藏医催泻疗法特点及临床应用研究

发布时间：2018-06-27 06:54

本文选题：催泻疗法 + 特点　；参考：《北京中医药大学》2016年博士论文

【摘要】：藏医催泻疗法是藏医五疗之一,是一个具有悠久历史的治疗方法,据现存藏医古籍记载该疗法可以追随到远古象雄时期。在吐蕃赞普时期,为当时医学的发展前后多次聘请印度、汉地等其它地区的医师,翻译和编写了各派医学著作,完善和丰富了藏医催泻疗法的理论,使藏医催泻疗法的实践操作趋于统一化和条理化,从而形成了先行准备、正行施治、术后调养的理论框架。在此基础上搜集和整理了历代各医家对催泻疗法的理论见解及实践经验,促成了《四部医典》中记载的催泻疗章节。目的：从《四部医典》中记载的催泻疗法内容来看,可用来治疗任何年龄阶段的各种疾病,尤其藏医治则中指出了“欲病者平之,已病者泻之”的治疗宗旨,可想而知催泻疗法在藏医临床治疗中有着不可缺少和无与伦比的地位。但由于种种原因该疗法在临床治疗中未得到广泛的应用,致使对各种疾病的治疗面临困境。因此我认为研究藏医催泻疗法即符合临床治疗的需求,更符合提高传统医学服务能力和促进传统医学的传承与发展的政策趋势。本文通过分析藏医药历史与各藏医古籍文献中记载的催泻疗法内容,进一步探讨藏医催泻疗法的演变、发展、成熟的过程;着重提出藏医催泻疗法的治疗特点；收集和分析治疗常见病的泻方,寻找其组方规律；了解目前临床治疗中催泻疗法应用的情况,提出后期研究方向等方面深入的研究,为进一步的临床治疗和科学研究奠定基础。方法：(1)对比和分析《敦煌本吐蕃医学文献》、《比其黄色经函》、《当许医文残卷》、《月王药诊》等吐蕃时期的藏医文献,探讨吐蕃时期催泻疗法的发展情况与理论体系的形成。(2)依据藏医古籍中记载的催泻疗法内容提出其治疗特点；结合自己的观点分析和论述了对催泻疗法的远近期先行准备、正行施治、术后调养等内容；(3)对赤巴、肝、胃、瘤、痛风、疼痛等临床常见病的泻方进行归类和分析。(4)以走访、询问、实地考察等方式了解目前临床中催泻疗法的应用情况。结果：(1)藏医催泻疗法具有悠久的历史,至少有1300多年的文字记载史,是在固有的藏医催泻疗法内容基础上汲取周边民族的相关知识和经验而形成了先行、正行、术后三个阶段的理论体系。(2)提出了藏医催泻疗法有九大治疗特点；古籍记载可泻之病58个,不可泻病30个,经梳理和分析确定了可泻之病11个,不可泻病4个。(3)根据古籍中记载的催泻完成程度内容,新制定了积分式催泻完成程度的评价表。(4)探讨了治疗赤巴、肝、胃、痛风、瘤、疼痛等六种病型催泻方剂的组方规律,提出了每种病型的催泻方剂主药及辅药。(5)以走访、询问、实地考察等方式了解到目前临床中常用的催泻方剂只有三个。结论：(1)在古籍文献《十万拳》中有“伏藏脓泻法源自苯教”的记载、《宇妥传》里记载“象雄有使疾病泻下的催泻疗法”、《藏多医学札记》中记载“肝泻与脾血泻源自《无畏的武器》”等内容来看,催泻疗法是个古老疗法,可以肯定至少有一千三百多年的文字记载史。从《医疗精汇》中印度泻方“哈布夏“和汉地泻方“麻细黄”的记载；赞普时期《泻疗银杯》、《内科疗法珍宝泻》等的翻译和编写可以看出藏医催泻疗法的发展始终遵循了传承固有、汲取他派之精的学术气氛。(2)藏医催泻疗法的内容有远期准备、近期准备、峻泻、缓泻、药物炮制、服法、促剂、出量、术后调理等完整的理论体系和条理性的实践步骤。(3)藏医催泻疗法具有九大治疗特点：治疗范围广、治赤巴病的优选、根除疾病、净化管腔、增升胃火、镇止疼痛、平衡三因、疗效快、防病保健等的作用。(4)通过对常见病类的催泻方分析得出催泻方剂的主药为平衡三因药(诃子)和寒热共泻药(白狼毒),在此基础上可以根据疾病性质和病情、患者的体质加以辅药的规律,为研制催泻新方提供了思路及依据。(5)对经典古籍中记载的可否催泻病进行统计和分析得出结论：可催泻的病为浮肿、水肿、麻风、昏花眼疾、类风湿性关节炎、绦虫病、熟期热疫、中毒、瘤等,不可泻的为孕妇疾病、胃火衰弱、外伤、肛疾。(6)目前临床中使用的催泻方剂为“阿如赛泻”、“十味缓泻”、“米同根均”。“阿如赛泻”主要用于治疗黄疸病,“十味缓泻”主要用于治疗培赤病、“米同根均”主要用于治疗早期普瓦木布病。总之,通过此次研究对藏医催泻疗法有了新的认识和新的发现,并对该疗法的临床运用和深层次的研究打下了坚定基础。也盼望本文对藏医临床服务能力提升和发展起到促进作用。
[Abstract]:The medicine of Tibetan medicine is one of the five treatments of Tibetan medicine. It is a method of treatment with a long history. According to the existing ancient books of Tibetan medicine, it is recorded that the therapy can follow the period of ancient elephant male. During the period of Tubo zantian, doctors of other areas, such as India, Han and other regions, had been employed to translate and compile various medical works for the period of the development of the Tibetan medicine. And enriches the theory of the Tibetan medicine purgative therapy, which makes the practice of the Tibetan medicine purgative therapy tend to be unified and organized, thus forming a theoretical framework of preparation, treatment and post operation. On the basis of this, the theoretical views and practical experiences of various medical practitioners in the past dynasties have been collected and arranged, which contributed to the records of the four medical codes. Objective: from the contents of the purgative therapy recorded in the "four medical codes", it can be used to treat all kinds of diseases of the age stage, especially in the Tibetan medical treatment, which points out the treatment aim of "the sick person is flat, the sick person purges", and it is conceivable that the purgative therapy is indispensable and unparalleled in the clinical treatment of the Tibetan medicine. But for a variety of reasons, the therapy has not been widely used in clinical treatment, which leads to the difficulties in the treatment of various diseases. Therefore, I think that the study of Tibetan medicine purgative therapy is in line with the needs of clinical treatment, which is more in line with the policy trend of improving the traditional medical service ability and promoting the inheritance and development of traditional medicine. Analysis of the history of Tibetan medicine and the contents of purging therapy recorded in the ancient books of Tibetan medicine, further discuss the evolution, development and maturity of the Tibetan medicine, and focus on the characteristics of the treatment of the Tibetan medicine, collecting and analyzing the prescriptions of the common diseases, looking for the rules of the prescription, and understanding the application of the current therapy in the clinical treatment. In order to lay the foundation for further clinical treatment and scientific research, methods: (1) comparison and analysis of the Tibetan medicine literature of Dunhuang Tubo, < than its yellow classics >, < Xu medical literature >, < Yue Wang Medicine > and other Tibetan medical literature, to explore the development of the Tubo Period. The formation of the situation and theoretical system. (2) according to the contents of the treatment of the ancient Tibetan medicine, the characteristics of the treatment were put forward, and in combination with his own viewpoint, the far near preparation, treatment and postoperative care were analyzed and discussed, and (3) the classification of clinical common diseases such as Cheb, liver, stomach, tumor, gout, and pain were classified. And analysis. (4) by visiting, inquiring, field investigation and other ways to understand the application of the current clinical therapy of diarrhea. Results: (1) Tibetan medicine diarrhea therapy has a long history, at least 1300 years of history of written records, is based on the content of the inherent Tibetan medicine to absorb the related knowledge and experience of the surrounding ethnic groups formed the first, The theory system of the three stages after the operation. (2) it is proposed that there are nine characteristics of the treatment of Tibetan medicine for diarrhea; 58 of the ancient books can be diarrhoea, and 30 are diarrhoea, and 11 diarrhoea and 4 diseases are determined by combing and analysis. (3) the completion degree of the integral type of diarrhea is newly developed according to the content of the completion degree recorded in the ancient books. The evaluation table. (4) to discuss the prescription rules of six kinds of prescriptions for the treatment of Chek, liver, stomach, gout, tumor, pain and so on, and put forward the main and auxiliary drugs for each type of diarrhea prescription. (5) there are only three commonly used diarrhea prescriptions in clinic by visiting, inquiring and field investigation. Conclusion: (1) there are one hundred thousand boxing in ancient books. The records of "the source of purpur and diarrhoea from the origin of benzene" are recorded in the legend of "Xiang Xiong", "Xiang Xiong has diarrhea and diarrhea therapy", and the contents of "liver diarrhoea and spleen blood diarrhea originating in the fearless weapon >", and so on, are an ancient therapy, which can be affirmed for less than more than 1300 years of written history. The records of "Hun Bu Xia" in India Xie Fang and the decoction of Han and Chinese diarrhoea, the translation and compilation of the Zan Pu period < Xie therapy silver cup > < internal medicine therapy treasure diarrhea > can be seen that the development of the Tibetan medicine purgative therapy has always followed the inheriting nature and absorbed the academic atmosphere of his school. (2) the content of the Tibetan medicine purging therapy is prepared for a long time. In the near future, the comprehensive theoretical system and rational practice steps were prepared, such as diarrhoea, laxative, drug processing, medication, agent, dose, and postoperative conditioning. (3) the Tibetan medicine purgative therapy has nine characteristics: the wide range of treatment, the optimization of the treatment of Chek's disease, the eradication of the disease, the purification of the lumen, the increase of stomach fire, the pain in the town, the balance of three causes, the quick curative effect and the health care health care. (4) (4) through the analysis of the common diseases, the main medicine of the expressing prescription is to balance the three drugs (don ") and the cold and hot cathartic cathartic (Bai Langdu). On this basis, according to the nature of the disease and the condition of the disease, the constitution of the patient is supplemented by the medicine, which provides the idea and basis for the development of the new prescription of expressing diarrhea. (5) the classical ancient books are recorded. Can the diarrhea disease carry on the statistics and analysis to the conclusion: the disease that can induce diarrhea is edema, edema, leprosy, faint eye disease, rheumatoid arthritis, tapeworm disease, hot pestilence of ripe stage, poisoning, tumor and so on, which can not be diarrhoea for pregnant women, stomach fire, trauma, anus disease. (6) "Asiatic diarrhea" and "ten taste laxation" used in the clinic. "Alex diarrhoea" is mainly used in the treatment of jaundice, and "ten flavour laxative" is mainly used in the treatment of pellucosis. "Mi Tong root" is mainly used for the treatment of early purewood disease. The study laid a firm foundation and hoped that this paper will promote the improvement and development of Tibetan clinical services.
【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】：R29

【参考文献】