【摘要】：癃閉的定義：癃閉是以排尿困難、小便量少、點滴而出,甚則閉塞不通為主的病證。一般以小便不利、點滴而短少、病勢較緩者稱為癃,而以小便閉塞、點滴不通、病勢較急者稱為閉。病位在腎與膀胱,因兩者功能失調(diào),三焦氣化不能宣行所致。本病證相當(dāng)于西醫(yī)學(xué)中因各種原因所致的尿潴留和無尿癥,如腎前性、腎后性及腎實質(zhì)病變所致的急慢性腎功能衰竭的少尿或無尿癥,以及尿路結(jié)石、尿路腫瘤、尿道狹窄、尿路損傷、前列腺增生、膀胱括約肌痙攣、神經(jīng)性尿閉、脊髓炎所致的尿潴留。1.研究目的：①厘清“癃”在古代文獻(xiàn)中的多重涵義以及與癃閉相關(guān)病名的歷史沿革；②按照時間脈絡(luò),挖掘、整理、剖析重要醫(yī)家及論著辨治癃閉的學(xué)術(shù)觀點,理清學(xué)術(shù)上的繼承性和發(fā)展性；③探討脈診在癃閉五臟辨治中應(yīng)用的相關(guān)問題。2.研究方法：本課題采用傳統(tǒng)文獻(xiàn)學(xué)研究方法,以先秦到清代各個時期與癃閉相關(guān)的文獻(xiàn)為研究對象,主要從病因病機(jī)、辨證分型、治則治法、處方用藥、預(yù)防調(diào)攝等方面整理分析。具體操作方案：通過《中國中醫(yī)古籍總目》篩選出與癃閉相關(guān)的古籍,再結(jié)合《中華醫(yī)典》檢索書籍中的內(nèi)容,機(jī)檢與手檢相結(jié)合,確定最終選用的醫(yī)籍；圖書自北京中醫(yī)藥大學(xué)圖書館、中國中醫(yī)科學(xué)院圖書館、中國國家圖書館獲取。3.研究結(jié)果：①“癃”在古代文獻(xiàn)中的涵義：“小便不利或尿閉”、“不能行走”、“疲病”,中醫(yī)學(xué)主要取第一個含義。②癃閉相關(guān)病名的歷史沿革：“癃”與“淋”一直混淆不清,到了明代,癃、淋的含義得到厘清,才被作為獨立的病癥分而論治。③各個時期對癃閉的認(rèn)識：先秦兩漢至魏晉南北朝時期,藥物學(xué)、方劑學(xué)、治療學(xué)都處于摸索的狀態(tài),但《黃帝內(nèi)經(jīng)》對其病位、病因、病機(jī)、治則皆有論述；隋唐時期,癃閉辨治最大的進(jìn)展為外治法中導(dǎo)尿術(shù)的創(chuàng)新、方劑的輯錄及癃閉嚴(yán)重性的提出；宋金元時期,對癃閉的研究各家爭鳴,許多醫(yī)家提出了卓越性見解,此期官修醫(yī)書中關(guān)于小便不通的辨治文獻(xiàn)十分可觀；明代,癃閉的辨治體系趨于完善,對并發(fā)癥、診斷分型、治則治法、藥物方劑皆有極大地發(fā)展,并理清了癃閉淋的區(qū)別；到了清代,癃閉的辨治已經(jīng)成熟,尤其是提出了辨證中的六大誤區(qū),四大最危急癥,處方用藥也有提升。④脈診在癃閉五臟辨治中的應(yīng)用：心肝脾肺腎五臟的功能紊亂皆可導(dǎo)致癃閉的發(fā)生,當(dāng)病患癥狀表現(xiàn)過于單一或者雜亂難于辨證時,脈診有利于分析癃閉發(fā)病的根源,更有針對性地指導(dǎo)處方用藥,從而增強(qiáng)療效。
[Abstract]:The definition of dysphagia: dysuria is dysuria, urination is less, dripping out, and even block the main symptoms. Generally to urinate unfavorable, drip and short, the disease is called longer, and to urinate obliterate, drip impassable, the disease is more urgent called closed. The disease is located in the kidney and bladder, due to the dysfunction of the two, three-coke gasification can not be declared. This syndrome is equivalent to oliguria or anuria caused by various causes in western medicine, such as acute and chronic renal failure caused by prerenal, postrenal and renal parenchymal lesions, as well as urinary calculi, urinary tract tumors, and urethral strictures. Urinary tract injury, Prostatic Hyperplasia, sphincter of bladder spasm, Neurostatic urinary obturation, Myelitis induced urinary retention. 1. 1. Objective: to clarify the multiple meanings of "longong" in ancient literature and the historical evolution of the name of the disease associated with dystopia. [2] to explore, sort out and analyze the academic viewpoints of important doctors and books on the treatment of dystopia according to the time context. To study the application of pulse diagnosis in the treatment of dysphoria. Research methods: this topic adopts the traditional philology research method, taking the literature related to dysphoria from pre-Qin to Qing Dynasty as the object of study, mainly from etiology and pathogenesis, syndrome differentiation, treatment method, prescription drug use. Prevention adjustment and other aspects of analysis. The concrete operation plan: through "Chinese traditional Chinese Medicine Ancient Books General catalogue" to screen out the ancient books related to dysphagia, then combined with the "Chinese Medical Code" to retrieve the contents of the books, machine examination and hand examination to determine the final selection of medical books; Books from Beijing University of traditional Chinese Medicine Library, the Chinese Academy of traditional Chinese Medicine Library, the National Library of China access. 3. The results showed that the meaning of "long" in ancient literature: "unfavorable urination or obstruction of urine", "inability to walk", "fatigue", Traditional Chinese medicine mainly takes the first meaning of the historical evolution of the name of Longobu related diseases: "long" and "Lin" have been confused, by the Ming Dynasty, the meaning of Longlin has been clarified, It was treated as an independent disease. 3. The understanding of dystopia in every period: from the pre-Qin and Han dynasties to the Wei, Jin and Southern and Northern dynasties, pharmacology, prescriptions, and therapeutics were all in a groping state, but Huangdi Neijing was concerned about the location, etiology, and pathogenesis of the disease. During the Sui and Tang dynasties, the greatest progress in the treatment of dysphoria was the innovation of catheterization, the compilation of prescriptions and the presentation of the severity of dysphoria. Many physicians have put forward outstanding opinions, and the literature on distinguishing and treating impassable urination in this period of the official medical book is quite considerable. In the Ming Dynasty, the system of distinguishing and treating dysphagia tended to be perfect, and the complications, diagnosis, classification, and treatment were treated according to the law. Drug prescriptions have greatly developed and sorted out the difference between dysphoria and dysphoria. By the Qing Dynasty, the differentiation and treatment of dysphoria had matured, especially six major misunderstandings in syndrome differentiation and four of the most critical diseases. Prescription medication also promoted the use of .4 pulse diagnosis in the treatment of dysphoria: the dysfunction of heart, liver, spleen, lung, kidney and five viscera could lead to dysphonia, and when the symptoms of patients were too single or confused, it was difficult to differentiate symptoms. Pulse diagnosis is helpful to analyze the root causes of dysphagia and to guide prescriptive medication to enhance the curative effect.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R256.53

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