耳鸣耳聋的古代文献研究与学术源流探讨

发布时间：2018-04-11 02:12

本文选题：耳鸣耳聋 + 病因病机　；参考：《北京中医药大学》2017年硕士论文

【摘要】：目的及意义耳鸣、耳聋是耳鼻喉科常见病,中医治疗耳鸣耳聋具有一定优势。中医学对耳鸣耳聋的认识历史悠久,治疗方式多样,极具特色。现代中医学对耳鸣耳聋的研究,或是理法方药单独讨论,不够全面系统;或是试验研究,参差不齐;或是实验验证,偏于论证。所以对古代文献中耳鸣耳聋的学术源流进行梳理,可以为临床提供理论与实践指导。研究方法主要采用传统文献学研究方法、断代史研究法、归纳总结法及比较研究法。首先,手检与机检相结合,通过《中国中医古籍总目》及《中华医典》初步筛选搜集耳鸣耳聋相关古代文献资料。然后从先秦两汉时期到清代,从史学角度整理不同时期的文献资料,从时间上把握其源流及发展。着重探讨总结各个时期的学术发展特点把握其传承发展关系。最后,对相关问题进行讨论,必要时须借助史学、文化学等领域的研究方法和内容。研究成果及意义1.系统梳理先秦至清代医籍中耳鸣耳聋的学术源流首先,对耳鸣耳聋的定义及病名历史沿革进行探讨。其次,分五个时期介绍先秦到清代对耳鸣耳聋的认识。先秦至两汉时期是中医理论的奠基时期,经典医籍尤其是《黄帝内经》对耳鸣耳聋的论述一直为后世沿用。这个时期,耳鸣耳聋的病因病机及治法基本成型,病机主要从邪气、脏腑、经脉、阴阳、气血、运气等方面论述。治法以针刺为主,针药结合。晋唐时期,对病机的探讨开始深入但仍以风邪与肾虚为主,孙思邈从脏腑寒热虚实角度进行辨证,提出毒聋之说。治法则以针刺和外治法为主,关注养生导引术,形式内容丰富。宋金元时期,医分门户。刘河间从热证论述,提出水衰火实之说,发耳聋治肺之先声;李东垣强调脾胃的重要性;朱丹溪倡滋阴降火之论,论治杂病的学术思想丰富了耳鸣耳聋的病机。此外,出现了陈无择的三因分类和严用和的从心肾立论。这一时期内治外治并用,方药内容丰富,是一个创新发展的时期。明清时期,医家承金元之说对耳鸣耳聋病因病机进行深入探讨,温病学派立论无关少阳,治疗更加重视顾护正气,耳鸣耳聋病因病机系统逐渐完善。同时,西学东渐促使中西医汇通派产生,对耳鸣耳聋的认识更加客观理性。2.对耳鸣耳聋的一些相关理论进行探讨目前国内从肺、三焦及胆论治耳鸣耳聋的医家还很少,但临床疗效明显。从肺治耳聋、从三焦及胆立论治疗耳鸣耳聋的源流颇为久远,对其进行探讨,可以为临床实践提供帮助。目前对耳鸣耳聋相关古籍的引用有些是不正确的,所以需要进行追本溯源,对其进行纠正。另外,对于耳鸣耳聋肾虚的病因病机多数医家以补为主,但古人早已提出耳鸣慎补,耳聋忌纯用补涩剂的观点,并且古籍中记载的关于耳鸣耳聋的养生导引术对于预防和治疗耳鸣耳聋有很好的作用。笔者在梳理文献资料时发现一些现代教材未论述或极少论述的内容,遂对其中部分内容进行整理。通过对耳鸣耳聋古代文献的梳理可以让人们对本病的认识更加系统,避免以偏概全,对临床实践和理论研究都有意义。
[Abstract]:The purpose and significance of tinnitus, deafness is a common disease in Department of ENT, has certain advantages of traditional Chinese medicine. Traditional Chinese medicine for treatment of tinnitus and deafness of tinnitus and deafness has the long history and treatment of diverse, distinctive. Research on tinnitus and deafness in modern Chinese medicine, or prescription is discussed separately, the system is not comprehensive; or is the result of the experiment, uneven or; experimental verification, is demonstrated. So analyzing the academic origins of ancient literature, tinnitus and deafness, can provide theoretical and practical guidance for clinical research. The method mainly adopts the traditional literature research methods, history research method, inductive method and comparative research method. First, with the combination of manual inspection machine inspection. Chinese ancient books Chinese through < > and < > the preliminary screening of traditional Chinese medicine ancient literature collection of tinnitus and deafness. Then from the Qin and Han Dynasties to the Qing Dynasty, from the historical angle of all different periods To grasp the literature, from the time of its origin and development. Focus on the academic development of summing up the characteristics of each period to grasp the relationship between inheritance and development. Finally, the related problems are discussed, when necessary by means of history, research methods and content of cultural science and other fields. The academic origins of 1. nationality systematically from Qin to Qing Dynasty medical achievements and significance in the study of tinnitus and deafness. First, the definition and history of disease of tinnitus and deafness are discussed. Secondly, divided into five stages: introduction of pre Qin Dynasty to the Qing Dynasty. The understanding of tinnitus and deafness from pre Qin to Han Dynasty is the period of foundation of traditional Chinese medicine theory, classic medical books especially discusses the classic < > on tinnitus and deafness has been later use. During this period, tinnitus and deafness pathogenesis and therapeutic methods of forming the basic pathogenesis, mainly from evil, viscera, meridians, Qi and blood, yin and Yang, discusses the luck and so on. Treatment with acupuncture, acupuncture and medicine. . Jin and Tang Dynasties, to explore the pathogenesis of deep but still pathogenic wind and kidney deficiency, Sun Simiao syndrome from the organs of cold and heat, the poison deaf said. Therapeutic principle of acupuncture and external treatment, pay attention to health guidance, form rich content. The Song Jinyuan period, medical portal from Liu He Jian. Heat syndrome is discussed, put forward water ring fire Shi ", issued the first sign of pulmonary deafness; Li Dongyuan emphasized the importance of the spleen and stomach; Zhu Danxi and Yin theory, on the treatment of diseases of academic thought has enriched the pathogenesis of tinnitus and deafness. In addition, Chen Wuze appeared in three for classification and strict use and from the heart and kidney argument. In this period the extraterritorial governance and the use of herbs rich in content, is a new development period. During the Ming and Qing Dynasties, doctors said on the Jinyuan tinnitus and deafness etiology and pathogenesis are discussed, febrile diseases, independent argument Shaoyang, more attention for protecting vital qi, ear Ming deafness pathogenesis system gradually improved. At the same time, the Western Learning School of integrative medicine, understanding of tinnitus and deafness is more objective theory of rational.2. to discuss the current domestic tinnitus and deafness from the lung, and the bile of tinnitus deafness doctors are rare, but the clinical effect from the lung to deafness. From the origin, and the common argument for tinnitus and deafness is quite long, and carry on the discussion, can provide help for the clinical practice. The tinnitus and deafness related books refer to something is not right, so it is necessary to chase the source, it can be corrected. In addition, most of the doctors for the etiology and pathogenesis of tinnitus and deafness kidney deficiency to fill the main, but the ancients had made careful tinnitus, deafness bogey with pure complement astringent view, and historical records about tinnitus and deafness health guidance for the prevention and treatment of tinnitus and deafness Have a very good role in combing the literature. The author found some modern textbooks are not discussed or rarely discussed, then some of them were collected. The contents of ancient literatures of tinnitus and deafness can make people more systematic understanding of the disease to avoid Overgeneralization, have implications for clinical practice and theoretical research.

【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R276.1

【参考文献】