张元素脏腑辨证理论及用药特点的研究

发布时间：2017-12-31 05:00

本文关键词：张元素脏腑辨证理论及用药特点的研究　出处：《北京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对张元素生平、著作及所处社会历史背景、个人背景资料进行汇集整理,系统总结并阐释张元素脏腑辨证理论内涵及特色,明晰张元素脏腑辨证理论形成、发展源流,探析张元素学术思想,尤其是脏腑辨证理论及对后世医家学术思想形成与临床遣方用药的指导意义。方法:第一,结合史学研究方法,历史唯物主义认为,物质生活的生产方式决定社会生活、政治生活和精神生活的一般过程,社会存在决定社会意识;张元素在其所处的历史时代所经历的特殊生存环境中,不断发展、形成了独树一帜的医学理论和临床经验,符合时代特征与人民需求。因此,追本溯源,在特定历史环境中研究历史人物及其学术思想尤为重要。第二,采用数据挖掘的方法探析张元素学术理论在临床中的应用。第三,结合实地调研与文献学的研究方法,全面搜集、考证古今相关史料、医籍,综合整理,对资料进行汇总分类,以探究张元素生平、医学理论的形成、特点及对后世医学发展的影响。结果:第一,张元素学术思想的形成,与时代背景、地理背景、学术渊源及个人品质有紧密联系。宋金元时期,战乱频发、疾病流行,人民疲于奔命,内伤病较多;当时医学界抱守残缺、泥古不化,医家不思进取;易州地区药材资源丰富,为诊疗起到支撑作用;张元素本人勤勉踏实、兼容并蓄、追求真理、力主创新;金元时期,医学中兴,百家争鸣,学术交流频繁,流派之间取长补短,有利于张氏学术思想的形成。总之,张元素能取得如此辉煌的学术成就,与其所处的时代背景、地理环境及其良好的个人品质密不可分,值得后人从多方面深入研究和探讨。第二,张元素学术思想对后世影响深远。其学术思想,首传李杲和王好古,李杲又传于罗天益。至明清,私淑张元素、李杲之学的有薛立斋、张介宾、李中梓诸家。之后,赵献可私淑薛立斋,传赵献可之学者,有高鼓峰、吕留良、董废翁诸家。李中梓之学,先传沈朗仲,次传马元仪。马元仪再传尤在泾。张元素学术之传承,以脏腑辨证理论为基础,逐步深入发展,形成了以脾胃学说和肾命学说的为核心的理论体系。第三,脏腑辨证是张元素的主要学术思想,对临床诊治有重要的现实意义。以脏腑辨证为原则,对皮肌炎的脏腑辨证及传变规律和处方用药规律进行探讨,可以将皮肌炎的临床常见证型总结为:脾气虚证、热毒炽盛证、肾阴虚证、肺气虚证和肝阴虚证五类主证,其中脾气虚证所占比例最高(28.82%);进而通过分析,筛选出方剂72首,药物243种,得出了治疗皮肌炎的常用药物、用药模式、用药规则及药物关联的网络化展示图。结论:脏腑辨证是张元素学术思想的核心,张元素作为脏腑辨证理论的集大成者,确立了理法方药完备的脏腑辨证论治体系;同时,脏腑用药是其学术思想的一大特色,补充了脏腑辨证体系,对提高临床疗效起到十分重要的作用;张元素创立易水学派,经代代传承与发挥,逐步完善了脏腑辨证理论,并发展出肾为先天本、脾为后天本的学说,上述种种对中医学的发展起到了巨大的作用。
[Abstract]:Objective: Based on Zhang Yuansu's life, works and social historical background, personal background data collection system, summarize and explain the elements of syndrome differentiation theory connotation and characteristics, a clear elements of syndrome differentiation theory, the origin and development of a element of academic thoughts, especially the viscera theory and on the later doctors academic thought formation prescription and clinical significance. Methods: first, combining the research methods of history, historical materialism believes that the mode of production of material life determines the general process of social life, political life and spiritual life, social existence determines social consciousness; development of special living environment, Zhang Yuansu's experiences in the historical era in the form, become an independent school medical theories and clinical experience, with the characteristics of the times and the needs of the people. Therefore, we in the specific historical environment research The historical figures and their academic thought is particularly important. Second, the application of data mining method in clinical academic Zhang elements. Third research methods, combined with field research and literature comprehensive collection, textual research and related historical materials, medical books, a comprehensive summary of the data collation, classification, in order to explore the elements of Zhang's life and the formation of medical theory, characteristics and influence of medical development. Results: first, to form the elements of academic thought, and the historical background and geographical background, is closely related to the academic origin and personal qualities. Song Jin and Yuan Dynasty, frequent wars, epidemics, people's injury was more constantly on the run, the medical community hold; incomplete, rigid, doctors no; easy abundant medicinal resources area, supporting role in diagnosis and treatment; Zhang Yuansu himself diligently steadfast, the pursuit of truth, for fully inclusive and equitable, Jinyuan period of innovation, Medical ZTE, academic communication, School of contention of a hundred schools of thought, between each other, is conducive to the formation of Zhang's academic thoughts. In a word, Zhang elements can achieve such a brilliant academic achievement, with the background of the times, geographical environment and good personal qualities are inseparable from many aspects, worthy of further research and discussion. The second elements, Zhang the academic thought of far-reaching influence on the later generations. His academic thought, the first Chuan Li Gao and Wang Haogu, Li Gao came to Saul Tianyi. To Ming and Qing Dynasty, study of Chang Li Gaozhi learning elements, Xue Lizhai, Zhang Jiebin, Li under the home. Later, Zhao Xian can be formed from scholars Xue Lizhai, Zhao Xian may have high, for instance Lv Liuliang, Dong Feiweng, Lee under study, the first time Shen Langzhong, Ma Yuanyi. Ma Yuanyi pass you Zaijing. Zhang academic heritage elements, with the Zang Fu theory, gradually into the deep development, formed by the theory of spleen and stomach And the theory of kidney diseases as the core of the theoretical system. In third, Zhang Yuansu's academic thought is the main viscera, it has important practical significance for clinical diagnosis and treatment. The principle of syndrome differentiation, dermatomyositis and viscera transmission rules and prescription drug laws are discussed, the common clinical syndromes of dermatomyositis were summarized as: spleen deficiency syndrome, heat toxin syndrome, kidney yin deficiency, Qi deficiency and liver yin deficiency syndrome five principal syndromes of spleen deficiency syndrome which has the highest proportion (28.82%); and then through the analysis, screening out 72 prescriptions, 243 kinds of drugs, the commonly used drugs, drug treatment of dermatomyositis model, network medication and drug the associated display chart. Conclusion: syndrome differentiation is the core of Zhang Yuansu's academic thought, Zhang Yuansu as a master of syndrome differentiation theory of the viscera prescription on the treatment of complete system; at the same time, the medication is viscera A major feature of his academic thought, added the Zang Fu system, is very important to improve the clinical efficacy; Zhang Yuansu founded Yishui school, with the play from generation to generation, and gradually improve the viscera theory, and the development of the kidney is the congenital and the spleen of the theory, the development of TCM played a huge role.

【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】：R22

【参考文献】