水肿的古代文献研究与学术源流探讨

发布时间：2017-12-30 18:10

  本文关键词：水肿的古代文献研究与学术源流探讨　出处：《北京中医药大学》2016年博士论文　论文类型：学位论文

  更多相关文章： 辨证 病因 病机 文献研究 水肿 治疗

【摘要】：目的水肿是临床常见病证。中医学对水肿的认识有悠久的历史,对水肿的治疗有优势与特色。水肿理论发展至今,一方面,概念的内涵难免变迁,而一些治法方药亦可埋没；另一方面,建国以后,中医学对水肿的研究主要有专著、学位论文、期刊文献的形式,或因篇幅所限,失之全面；或为文献汇编,缺乏分析；或从理法方药横向研究。因此系统地整理水肿的古代文献,梳理水肿的学术源流,对于理论和实践均有重要的意义。方法本文运用文献学、逻辑学等方法,对水肿古代文献进行研究。其具体方法为：①机检与手检相结合收集资料。利用《中华医典》初步筛选相关资料,结合《中国中医古籍总目》与《中医文献学》,确定最终选用的医籍及版本。以此来获取古代文献。现代文献：主要指国内外于1949-2014年间公开发表的中医药学位论文、期刊文献、会议文献。通过机检中国生物医学文献数据库、中国中医药期刊文献数据库获取题录,之后通过相关期刊论文全文下载的方式获得文献。②按不同历史时期对资料进行汇总,并按病因、病机、治疗、预后等分类。③采用纵横比较的方法,对于同一历史时期的资料,结合当时医学发展概况对相关资料进行横向比较,理清不同医家之间学术观点的异同,整理总结出这一时期中医学对水肿的总体认识和各个医家的学术特点；再将不同时期、不同医家纵向比较,理出历代医家在学术观点上的继承和发展,从而得出中医对水肿认识发展的脉络。结果本文分为九节。第一节介绍了水肿的定义、范围,并对相关病名进行概述。第二节至第八节,是本文的主要部分。以历史发展为主线,以断代史的方法,分将水肿发展史分为七个时期：先秦两汉、三国魏晋南北朝、隋唐五代、两宋、金元、明、清。通过各时期医家及主要医学著作中对水肿的记载,从病名、病因、病机、诊断、治疗和方面来概括其学术发展情况。通过以上研究,第九节则提出了一些相关问题,并进行了初步探讨。结论①首次全面系统地整理了水肿的古代文献。按水肿的学术发展进程,将历史划分为七个不同的发展阶段：先秦两汉、三国魏晋南北朝、隋唐五代、两宋、金元、明、清。先秦两汉是水肿理论发展的创始期,《黄帝内经》对水肿病因、病机、治疗、预防的认识,为后世的研究奠定了基础；汉代张仲景《金匮要略》的杂病脏腑辨证为后世水肿辨治的理法方药奠定了法度。三国魏晋南北朝时期对水肿的认识主要体现在诊断学和针灸学方面,代表作是《脉经》和《针灸甲乙经》,另有大量方书,存世不多,可从《肘后备急方》与《小品方》中窥见一斑。隋唐时期主要是文献的收集和整理,《诸病源候论》详于证候的记载和病机的阐发,孙氏二书及《外台秘要》在论述病因病机时均引录《病源》,收录前代方药。两宋时期,北宋时大型官修方书收集与整理文献资料,而南宋则在此基础上由博返约,突出体现在水肿的阴阳分类上。金元时期,学术争鸣,刘完素对湿热进行阐述,张从正对汗吐下法重新认识,朱丹溪提出的有关水肿病机、治疗方面的理论得到了后世医家的广泛认同。明代,水肿辨证论治体系基本确立,并在前代的基础上,有所提升和发挥。清代是水肿辨治理论更为成熟与完善的阶段,医家从各个方面对水肿理论予以补充。②对水肿分类、水肿与痰饮的鉴别、汗法治疗水肿、肾气丸考等理论进行探讨。通过对历代医书中水肿归属及水肿分类的总结,水肿是一个病因病机复杂,多脏腑相关的疾病,将其简单分入肾系疾病下是不全面的,将其作为气血津液病更为合理。痰饮与水肿均是水液代谢异常、在体内停聚为患的疾病；临床有相似之处,且易相兼发生,故相辨别。汗法是八法之一,应用广泛,现将其治疗水肿专题以述。肾气丸始载于《金匮要略》,初不为水肿所设,至薛己、赵献可、张景岳始治水肿,现辨此源流。
[Abstract]:The purpose of edema is a common clinical disease. The TCM understanding of edema has a long history, treatment of edema have advantages and characteristics. The theory of edema development so far, on the one hand, the connotation of the concept of inevitable change, and some herbs can also be buried; the other hand, after the study of the traditional Chinese medicine mainly edema there are books, theses, journals, or because of the limited space, not comprehensive; or for documentation, or the lack of analysis; cross-sectional study in prescription. Therefore systematic edema of the ancient literature, the academic research on the origin and development of edema, to have important theoretical and practical significance of this method. By using literature, logic and other methods to study the edema ancient literatures. The specific methods are: machine inspection and manual inspection combined to collect data. Using the data related to the preliminary screening of traditional Chinese medicine combined with < >, < Chinese ancient Chinese medicine total Order "and" Chinese Literature ", medical books and determine the final selection version. In order to obtain the ancient literature. Modern literature mainly refers to both at home and abroad in 1949-2014 years published medical dissertations, journal articles, conference papers. Check through the machine China biomedical literature database, China medicine journal literature database acquisition bibliography get through the way of literature, after downloading Chinese full-text periodicals database. According to the different historical periods of data were collected, and according to the etiology, pathogenesis, treatment, prognosis and classification. The method of comparison, for the same period, combined with the medical development compared to the related data, to clarify the similarities and differences between different physicians between the academic point of view, we summarize this period of Chinese medicine overall cognition and various physicians on the edema of the academic characteristic of the time period, Different doctors in the longitudinal comparison, a medical history of inheritance and development in the academic view, so that the traditional Chinese medicine on the understanding of the context of development. Edema results in this paper is divided into nine sections. The first section introduces the definition of the scope of edema, and an overview of the related problems. The second section to the eighth section is the main part of this paper. Based on the historical development as the main line, with the method of the dynastic history, the history of the development of edema is divided into seven periods: Pre Qin Dynasty and Han Dynasty, the Wei Jin Southern and Northern Dynasties, Sui and Tang Dynasty and Five Dynasties, two song, Jin, Ming and Qing period. The doctors and medical writings on water swelling records, from the name of disease, etiology the pathogenesis, diagnosis, treatment, and to summarize its academic development. Through the above research, the ninth section proposes some relevant issues and discussed. Conclusion the first comprehensive collation of ancient literature. According to the academic development of edema and swelling of the water, The history is divided into seven stages: the pre Qin Dynasty and Han Dynasty, the Wei Jin Southern and Northern Dynasties, Sui and Tang Dynasty and Five Dynasties, two song, Jin, Ming and Qing. Qin and Han Dynasty is a founding period of edema in the development of the theory, "Huangdi Neijing > on the etiology, pathogenesis, treatment and prevention awareness, laid the foundation for later on; Zhang Zhongjing of the Han Dynasty" Jinkui yaolue > viscera and laid the testimonies for miscellaneous prescription in treating edema. The three generations of the Wei and Jin Dynasties of edema is mainly reflected in the field of diagnostics and acupuncture, is representative of the < > and < > zhenjiujiayijing, while a large number of books. There is not much, can get a glimpse from the "zhouhoubeijifang > and < >. Prescriptions in the Sui and Tang Dynasties is mainly literature collection and collation, analysis based on detailed records < and > syndrome pathogenesis, sun Shier books and" waitai miyao "in the discussion of etiology and pathogenesis are quotation < > source The previous generation, included prescription. The two Song period, when the Northern Song Dynasty, Xiufang book collection and collation of large documents, and on the basis of the Southern Song Dynasty embodied in Yin and Yang from abundance back to limitation, the classification of edema. The Jin and Yuan Dynasties, academic contend, Liu Wansu elaborates on Zhang Congzheng on the damp heat, sweat vomit purgation reconsidered, related to edema Zhu Danxi's disease treatment, the theory has been widely recognized by later generations. In Ming Dynasty, edema syndrome differentiation system is established, and on the basis of former generations, to improve and play. The Qing Dynasty is edema differentiation theory more mature and perfect stage, doctors from the aspects of edema theory to be added. The classification of edema, edema and differentiation of phlegm, perspiration treating edema of Shenqi Pill test theory. Based on the classification and classification of edema edema in the summary of previous books, edema is a complex etiology and pathogenesis, Many viscera related diseases, will be divided into the simple kidney disease is not comprehensive, as a disease of Qi blood and body fluid is more reasonable. Phlegm and edema are water metabolism abnormal, stop poly diseases in vivo; clinical similarities, and easy combination, so the phase discrimination. Sweating method is widely used, one of the eight methods, the treatment of edema in the subject. Shenqi Pill was contained in the "Golden Chamber", the beginning is not set to edema, Xue Ji, Zhao Xian, Zhang Jingyue began to treat edema, is this differentiation origin.

【学位授予单位】：北京中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R256.51
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本文编号：1355860