象思维在失眠诊疗中的应用初探

发布时间：2018-01-06 17:25

本文关键词：象思维在失眠诊疗中的应用初探　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】：背景认知科学正在发生一场具身性革命的思潮,诸多的理论和实验已经论证了身体与心智、主体与客体、感性与理性的统一性。象思维被认为是中医的特征性思维,关于象思维在中医中的应用研究涉及到哲学、语言和思维框架等角度,其研究内容覆盖了大部分中医学领域,并出现了一些跨学科研究和创新诊疗方法。失眠是最常见的心身疾病。中医对失眠的认识角度多样,治法不同,但疗效肯定,主要有内服法、外治法和行为与心理疗法。低阻抗意念导入法(TIP)是源自中医心理学的创新疗法,在失眠的治疗上可以不借助药物等理化手段,起效迅速、疗效确切、持久,已经形成一套规范的诊疗体系。笔者从自己的临床实际出发,围绕象思维的临床与应用,从失眠的诊疗着手,采用文献研究和质性研究的方法,旨在尝试初步探索象思维的存在方式(即象思维认识事物的方式方法、影响因素,和对人体的反作用),其形成和发展的原因,及其同心身疾病的关系,以解释TIP疗法的原理,以及中医不同诊治法都能够起效的原因。理论研究象思维是在心身一元、物我一体的哲学思想指导下,从表象出发,运用表象的自我运动进行认识活动及其他思维操作,并以从根本上基于身体感觉的概念形式来进行表述的思维方法。在农业生产生活方式、汉语的思维习惯和大一统的意识形态的影响下,具有系统性的象思维得以充分发展和巩固,并成为中国人认识事物的核心方法。从临床应用角度划分,中医象思维包含了意象思维和具象思维两个方面,即身体参与思维和思维领导身体两个方面,认知在这种身体与环境的互动中逐渐发展起来,身体也在被认知塑造着,二者组成了一个动态的过程。心身一元、形神合一是中医的指导思想之一,与心身医学一样,中医也将所有的疾病视为心身问题,并描述为气血的逆乱。情志由心主宰,出于五脏,对气血有直接的作用,因此能够直接影响五脏功能。五脏的正常功能有其特定的运动方向,因此,诊断就是根据种种表象,是找出能够带来这些气血变化的因素,并根据一定的系统进行判断,包括经络、六经、五脏、气血等;而"治之要"在"极于一",找到神层面的病因,对因治疗。中医治疗的方法形式上虽然不同,但原理都是通过调理气血,使之恢复平衡。诊断过程属于意象思维,是象思维的理性认识,由表象的概括、判断、确证、深化而得到。高层次的具象思维能够实现意识改变感知觉的作用,因此可以利用这一点提高治疗的效果。质性研究目的:探索中医心理学对失眠的诊疗特色和取效原因,以为中医理论和实践的创新提供更细微的见解。核心问题:失眠的中医心理诊疗是如何应用象思维的?具体问题:患者对于失眠都有哪些体验和认识?它们是如何形成的?与失眠有什么关系?有什么因素对这些过程造成了影响?TIP为什么能够获得疗效?对象与方法:研究者在广安门医院心理科、睡眠医学专题门诊以及北京广安中医心理研究院进行观察、基于WIIQ的访谈和案例分析的质性研究,研究对象须是采用TIP睡眠调控技术治疗失眠的患者,并曾经寻求过其他治疗方法,包括西药、中药和针灸;入选者均精神、记忆能力正常;有完整的汉语表达能力并且自愿参与本研究。研究者会对转录后的资料和现场观察笔记用Atlas.ti进行编码和质性分析,即在全面把握这些资料的基础上,找出对失眠形成有意义的部分进行编码,从中引申和归纳出一系列分类和主题,并且就其关键环节的表述开展精密的解析分析,建立理论框架,最终回到患者处进行验证。结果:知识、期待、压抑(愤怒)、焦虑、创伤感、恐怖、控制是失眠患者所表述的共同主题。象思维是一种基于体验的思维方式,具有接近、导致、反映事物的本质的能力。然而,受种种主客观因素的影响,表象在接近和导致事物的本质过程中也会不同程度地偏离事物的本质。与此同时,象思维对身体有能动作用,这是心身疾病的来源。象思维能即刻产生生理效应,但可视、可感的症状可能会延迟出现,因为存在压抑和屏蔽作用。结论:重视和利用感觉,是TIP疗法成功治疗失眠等心身疾病的关键。
[Abstract]:The background of cognitive science is a body of revolution thoughts, theories and experiments have demonstrated many of the body and mind, subject and object, the unity of emotional and rational thinking. As is regarded as a characteristic of thinking of traditional Chinese medicine, on the application of image thinking in Chinese traditional medicine research involves philosophy, language and the thinking frame of point of view, its research content covers most of the field of Chinese medicine, and there have been some interdisciplinary research and innovative treatment methods. Insomnia is the most common psychosomatic disease. Understanding TCM for insomnia treatment varied, different, but curative effect, mainly oral administration, external treatment and behavioral and psychological therapy. Low impedance ideas into method (TIP) is an innovative therapy from the psychology of TCM, in the treatment of insomnia can means without the use of drugs such as quick and effective, durable, has formed a set of standardized treatment. Department. The author from his own clinical practice, clinical application and thinking around like, starting from the diagnosis and treatment of insomnia, using literature research and qualitative research methods, attempts to explore the existence way of thinking (that is, like, thinking way and influencing factors on human body reaction) and the formation and development of the cause of disease, and its relationship to explain the concentric body, the principle of TIP therapy, traditional Chinese medicine and different treatment methods are able to effect the reason. The theoretical research on image thinking in a mental element, were I one philosophy under the guidance, from the appearance of the self motion imagery of understanding other activities and thinking, and based on the fundamental concept in the form of feeling to express the thinking method. In the agricultural production and life style, influence the ideology of Chinese thinking habits and the unification, has The system of image thinking can be fully developed and consolidated, and become the core method of understanding things. Chinese divided from the aspect of clinical application of traditional Chinese medicine, like thinking includes two aspects: image thinking and concrete thinking, the body in the two aspects of thinking and thinking of leadership body, cognition develops gradually in the interaction between body and environment in the body are also cognitive shaped, two formed a dynamic process. A psychosomatic element of one spirit, is one of the guiding ideology of Chinese medicine, Chinese medicine and psychosomatic medicine, also all diseases as psychosomatic problems, and described as disorder of Qi and blood. The emotional heart dominate out of the five internal organs, has a direct role in the blood, so it can directly affect the normal function of the five zang viscera function. The direction of movement, therefore, the diagnosis is according to various images, is to find out these can bring the change of Qi and blood Factors and judging according to certain system includes six meridians, Qi and blood, organs, etc.; and the "rule" in the "on", to find the cause of God level, due to the treatment method of Chinese medicine treatment on the form. Although different, but the principle is through regulating qi and blood, so as to restore the balance. The diagnosis process belongs to the image thinking, image thinking is the rational understanding of representation by summary judgment, confirmation, and deepening. Concrete thinking high level can realize the change of consciousness of perception, so we can use this to improve the treatment effect. The purpose of qualitative research: to explore the characteristics of diagnosis and treatment of insomnia in TCM psychology the reason and effect, thought innovation theory and practice of Chinese medicine to provide more subtle insights. The core problem: TCM psychological diagnosis and treatment to insomnia is how to use image thinking? What are the specific problems with experience and understanding of them is like insomnia? What form? What is the relationship with insomnia? What are the factors affecting the process? TIP why can obtain curative effect? Objects and methods: researchers in the psychology department of Guanganmen hospital, Beijing special out-patient and sleep medicine of Guang'an traditional Chinese Medicine Institute of mental observation, qualitative research interviews and case analysis based on WIIQ. The object of study is to use TIP sleep regulating technique in the treatment of insomnia patients, and have sought other treatments, including western medicine, Chinese medicine and acupuncture; subjects had spirit, memory ability is normal; Han language complete expression ability and willingness to participate in this study. The researchers of post transcriptional data and field observations with notes Atlas.ti analysis of encoding and qualitative, which is based on a comprehensive understanding of the data, find out the insomnia form meaningful part in extension and encoding, summed up a series of points And theme, and carry out the analysis precision of the analysis of the key expression, the establishment of theoretical framework, finally returned to the patient tested. Results: knowledge, expectations, depression, anxiety (anger), a sad, terror, control is a common theme of insomnia patients expressed. Like thinking is a kind of experience the way of thinking, based on close, which reflect the nature of things. However, affected by various subjective and objective factors, and lead to close representation in the essence of things will vary from things. At the same time, like thinking of the dynamic role of the body, and this is a source of psychosomatic diseases like. Thinking can instantly produce physiological effects, but the visual sense, the symptoms may be delayed, because of the presence of depression and shielding effect. Conclusion: the attention and use feeling, is the key to successful treatment of TIP therapy of psychosomatic diseases such as insomnia.

【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】：R256.23

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