中医“伤寒”应用理论框架的研究

发布时间：2018-03-11 00:02

本文选题：伤寒　切入点：诊断　出处：《辽宁中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：伤寒的应用理论是数千年来,无数医家站在巨人的肩膀上,阅读临床,凝练而成的中医伤寒学方法论,是中医学的临证精华,它并非某个学术理论,也不是某个单纯的辨证体系,它是连接中医理论与中医临证的桥梁。本次研究是运用起源于社会学的“框架”理论将中医学中有关伤寒临证的方法论呈现出来,将中医伤寒学中,那些学术理论具体指导临床辨证的过程,层次性更清晰地展示出来。“框架”理论的形成尚不足半个世纪,因其所涵盖的理论较完整地链接了理论与实践的关系,故近三十年内,其被植入多个学科,用其升华学术理论和指导工作实践。本次研究分为两个主要部分,一是通过文献的梳理,进行概念的界定,二是通过文献中临床经验的归纳和演绎,推导出各概念间的关联性,并构建框架。在对文献的整理中,本次研究采取了时间、空间双向进行的研究方法,以时间维度为轴,梳理出伤寒学发展的历史脉络,以空间维度为轴,整理出中医诊疗伤寒的共性理论和个性化经验。通过研究,伤寒应用理论的形成发展大致可分为三个主要的历史阶段:一为奠基期,在这个阶段,《五十二病方》、《黄帝内经》、《黄帝八十一难经》三书奠定了学术基础,从疾病范围、发病条件、发病机理、治则治法等多个概念进行了详细的理论阐述,但各概念之间关系较割裂,并没有规律的联系。二为形成期,《伤寒杂病论》一书承先人之精华,合临证之诣要,将前人之临床经验进行较系统、较完整的理论升华,形成六经辨证体系,其中潜藏之辨证论治之理,成为了伤寒应用理论框架的核心价值,其所蕴含的病邪传变之机要,诠释了伤寒所独有的方法论特点,另,华佗之六部三法、巢元方这症候辨治等都在理论向临床的过渡上,起到了重要的推动作用,成不朽之伟业。三为发展期,自秦汉至明清,伤寒之发展寻源而有序,自《黄帝内经》奠定了学术之基调,《伤寒杂病论》树立了临证之标尺,后世诸医家均以此两部经典为治学之圭臬,晋代王叔和考天地气候之短长,立以气候条件参考治疗之法,后世庞安时等医家遂从之。唐代孙思邈深谙人体生、长、化、收、藏的生命特点,据患者所处的生理阶段进行治疗方案的确立,并着重养生之道,重论日常饮食、房室禁忌,病后调护等养生之法,以助针药治疗伤寒。宋代诸医家创“证候”之说,以阴阳、表里、寒热、虚实八个纲目进行相应的病机分析,将伤寒之不同阶段以证候之词一而统之。证候的出现对中医学治法的甄选有着革命性的作用,据证候立治法的论治方法已被延用至今。时至宋后,中医界百家争鸣,金元四有,温病一派接踵而至,虽其所专不为伤寒,但其于伤寒的造诣可见一斑,刘完素越宋而追古,崇病机,创立了一套以遏止病机为主的治疗方法,李东垣、朱丹溪追同药王孙思邈,以体质论为主,从体质特点作为用药的主要参考因素,张子和重视病位,提出了以法为先的治疗思路,柯韵伯提出六经横纵论,单以病位罗列治法的治疗思路,又如王好古、敖氏等将脏腑辨证参入伤寒的诊疗当中等等。时至清末,伤寒之诊疗方式众多,但皆不出《伤寒杂病论》六经辨证之大纲,中医伤寒学形成了一套以脉症、病机为核心,传变、病位为主要特点的应用理论框架。
[Abstract]:The application of the theory of typhoid fever is thousands of years, countless doctors standing on the shoulders of giants, reading on clinical, a concise method of traditional Chinese medicine and typhoid fever, is the traditional Chinese medicine clinical essence, it is not an academic theory, nor is it a simple dialectical system, it is connected with TCM theory and clinic for the bridge. This study is the use of origin in sociology "framework" theory in traditional Chinese medicine on typhoid clinical methodology presented, TCM febrile disease, the academic theory of specific guidance for clinical diagnosis, level more clearly displayed. "Frame" theory is still insufficient for half a century, because it covers the theory of a complete link between theory and practice, so in the past thirty years, the implantation of multiple disciplines, the sublimation of academic theory and guide practice. This research is divided into two main parts, one is Through literature review, the definition of the concept, two is through the clinical experience in the literature induction and deduction, derived the relevance between concepts, and building the framework. In the literature, this research adopts the research method of space time, two-way, taking the time dimension to the shaft, comb the history of the development of typhoid fever, with the space dimension axis, sorting out the TCM diagnosis and treatment of typhoid fever and common theories and personalized experience. Through the research, the formation of application of the theory of typhoid development can be roughly divided into three main stages: one is the foundation period, at this stage, < fifty-two > < Huangdi's internal disease. The < >, eighty-one > 3 Nanjing emperor laid the academic basis, from the range of disease, disease conditions, pathogenesis, therapeutic methods and many other concepts are described with the theory, but the relationship between the concepts is fragmented, there is no law of the contact. The formation period, "Shanghanzabinglun" a Book of the ancestors of the essence of combined clinical go to clinical experience, previous systematic, complete theoretical sublimation, the formation of the system of the six, including the treatment of hidden dialectical reason, has become the core value of the theoretical framework of the application value of typhoid fever, the confidential contains the pathogen, interpretation of the unique characteristics of the method of typhoid fever, on the other, six of Hua Tuozhi's three law, the symptoms are in the treatment of pharmaceutical research to clinical transition, has played an important role in promoting, become immortal. Albert three development period, from the Qin and Han Dynasty to the Ming and Qing Dynasties. The search for the source of development of typhoid and orderly, since < Neijing lays > academic tone, < Shanghanzabinglun > set scale near card later, the doctors are taking two classic as research model, the Jin Dynasty Wang Shuhe admitted in the world long climate, climate reference therapy, later When the doctors then from Ann Pang. Sun Simiao of the Tang Dynasty, well versed in human life, and life, characteristics of reservoir, according to the established physiological stage patients of the treatment plan, and focus on heavy diet, a way of keeping good health, AV taboo, nursing and other health law after the disease, in order to help the acupuncture and medicine treatment in the Song Dynasty. The doctors "typhoid fever syndrome", on the table, cold and heat, deficiency of yin and Yang, eight class analysis pathogenesis of the different syndromes of typhoid in word and the EC. There syndromes of traditional Chinese medicine treatment on the selection of a revolutionary role, according to stand on the treatment of syndrome treatment methods have been used so far. Even after Song Dynasty, traditional Chinese medicine have a febrile disease Jinyuan, contention of a hundred schools of thought, sent followed, although its not designed for typhoid, but its remarkable attainments in typhoid fever, the Song Dynasty and ancient Liu Wansu's chase, Chong pathogenesis, created a set of to prevent disease the treatment of machines. Li Dongyuan, Zhu Danxi, chase with Sun Simiao manual, mainly from the theory of constitution, constitutional characteristics as the main factor influencing medication, Zhang Zi disease and attention, put forward ideas for the treatment of Ephraim, Ke Yunbo proposed six on the cross, to disease treatment and treatment list of ideas, such as Wang Haogu, Ao Shi the diagnosis and treatment of viscera and incorporation of typhoid fever and so on. At the end of the Qing Dynasty, many of the diagnosis and treatment of typhoid, but they are not < Shanghanzabinglun > Outline six, TCM febrile disease formed a set of symptoms, pathogenesis as the core, transmission, application of the theoretical framework for the main features of the disease.

【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R222.2

【相似文献】