgative therapy has always followed the inheriting nature and absorbed the academic atmosphere of his school. (2) the content of the Tibetan medicine purging therapy is prepared for a long time. In the near future, the comprehensive theoretical system and rational practice steps were prepared, such as diarrhoea, laxative, drug processing, medication, agent, dose, and postoperative conditioning. (3) the Tibetan medicine purgative therapy has nine characteristics: the wide range of treatment, the optimization of the treatment of Chek's disease, the eradication of the disease, the purification of the lumen, the increase of stomach fire, the pain in the town, the balance of three causes, the quick curative effect and the health care health care. (4) (4) through the analysis of the common diseases, the main medicine of the expressing prescription is to balance the three drugs (don ") and the cold and hot cathartic cathartic (Bai Langdu). On this basis, according to the nature of the disease and the condition of the disease, the constitution of the patient is supplemented by the medicine, which provides the idea and basis for the development of the new prescription of expressing diarrhea. (5) the classical ancient books are recorded. Can the diarrhea disease carry on the statistics and analysis to the conclusion: the disease that can induce diarrhea is edema, edema, leprosy, faint eye disease, rheumatoid arthritis, tapeworm disease, hot pestilence of ripe stage, poisoning, tumor and so on, which can not be diarrhoea for pregnant women, stomach fire, trauma, anus disease. (6) "Asiatic diarrhea" and "ten taste laxation" used in the clinic. "Alex diarrhoea" is mainly used in the treatment of jaundice, and "ten flavour laxative" is mainly used in the treatment of pellucosis. "Mi Tong root" is mainly used for the treatment of early purewood disease. The study laid a firm foundation and hoped that this paper will promote the improvement and development of Tibetan clinical services.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2016
【分類號】：R29

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