基于知识考古学的中风泛发外风说向肝风内动说转变的探讨

发布时间：2018-01-01 14:07

  本文关键词：基于知识考古学的中风泛发外风说向肝风内动说转变的探讨　出处：《北京中医药大学》2017年硕士论文　论文类型：学位论文

  更多相关文章： 泛发外风 风 肝风内动 知识考古学 中风

【摘要】：目的本论文以知识考古学为方法,以研究风的概念为切入点,采用知识考古学话语构成分析的方法,考察风的概念与中风病因病机理论的关系。探究两者从汉唐时期至明清时期,中风病泛发外风说至肝风内动说的演变,分析中风病因病机理论及其背后的知识结构体系形成和演变的历史。方法本论文采用知识考古学话语构成的分析方法,对中风病病因病机理论的历史进行考察,通过对象的形成、陈述方式、概念的扩散、主题策略的选择及概念间的关系等内容的考察,分析中风由泛发外风说至肝风内动说理论的演变现象。1.考察《黄帝内经》中"风"概念对象的形成,也就是历代医家对"风"所指范围的确定,即"泛风"指的是什么,"外风"指的是什么,"专风"指的是什么。对于"风"概念的界定及陈述方式,其分别以什么方式、与哪些概念、以什么次序关系出现在当时的中医理论体系当中。2.考察历代医学文献中中风病因病机从属的主题,即中风病因病机是在讨论什么问题时出现及其临床应用的改变。3.考察汉唐时期文献中,"泛风"说对于中风病病因病机的陈述方式,其理论所从属的主题。4.考察宋元时期文献中,外风说之下产生的肝中外风与痰火对于中风病病因病机的陈述方式,其理论所从属的主题。5.考察明清时期文献中,"专风"视角下的肝风说对于中风病病因病机的陈述方式,其理论所从属的主题。结果汉唐时期,在"天人相应"、"形气相合"观念的影响下,以术数为学术背景、经学影响下的阴阳五行成为主流意识形态。以《黄帝内经》为理论源头,出现了"泛风"、外风及"风",即成为了"风"的对象。"泛风"被概括为大自然中感受的多种风,风是弥泛于大自然的,是风所呈现出的一种状态,可以指四季八方皆是风;外风可以理解为自然界流动之气发生变化成为风邪,即六淫之风邪,外在的风邪侵犯并进入人体。在"泛风"转变至"专风"的过程中,由于风与肝相应,肝气储藏应于春的少阳之气。风与木是直接对应的关系,天之木运主风,风燥之气入肝。肝为厥阴风木,于是成为了"专风"。"泛风"说对于中风的陈述方式表现在《金匮要略》及《诸病源候论》的内容上,中风病因病机以正气不足,外风泛中五脏六腑为主,提出脏腑经络皆可中风。这一时期有关中风的内容繁杂,理论较为模糊不清,尚未有较系统的论述。宋元时期,战役的发生造成热病的盛行及五运六气在医学界的影响下,外风的概念逐渐扩展并延伸,出现了肝中外风说及痰火说。尽管宋以后的内因论中仍有外风理论的阐述,但从理论结构上看,内因论的理论结构和诊治思路与外因论存在较大的不同。宋元医家持内外相因的特点,强调内因但未完全否认外风致病,中风病因病机以内伤积损为主。明清时期,在理学的基础上提出体用一源,其理论背景导致新学说的产生。"专风"视角下的肝风成为这个时期对于中风的认知模式。在非风及内风的新理论出现下,中风病因病机开始以内因论为主轴。由此可见,中风理论随着风的指代对象不同而变化,其内涵亦随之而改变。结论1.中医"中风"的理论内涵随着"风"所指代对象不同而发生变化。2.伴随着话语场的改变,不同时期随着世界图示和人体认知模式的变化,中风病因病机理论的演变经历了三个阶段:泛发外风、内外相因、肝风内动。
[Abstract]:The purpose of this paper to the archaeology of knowledge as a method to study the concept of wind as the starting point, the archaeology of knowledge discourse analysis method, the relationship between the wind and the concept of etiology and pathogenesis of stroke. To explore both the theory from the Han and Tang Dynasties to the Ming and Qing Dynasties, stroke pan wind said to say endogenous evolution analysis of the history of the formation of the knowledge structure system of stroke pathogenesis theory and its underlying and evolution. This paper adopts the method of discourse analysis method of Archaeology of knowledge, of apoplexy etiology theory of history study, through the presentation of the concept, formation, diffusion, study content and strategy between the concept of the theme the relationship between the analysis of stroke by the pan outside the wind said to internal stirring said evolution phenomenon theory.1. of < Neijing > "wind" in the concept of object, which is the ancient physicians of "wind" refers to The determination of the scope, namely "the wind" refers to what is, "what is the wind" means, "what is the special wind" refers to. The definition of "wind" concept and presentation, respectively, in what way, and what concepts, appear in what order relation in the theoretical system of traditional Chinese medicine.2. investigation of ancient medical literature in stroke pathogenesis of subordinate subjects, namely the etiology and pathogenesis of stroke is to discuss what problems and clinical application of the change of.3. on the Han and Tang Dynasties literature, "Pan wind" said for presentation of the etiology and pathogenesis of stroke, the theory of subordinate subject.4. study in the song and Yuan Dynasties in the literature, the outside wind under the wind and phlegm, said foreign liver fire for presentation of the etiology and pathogenesis of stroke, the theory of subordinate subject.5. study in the Ming and Qing Dynasties literature, "wind" from the perspective of the said statement for liver pathogenesis of stroke, the 璁烘墍浠庡睘鐨勪富棰，

本文编号：1364820