中医风邪病因研究

发布时间：2018-08-03 18:00

【摘要】：“风”,有关于病因病机、证候表现、诊治方药、五运六气等诸多方面,是中医理论的重要概念之一。在中医理论中,有关“风”的中医术语不胜枚举。本文对中医学“风”的概念、源流及其病因等方面进行了研究。“风”之概念的发展过程可分为三个阶段。第一阶段为先秦两汉时期,这是“风”的起源阶段。这一时期主要是基于天人合一的自然观,将“风”应用在多种术数体系中。在不同的术数体系中,风有着不同的含义。此时的文献多是记载自然界风的方位,当时人们通过判别风的方向,来推测吉凶。第二阶段为先秦两汉到宋之前的时期,这是“风”理论的成熟、运用阶段。这一时期,曾经被作为自然现象的“风”,逐渐被凝练、动态形象化。风开始与中医学的特征紧密结合,风形成了一种病因概念,称为“风邪”。是医学经典的确立,以诸多种自然观方式呈现,如：五行组成学说、四大组成学说,兼带其他各种术数运算的五运六气学说。对风的气化论,发挥到淋漓尽致,各有一套完整学说理论,并且散见于医家著作中。内容包含了“风”的性质多元化,于是“风”的理论越丰富,就显得“风”的内容越是无际无边,过度宽泛以及滥用无度,产生了两面效应,有十分积极的效果,但也有经不起推敲的结论,值得深究。第三个阶段从金元时期到清末,这是规范整合阶段,风的概念有了巨大的转变。在此之前,医家认为只存在“外风”,而这一阶段形成了“内风”学说。中医学有关“风”的概念从此争论不休,需要进行变革与规范。近代医家,纷纷开始进行规范与整合,他们认为内风并非外邪,而是“机体颓败而然”,应该是病机概念。此时的显著特征是祛风的方式和对风药的认识与之前有巨大的不同。本文分别从三个阶段论述了“风”的起源、发展、整合和运用。从最初的自然天象,逐渐术数化。《内经》时代形成了多种概念和理论体系,其中的五行术数学说流传千古,为中医体系框架的形成打下了基础。后世将其内容发展、整理,力图将各种发病机制融合。所以六淫之中,风邪易与各种邪气相兼为病,其概念容易混淆,学者们试图运用各种方式来解释临床现象。本文采用训诂的方法,探究风邪病因的源流演变。发现中华原典时期“风”根本没有与病因挂钩,直至《内经》大量论及“风邪”。通过对《内经》中的“风”的研究,发现“风为百病之长”的这一特殊病因进行深度研究,作为具体病因存在问题,与其他外感病因的理如何体现于临床,参考古今文献对此进行了归纳探讨。发现汉·张仲景《伤寒论》所论之“风邪”与《内经》有者不同观点,从太阳伤寒、太阳中风可知,用麻黄汤来辛温解表、用桂枝汤来解肌祛风。在汉代感受“风邪”,治疗时运用祛风之法,大多使用辛温之品,该法沿用至今。若只看病机显然,“风为阳邪”和“风性开泄”的认识就难以自圆其说,因此提出临床或许也有“阴邪”的观点,可供学术界进一步探讨。至今“风邪”作为病因实质上忽略审证求因的过程,与临床联系紧密。对“风邪”进行不偏不倚的研究实属必要。本文以“风”作为病因,探索从上古时期到各个朝代对“风邪”认识的演变,将所发掘的每个时期风的特点进行规范与总结。作为病因的“六淫”之首,是机体对自然界气候抵御能力的低下,患病后自身出现的症状表现,经审证求因得来的结果,也就是所谓的“因发而知受”。结合导师肖相如教授认为外感病初期,应当直接辨清寒、热、燥、湿之证,对证治疗,用药平调即可达到效果。“内风”虽然不是外感病因的概念,但经研究发现将“内风”病因误作了外感风邪所致,含混误治延宕千年之久,但却与“风邪”有着千丝万缕的联系,本文也连带进行了深入探讨,虽不是论文的主体但这却提供风邪作为病因发展重大转折点。最后佛教中也有“风”的论述,作为附录参考,可见在中国传统文化中,“风邪”病因的内容着实丰富。
[Abstract]:"Wind" is one of the important concepts of the theory of traditional Chinese medicine. In the theory of traditional Chinese medicine, the terms of traditional Chinese medicine on "wind" are numerous. In this paper, the concept of "wind", origin and etiology of traditional Chinese medicine are studied. The development process of the concept of "wind" It can be divided into three stages. The first stage is the period of the pre Qin and Han Dynasties, which is the origin stage of the "wind". This period is mainly based on the natural view of the unity of nature and man, and applies the "wind" to many kinds of operation system. In the different number system, the wind has different meanings. The second stage is the period of the pre Qin and Han Dynasties and the period before the Song Dynasty. This is the mature and application stage of the "wind" theory. In this period, it was used as the "wind" of the natural phenomenon. It was gradually condensed and dynamically visualized. The wind began to be closely combined with the characteristics of traditional Chinese medicine, and the wind formed a kind of etiological concept, called "the wind". "Wind evil" is the establishment of the medical classics, which is presented in various natural ways, such as the theory of the composition of five elements, the theory of the four major components, and the theory of the five transport and six gas of all kinds of operation numbers. The theory of the gasification of the wind is full, each has a set of complete theories and is scattered in the works of the doctors. The content contains the nature of the wind. The more abundant the quality, the more rich the theory of "wind", the more the content of "wind" is more and more boundless, excessive and abusing and abusing. It has two sides effect, which has a very positive effect. But it also has a very positive effect, but it also has a conclusion which can not be pushed forward. The third stages are from the Jin Yuan period to the end of the Qing Dynasty, this is the standard integration stage, the concept of wind is the same. Before this, doctors thought that there was only "external wind", and this stage formed the theory of "internal wind". The concept of "wind" in traditional Chinese medicine has been debated and needed to be changed and standardized. Modern doctors have begun to standardize and integrate, they recognize that the internal wind is not outside evil, but "the body is decadent", It should be the concept of pathogenesis. The striking feature of this time is that the way to dispel wind and the understanding of the wind medicine are quite different from that before. This article discusses the origin, development, integration and application of the "wind" from the three stages. From the original natural natural celestial images, the number of concepts and theories has been formed in the period of < internal classics >, and the five lines of which are formed. The theory of mathematics has been spread for a long time and laid a foundation for the formation of the framework of the traditional Chinese medicine system. Later generations have developed its contents and tried to integrate all kinds of pathogenesis. Therefore, in the six lews, the wind is easy to be confused with all kinds of evil, its concept is easy to confuse, and the scholars try to use various formulas to explain the clinical phenomenon. It is found that the "wind" is not linked to the cause of the cause in the period of the Chinese classics until the "wind" in the inner Sutra. Through the study of the "wind" in the inner Sutra, it is found that the special cause of "wind is the length of a hundred diseases" is deeply studied as a specific cause and other exogenous pathogenic factors. How is it embodied in the clinical literature and the reference to the ancient and modern literature on this? It is found that Han Zhang Zhongjing's theory of typhoid fever has different views on "wind evil" and "inner classic". From the sun's typhoid fever and the sun's stroke, it is known to use the ephedra soup to solve the table and use Guizhi soup to dispel the wind. Most of the use of symplectic temperature has been used up to now. If only the medical machine is obvious, the understanding of "wind for Yang evil" and "wind sexual vent" is difficult to understand itself. Therefore, it is suggested that the clinic may also have the viewpoint of "Yin evil", which can be further discussed by the academic circle. It is necessary to study the impartiality of "wind evil". This article, taking the "wind" as the cause, explores the evolution of the understanding of "wind evil" from the ancient times to the dynasties, and the characteristics of each period of wind excavated to be standardized and summed up. As the first of the "six prostitution" of the cause, it is the body's ability to resist the natural climate. Low, the symptoms of their own symptoms after the illness, after the result of the examination, which is the result of the so-called "cause to know". Professor Xiao Xiangru thought that the early stage of exogenous disease, should directly distinguish the cold, heat, dryness, wet syndrome, proof treatment, medication can achieve the effect. "Internal wind" is not the concept of exogenous pathogenic factors, However, it has been found that the cause of "internal wind" has been mistaken for the pathogenic wind, and the mistaken treatment has been delayed for a thousand years, but it has many connections with the "wind evil". This article has also carried on a deep discussion. Although it is not the main body of the paper, it provides the wind evil as a major turning point for the cause of development. Finally, the theory of "wind" in Buddhism also has the theory of "wind" As an appendix reference, we can see that the content of "wind evil" is rich in Chinese traditional culture.
【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】：R277.7

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