唐代及唐代以前合穴适宜病症的文献研究

发布时间：2018-06-17 08:35

本文选题：五腧穴 + 合穴　；参考：《广州中医药大学》2016年博士论文

【摘要】：目的：本文对唐代及唐代以前的针灸文献,通过统计主治病症对应合穴的频次,对比合穴与下合穴、合穴与原穴主治的异同,以探求合穴总体的治疗病症规律以及单个合穴的主治特点,从而为建立合穴适宜病症谱及临床应用与科研提供文献及理论基础。方法：一、源文献选择在《中国中医古籍总目》、《宋以前医籍考》、《中国医籍通考》书籍中查找唐代及以前的针灸类、医经类、内科、外科、妇科、产科、儿科类,对52部可能涉及合穴的医籍按标准筛选,最终选定：《黄帝内经》、《针灸甲乙经》、《难经》、《黄帝内经太素》、《千金要方》、《千金翼方》和《外台秘要》共七部医籍。二、版本选择中医博大精深,古籍数目汗牛充栋。但因编辑、传抄、刻版、增删、修改和刻写的文字大小、版面阔狭、印刷粗精及排版或装订的各种形式不同,同一本书籍就会产生不同版本。因此,本研究参考知名针灸文献研究员著作,鉴定上述医籍的版本,制作版本源流图,选择经现代学者精选底本校正、较接近原书本来面目之版本作为源文献。三、各医籍所载合穴定位法和取穴法对比进行腧穴主治归纳必须建立在各医籍腧穴相同的基础上,即建立在各医籍中所研究腧穴的定位和取穴法必须一致的基础上,否则极易导致张冠李戴的现象。因此,在检索分析之间,首先有必要考证各医籍的定位方法和取穴方法。四、文献检索策略在《中华医典》中运用计算机检索后配合人工检索上述所选典籍,分别以十二合穴、手三阳经原穴和十二原穴的名称及别名逐条搜索全文,并按标准筛选条文。五、数据标准化和数据库建立建立标准数据库前对病名进行规范化,将穴名、文献来源、病症、疾病类属、病位、刺灸法、定位等六项内容利用Microsoft Access建立资料数据库。六、分析结果采用归类分析、归纳演绎、传统阐释、相关对比等方法对合穴适宜病症进行分析。结果：一、版本的选择七部医籍对应较佳版本分别为：《素问》传本中明顾从德翻刻宋本较接近宋刊本,校勘质量较佳。《灵枢经》传本中以赵府居敬堂本流传最广,制作较佳。《难经》以注本流传,较好的版本有二,一是《难经集注》,二是《难经本义》。前者以“庆安本”为佳。后者以“医统正脉本”为佳。现存《甲乙经》为医籍中传世版本较差的医籍,相对而言“六经本”年代最早。《太素》“仁和寺本”为现存各个刊本的唯一祖本,文献价值最高。《孙真人千金方》未经北宋校正医书局校正的《千金要方》古本,研究价值极大。《千金翼方》的“元大德刊本“是现存最早的复刊本,为宋版最佳翻刻本。《外台秘要方》最佳版本为日本敬嘉堂的南宋刻本。二、各医籍合穴定位法和取穴法对比七部医籍中十二合定位与现代临床不同的有曲泽穴、尺泽穴。其余诸穴基本相近。七部医籍中同一合穴在不同医籍中的定位及取穴方法基本一致,排除了此六部医籍中合穴出现“同名异穴”的可能性。三、各医籍的关系所选文献中,年代较晚的医籍常大量引录较早的医籍。《内经》和《明堂经》是腧穴理论的来源,后者现已散佚,但被《甲乙经》大量的收录。《千金要方》腧穴主治多引录自《甲乙经》和《内经》,而《千金翼方》又大量引录《千金要方》,《外台秘要卷39》引自《甲乙经》,散在其他各卷腧穴主治大多来自《千金翼方》。四、十二合穴统计结果唐代及唐代以前的医籍中,合穴主治病症98种。出现频次最高者为癫病,有七个合穴可治疗,涉及手、足、阴经、阳经,因此合穴可普遍治疗癫病。频次为五个及以上的病症有腹痛、头痛、癫、腹胀、善惊、呕、寒热、狂、阴痛九个病症,其中三个脾系病,足三里穴同时出现在三个病症中,可见合穴擅长治疗消化系统疾病,足三里尤甚。可治疗“逆气而泄”的仅有尺泽和足三里。五、单个合穴统计结果尺泽主治肺病及本经病之外,还可疗心痛、疝瘕、唾血、癫、呕、泄、哕。曲泽穴主治心病及本经病。少海穴的主要治疗病症为齿痛、狂、臂疼、腋下瘰疬等。小海穴主治头痛、癫痫、寒热、疟等疾。天井穴主治胸痹心痛,上肢痹、痿等疾。曲池穴主治本经病及风邪相关疾病。阴陵泉、阴谷、曲泉穴主治本脏和本经病症。委中穴主治本腑和本经疾病。阳陵泉穴可疗本腑、相表里脏和本经疾患。足三里可疗本脏、本腑、大肠腑、小肠腑和胃经的病症。六、合穴和手三阳经下合穴对比上巨虚穴治疗病症主要集中在脾胃系统,肺系统和肢体经络类的疾病,即脏腑病症兼经络病均可疗。下巨虚穴较多治疗肢体经脉类、脾胃系类、肺系类、肝系及心系疾病。委阳穴治疗肾系病、肛门病和肢体经络疾病。七、合穴和原穴对比太渊穴主要治疗肺系病和肢体经络病,其中咳嗽、肺胀满、喘属于肺脏疾病,胸痹、胸痛、肘臂痛属于经脉所过,亦可疗五官疾病。合谷穴主要治疗上肢痿、上肢痹、头面五官疾病,为大肠经经脉所过之病症。亦可疗大肠腑病如肠鸣。太白穴多治疗脾脏病,脾脏虚实之证、脾经所过治病均可治疗。冲阳穴主要治疗胃经所过之病。其中头痛、牙痛、面浮肿、足痹、痿及口僻等均属于胃经疾患。可见神门穴主要治疗本脏疾患,兼本经疾病。腕骨穴主要治疗小肠经所过之处疾患及与风邪相关疾病。太溪穴对肾系病、心系病、肺系病及脾系病均有治疗作用,可疗五脏疾病。京骨穴多治疗膀胱经所过之处病症。大陵穴既可治心脏疾病和本经所过疾病。太冲穴对肝脏病和肝经病均可疗。丘墟穴主治胆经所过之处疾患。结论：自《内经》《难经》提出合穴主治“病在府”“逆气而泄”和“病在胃及以饮食不节得病者”后,历来对其理解有所争论,本研究通过对唐代及唐代前的合穴相关医籍进行分析,发现其中“病在府者治其合”应解为治疗六腑疾病的是下合穴。并不是所有合穴均可治疗“逆气而泄”,主要是指尺泽穴和足三里穴。并非所有合穴均可治疗脾胃系统疾病,手三阳经合穴大多不治疗消化系统疾病。此外合穴总体的主治病症有98种之多,癫疾排首位。从下合穴和原穴的主治分析得出：在唐代及唐代以前手三阳经之合穴较少治疗腑病,偏重肢体经脉疾病、心系和肺系疾病。而小肠、大肠和三焦下合于足阳经的委阳穴、上巨虚穴和下巨虚穴则擅长治疗本腑疾病,兼治本经之经脉所过疾患。可见,从在唐代及唐代以前医籍的分析来看,“病在府者治其合”之“合”当理解为下合穴更佳。原穴作为元气经过、留止的部位,侧重脏病。阴经的原穴治疗脏病和本经疾患,六阳经原穴多治疗本经病症。
[Abstract]:Objective: To investigate the frequency of acupuncture and moxibustion before the Tang Dynasty and the Tang Dynasty, compare the similarities and differences between the combined acupoint and the Xiuhe acupoint and the main points of the original acupoint by the statistics and treatment of the corresponding acupoints of the corresponding acupoints, in order to find out the rules of the general treatment of the acupoints and the main characteristics of the single acupoints, so as to provide the suitable disease spectrum, clinical application and scientific research for the construction of the acupoint. Literature and theoretical basis. Methods: first, the source literature selection in the Chinese traditional Chinese medicine ancient books, "song before medical examination", < Chinese medical examination > book examination books in the Tang Dynasty and the previous acupuncture, medicine, medicine, surgery, gynecology, obstetrics, paediatrics, 52 may involve the medical records of acupoints, the final selection: < Huangdi Neijing >, < needle. Moxibustion, moxibustion, "Jing", "Huangdi", "Huangdi", "Qianjin", "thousand gold", "thousand gold wing Fang >" and "outer platform secret", are seven medical books. Two, the version selection of Chinese medicine is extensive and profound, and the number of ancient books is abundant. But the size of editing, copying, engraving, adding and deletions, the size of the revised and inscribed text, the width of the layout, the printing rough and the various forms of typesetting or binding are different. A book will produce different versions. Therefore, this study, referring to the works of well-known acupuncture literature researchers, identifies the editions of the medical records, the source flow chart of the editions, and the selection of the original edition of the modern scholar, which is closer to the original version of the original book as the source literature. Three, the acupoint location method and the acupoint method carried on the medical books are compared to the acupoints. The main treatment induction must be based on the same basis of the acupoints of various medical books, that is, on the basis of the location of acupoints and the method of taking acupoints in the medical records, which is very easy to lead to the phenomenon of the opening of the acupoints. Therefore, in the search and analysis, it is necessary to test the location method and the method of taking acupoints of the medical records first. Four, the literature retrieval strategy. After the use of computer retrieval in the Chinese medical code, the selected classics were searched by computer, and the names and names of the original points and the twelve original points were searched for the full text by twelve points, the names of the original points and the twelve original points were searched separately. Five, the standard database was established to standardize the name of the disease before setting up the standard database. Source, disease, disease class, disease, location, pricking and moxibustion, location and other six items to use Microsoft Access to establish data database. Six, the analysis results are classified analysis, induction, traditional interpretation, correlation and other methods to analyze the suitable disease of acupoints. Results: 1, the version of the selection of seven medical versions of the better versions are: < In the transmission book, the song edition is closer to the song edition than the song edition, and the quality of the collation is better. The existing < Jia a Jing > as a medical book of poor medical records in medical books is the earliest. < Tai Su > "benevolence and monastery" is the only grandparent of the existing publications. The value of the literature is the highest. "Yuan dad publication" is the earliest extant copy book, the best edition for the song edition. The best version of the "outer table" is the Southern Song of the Southern Song Dynasty. Two, the location method and the acupoint method of the medical books are compared with the seven medical books, which are different from the modern clinic. The other points are basically similar. In the seven medical books, the other points are similar. The location of the same acupoint in the different medical records and the method of taking acupoints are basically the same, excluding the possibility of "the same name different points" in the six medical books. Three, in the literature selected by the medical records, the later medical books often lead to the earlier medical records. The < Jing > and the Ming Tang Jing are the sources of the theory of acupoints, the latter has been lost, but the latter has been lost. < Jia Jing > a large number of records. < thousand gold prescription > the main treatment of acupoints is recorded from < Jia b > and < inner Sutra >, and < Qianjin wing recipe > a large number of quotes of Qianjin prescription >, "outer platform constipation 39>" is introduced from < Jia Yi Jing >, mostly from < thousand gold wing prescription >. Four, twelve acupoints statistics result in Tang and Tang Dynasty medical books, in the medical records of the Tang Dynasty, to the acupoints There are 98 kinds of disease. The highest frequency is epilepsy, and seven acupoints can be treated. It involves hand, foot, Yin meridian and Yang Meridian. Therefore, it is common to treat epilepsy. There are five or more cases with abdominal pain, headache, epilepsy, abdominal distention, nine symptoms of good shock, vomiting, cold and fever, and negative pain, of which three spleen diseases and the three ailments at the Zusanli point simultaneously. In the treatment of digestive diseases, it is very good for the treatment of digestive diseases. The only ulnar and Zusanli can be used to treat "anti gas and vent". Five, single acupoint statistics result in the main treatment of lung disease and the meridian disease. Pain, madness, arm pain, axillary struter and so on. Xiao Hai acupoint mainly treats headache, epilepsy, cold and fever, malaria and other diseases. Tianjing point is the main treatment for chest pain and heart pain, upper limb arthralgia, impotence and other diseases. The main treatment of this disease and wind pathogenic diseases. Yin mausoleum, Yin Valley, Qu Quan points to treat the dirty and the disease. The disease of Zusanli can treat the dirty, the Zang Fu, the large intestine, the small intestine and the stomach. Six, the combination of the acupoints and the three Yang meridian points is mainly concentrated in the spleen and stomach system, the lung system and the meridian diseases of the limb and collaterals, that is, the viscera disease and the meridian disease can be treated. Class, lung, liver and heart disease. The treatment of kidney disease, anal disease and extremity meridian disease. Seven, acupoint and original point Taiyuan acupoint mainly treatment of lung disease and limb meridian disease, including cough, lung fullness, lung disease, chest pain, chest pain, elbow arm pain, may also treat five diseases. Hegu acupoint is the main treatment. Limb flaccid, upper limb arthralgia and five diseases of the head and face, it is the disease of the large intestine through meridians. It can also treat the disease of the large intestine, such as the bowel disease. It can treat spleen disease, spleen deficiency and real syndrome, spleen meridian treatment can be treated. The main treatment of the disease of the stomach meridian is Chong Yang point. The main treatment of the disease. The main treatment of the disease. The carpal point is mainly to treat the diseases of the small intestine and the disease related to the wind. The point of the Tai Xi point has the therapeutic effect on the kidney disease, the heart system, the lung system and the spleen system. It can treat the diseases of the five zang organs. The disease. It can treat the liver disease and the liver meridian disease. Qiu Xu point is the main treatment of the disease of the bile. Conclusion: since the "inner meridian >" > < difficult menstruate > the main treatment of the disease in the house, "the disease is in the stomach and the diet is not diseased person". According to the analysis of the related medical records of the acupoints, it is found that the "disease in the government" should be solved for the treatment of the disease of the six Fu organs. Not all the acupoints can treat the "retrograde Qi", mainly refers to the ulnar acupoint and Zusanli point. Not all the acupoints can treat the spleen and stomach system diseases, and the most of the three yang meridians do not treat the digestive system diseases. In addition, there are 98 kinds of disease and disease in the main disease of the total acupoints. From the main treatment of the next point and the original point, it is concluded that the combination of the three yang meridians of the hands of the Tang Dynasty and the Tang Dynasty had less treatment for the Fu Fu and the diseases of the extremity meridians, the heart system and the lung system. The virtual acupoint is good at treating the disease of the Fu Fu organs. It can be seen that, from the analysis of the medical records of the Tang and Tang Dynasties, the "combination" of "the disease in the government" is better understood as the better down acupoint. The original point is used as the yuan Qi, the site of the retention and the visceral disease. The original point of the Yin meridian is used to treat the viscera and the disease, and the six Yang Meridian is used. Most of the original points are treated by the disease.
【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R245

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