【作者】 周宝宽；

【导师】 李德新；

【作者基本信息】 辽宁中医学院 ， 中医基础理论， 2003， 博士

【摘要】 研究目的：通过有代表性的中国历代医籍的整理与研究，规范出较为系统的中医疲劳术语；概括出中医疲劳的病因病机；探讨中医疲劳与亚健康的关系；整理出抗疲劳防治亚健康的方药。 研究方法：(1)资料收集法：以古代中医文献为主，现代医学文献为辅，并注重二者的结合与认证。古代中医文献在本文中指从109本中医古籍中查出的例证(包括疲劳术语例句、相关医案、方药等)。(2)综合分析法：运用中医药理论及文献学、语言学、逻辑学等多学科知识，从具体分析到抽象分析，从历史分析到现实分析并使用实证与规范分析相结合，定性与定量分析相结合等分析方法。 研究内容：从《黄帝内经》到清代109本中医古籍中整理出中医疲劳术语，并使之系统化；概括出中医疲劳的病因病机，探讨过劳与气血津液及五脏的关系；阐述现代医学对亚健康的认识及中医疲劳与亚健康的关系；整理出抗疲劳防治亚健康的方药并阐明其防治原理及使用基本原则。 研究结果：中医描写疲劳的术语丰富多彩，既有描写体力疲劳的又有描写精神疲劳的或两者兼而有之的，既有描写全身疲劳的又有描写局部疲劳的。疲劳术语的多样性已远远超过了现代医学对疲劳的描述。从上迄《黄帝内经》下至清代的109本古代医籍中整理出的133个疲劳术语，分为11类。中医疲劳病因纷繁复杂，呈现多元性，因内、外因皆可导致疲劳，但以过劳最为多见，过劳既可损伤气血津液，又可损伤脏腑官窍。中医学中虽无亚健康一词但却有类似的描述，如“萌芽”、“微病”、“欲病”等，而就其表现来看多类似于中医学中“虚”、“虚劳”范畴中的轻微表现，暂称其为“阴阳失调临界态”。亚健康的表现虽复杂多样，但其最典型、最多见的表现是疲劳，而疲劳多属于“虚劳”范畴。从10万余首方剂中，整理出抗疲劳防治亚健康的方剂1079首，按气、血、阴、阳及五脏分类，每类又分为首选方与次选方。方剂以补益养生方为主。补气、补阳、补脾、补肾方占绝大多数，从其药物组成看主要为补虚药，其中补气药及补阳药占绝大多数，使用频率较高的前10种中药为：人参、肉桂、茯苓、甘草、牛膝、附子、熟地黄、当归、黄芪、肉苁蓉。如果以气血阴阳为纲五脏为目，可以说抗疲劳防治亚健康的主要途径是以补气、补阳、补脾、补肾。 结论：以疲劳为中心，以“虚”的证候为准绳，以补益养生方为切入点，从有代表性的中医古籍中收集有关疲劳的论述及补益养生方剂，用综合分析法，概括出中医疲劳的术语及病因病机，整理出抗疲劳防治亚健康的方药。不但继承而且还有所发现与创新，发挥了中医药抗疲劳防治亚健康的优势，丰富了中医药理论。更多还原

【Abstract】 Objective: Through systematizing and studying the representative Chinese classics of all ages to standardize some more systematized Traditional Chinese Medicine (TCM) terms; to summarizing TCM etiopathology of fatigue; to investigate the relationship between fatigue and subhealth and systematize the prescriptions for antifatigue and prevention and treatment of subhealth.Methods: 1. Date collection: Collecting ancient TCM literatures with some modern literatures as the subsidiary, and putting stress on combination and mutual attestation. Examples (including texts of term fatigue, relative case reports and prescriptions) were selected form 109 books of TCM classics. 2. Synthetic analysis: Applying knowledge of TCM theories, literature and logic, from the concrete to the abstract, from history to reality, to analyze both examples and standardization both quantitatively and qualitatively.Contents: Some TCM terms of fatigue from 109 books of TCM classics from the times of Huangdi’s Internal Classic of Medicine to the Qing dynasty had been systematized. The etiopathology of fatigue in TCM was summed up, the relationship between fatigue and Qi-blood-body-fluid and the five viscera was investigated. The recognition of subhealth in Modern Medicine and the relation of fatigue in TCM to subhealth were expounded. The prescriptions to resist fatigue and to prevent and treat subhealth were systematized, and the mechanism for prevention and treatment as well as the basic principles for application were expounded.Results: The terms in TCM to describe fatigue are rich and varied. Some describe physical fatigue, some describe mental fatigue and some others describe the both collectively; some describe general fatigue and some describe local fatigue. The variety of terms describing fatigue in TCM is far more than that in Modern Medicine. Here 133 terms on fatigue had been selected and systematized from 109 books from the times of Huangdi’s Internal Classic of Medicine to the Qing dynasty and they were classified into 11 kinds. The causative factors of fatigue in TCM are varied and complex, being polyphyletic. While both the endogenous factors and exogenous factors can cause fatigue. However overstrain is the most common one. Overstrain can bothdamage Qi-blood-body-fluid and injure the viscera and sense organs-orifices. There is no word "subhealth" but there is similar description in TCM, such as "Mengya" (seeds), "Yubing" (disease in bud), "Weibing" (mild disease), etc. Viewing from their presentations they are most similar to the mild manifestations in the category of "Xue" (deficiency) or "Xue Lao" (deficiency and overstrain) in TCM. Here we tentatively call it "critical state of imbalance of Yin-Yang". The presentations of subhealth are many and varied, but mostly belongs to the category of "deficiency and overstrain". 1079 formulae that resist fatigue and prevent and treat subhealth had been selected and systematized form the ten thousand formulae, and they were classified according to the theories of Qi-blood-Yin-Yang and the five viscera, and each class was again grouped as two kinds of the first-placed and the second-placed. The formulae with the actions of tonification and health preservation are predominant. The most majority of the formulae are those boosting Qi, invigorating Yang, strengthening the spleen and reinforcing the kidney. As for the compositions of drugs, the agents reinforcing the deficient prevail. Among them the most majority are those boosting Qi and invigorating Yang. The agents ranged in the first decade according to the rate of employment are Renshen (Radix Ginseng), Rougui (Cortex Cinnamomi), Puling (Poria), Gancao (Radix Glycyrrhizae), Niuxi (Radix Achyranthis Bidentatae), Fuzi (Radix Aconiti Praeparata), Shudihuang (Radix Rehmanniae Praeparata), Danggui (Radix Angelicae Sinensis), Huangqi (Radix Astragali seu Hedysari), and Roucongrong (Herba Cistanchis). If we take Qi-blood-Yin-Yang as the class and the five viscera as the subclass, then we might say that the major ways to resist fatigu更多还原