【摘要】：目的：系統(tǒng)整理明代六本中醫(yī)著作中的有關(guān)瘴病證治的文獻(xiàn),分析瘴病證治方、藥數(shù)據(jù),總結(jié)明代中醫(yī)治療瘴病的規(guī)律與特點(diǎn),并探討明代瘴病文獻(xiàn)對嶺南醫(yī)學(xué)流派理論建設(shè)的價(jià)值及影響。方法：以文獻(xiàn)研究法為主,對明代醫(yī)著《普濟(jì)方》、《明醫(yī)雜著》、《古今醫(yī)統(tǒng)大全》、《景岳全書》、《瘴瘧指南》、《三合集》六書瘴病相關(guān)內(nèi)容進(jìn)行整理。對文獻(xiàn)中有關(guān)瘴病的理論進(jìn)行系統(tǒng)收集,分類進(jìn)行梳理；從病因、病機(jī)、治法、方藥等角度,總結(jié)明代的瘴病論治的規(guī)律特色�？偨Y(jié)瘴病相關(guān)方藥、方劑數(shù)據(jù),并進(jìn)行分析。將數(shù)據(jù)分析結(jié)果與理論研究進(jìn)行對照分析,進(jìn)一步歸納明清瘴病證治的規(guī)律與特色。結(jié)合天人合一和異病同治思想,探討明代瘴病文獻(xiàn)中的環(huán)境病理思想要素與體質(zhì)病理思想要素及其對嶺南醫(yī)學(xué)理論研究的意義。成果：《普濟(jì)方》論瘴病分為“山嵐瘴氣瘧”和“時(shí)氣瘴疫”,列治瘴方藥共136條,集明以前醫(yī)家之大成。病因理論,包括氣候條件致病、“饑飽過傷”、“榮衛(wèi)虛弱”、“山嵐煙霧”、“蛇虺郁毒”、“涉溪澗”、“山溪毒氣”、“風(fēng)溫痰飲”、“鬼癘”、“熱毒”等,所論瘴病辨治主張以檳榔御瘴,重視瘴病合并泄痢的調(diào)理,主張瘴病愈后精心調(diào)理,待正氣恢復(fù)。王綸《明醫(yī)雜著·擬治嶺南諸病篇》將瘴病分嶺南傷寒、瘧證、天行瘟疫熱病、溫黃四種論治。注重瘴病的愈后調(diào)攝。徐春甫《古今醫(yī)統(tǒng)大全》將瘴病分“瘴瘧”與“瘴氣”兩類,治療與愈后調(diào)養(yǎng)都注重培補(bǔ)正氣�！墩委懼改稀分�,《辨證》章分別論述瘴病病因、癥狀、鑒別診斷、分型、脈象、預(yù)后判斷、婦人小兒瘴病、調(diào)理方法、并發(fā)癥處理等內(nèi)容�！侗嫠帯氛掳此幮躁U述升藥、降藥、平胃藥,隨后詳列麻黃、柴胡、檳榔、附子、常山、黃芪、白術(shù)等藥在治療瘴病時(shí)的使用方法。卷下六章,將治瘴常用方按治法分六類述之。《景岳全書》作者張介賓認(rèn)為嶺南瘴病與嶺北傷寒、瘧疾無異,治瘴不離寒熱虛實(shí)及有邪無邪。治瘴應(yīng)重視內(nèi)虛病機(jī),隨證補(bǔ)之。《三合集》引入六經(jīng)、六氣辨證,結(jié)合因地制宜等因素,提出瘴病雖因外感瘴氣發(fā)病,但本因?yàn)閮?nèi)傷不足。治療以“解外感”為主,間或輔以“扶內(nèi)傷”。結(jié)論：明代醫(yī)家在對瘴病的診療過程中明晰了瘴病的外感病內(nèi)涵；完善了瘴病病機(jī),對內(nèi)虛病機(jī)的重視成為發(fā)展嶺南特色雜病證治的重要理論基礎(chǔ)；開始探尋了嶺南外感病治療體系,為嶺南醫(yī)學(xué)流派建設(shè)提供了理論基礎(chǔ)。明代醫(yī)家對瘴病的探索深化了人們對嶺南體質(zhì)的認(rèn)識(shí)和嶺南疾病的認(rèn)識(shí)。從瘴病中分離出雜病部分,提高了嶺南雜病證治水平。
[Abstract]:Objective: to systematize the literature on the syndromes and treatment of miasma in six books of the Ming Dynasty, analyze the prescriptions and data of the treatment of miasma, and summarize the law and characteristics of the treatment of miasma in the Ming Dynasty. The value and influence of the literature on miasma in Ming Dynasty on the theory construction of Lingnan medical school were discussed. Methods: the literature research method was used to sort out the related contents of the medical works of Ming Dynasty, such as Puji recipe, mixed Medical works of Ming Dynasty, General Collection of Ancient and Modern Medicine, Jingyue Guidebook, Guide to miasma and Malaria, and six Books of miasma. This paper systematically collects and classifies the theory of miasma in the literature, and summarizes the characteristics of the law of the treatment of miasma in Ming Dynasty from the angles of etiology, pathogenesis, treatment, prescription and medicine. To summarize and analyze the data of related prescriptions and prescriptions for miasma. The results of data analysis and theoretical study were compared and analyzed, and the law and characteristics of the treatment of miasma syndrome in Ming and Qing dynasties were further summarized. Combined with the thought of the unity of nature and human being and the same treatment of different diseases, this paper discusses the elements of environmental pathology and physique pathology in the literature of miasma in Ming Dynasty and their significance to the theoretical study of Lingnan medicine. Results: the miasma is divided into "Shan Lan miasma malaria" and "Shiqi miasma epidemic". There are 136 prescriptions for treating miasma. Etiological theories, including climatic conditions, "hunger and satiety injury", "Rongwei weakness", "mountain haze", "snake cobra depression", "wading stream", "mountain stream gas", "wind-warming phlegm drink", "ghost plague", "heat poison", etc. In this paper, the treatment of miasma disease is called betel nut imperial miasma, attention is paid to the management of miasma disease combined with diarrhea, and it is advocated that after the miasma disease is cured, the patient should be carefully treated, and the recovery of qi should be done. Wang Lun's "mingling Medicine to treat Lingnan Diseases" will be divided into four kinds of miasma: typhoid fever, malaria syndrome, plague fever and warm yellow. Pay attention to the recovery of miasma. Xu Chunfu divided the miasma disease into two types: "miasmatic malaria" and "miasma". Both the treatment and the recuperation after recovery pay attention to nourishing and nourishing the qi. In the Guide to Malaria, the chapter "Syndrome differentiation" discusses the etiology, symptoms, differential diagnosis, classification and pulse of miasma, respectively. Prognosis judgment, miasma of women and children, methods of nursing, management of complications, etc. According to the medicine, Zhang described the drugs of ascending, descending, leveling stomach medicine, then detailed listed ephedra, chaihu, areca nut, aconite, Changshan, astragalus, etc. Atractylodes macrocephala and other drugs used in the treatment of miasma. Zhang Jiabin, author of JingyueGuanshu, thinks that Lingnan miasma is no different from northern mountain typhoid, malaria, treatment of miasma, cold and heat deficiency and evil. In the treatment of miasma, we should pay attention to the pathogenesis of internal deficiency and supplement it with syndromes. The introduction of six meridians and six qi differentiation, combined with local conditions and other factors, suggests that although the miasma is caused by exogenous miasma, the internal injury is insufficient. The treatment was mainly "external feeling", sometimes supplemented by "internal injury." Conclusion: in the course of diagnosis and treatment of miasma, the doctors of Ming Dynasty made clear the connotation of external disease of miasma, perfected the pathogenesis of miasma, and attached importance to the pathogenesis of internal deficiency, which became the important theoretical basis for the development of syndrome and treatment of characteristic miscellaneous diseases in Lingnan. It begins to explore the treatment system of Lingnan exogenous disease, which provides a theoretical basis for the construction of Lingnan medical school. The exploration of miasma in Ming Dynasty deepened people's understanding of Lingnan physique and Lingnan disease. The miscellaneous diseases were isolated from the miasma disease, which improved the level of syndrome treatment of Lingnan miscellaneous disease.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R249;R254

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