赵炳南中医皮肤科学术渊源及学术特点研究

【作者】 耿学英；

【导师】 宋乃光；

【作者基本信息】 北京中医药大学 ， 中医临床基础， 2009， 博士

【摘要】 名老中医的学术思想与经验是中医学的宝贵财富,继承、挖掘与传播名老中医的学术思想是加快中医事业发展与创新的重要途径。赵炳南教授(1899-1984)是我国著名中医皮外科专家,是现代中医皮肤科的奠基人和开拓者,为发展中医皮肤科事业做出了卓越贡献。但我们对其搏大精深的学术思想体系还缺乏深入系统的研究。这种状况在很大程度上限制了赵炳南皮肤科学术精髓的传承与推广。深入进行赵炳南中医皮肤科学术渊源、学术思想和经验特色的研究,对中医皮肤科的可持续发展具有重要意义。“中医皮肤科赵炳南学术流派及其传承研究”是2006年度北京市中医药科技发展基金项目“51510”重大项目。“中医皮肤科赵炳南学派学术渊源及学术思想研究”是此重大项目中的第一个子课题,由北京中医药大学中医临床基础系温病教研室负责完成。笔者所选课题为此子课题中的一部分,重点是对赵炳南中医皮肤科学术思想之渊源及特点进行深入研究总结。本研究论文旨在探寻赵炳南中医皮肤科学术思想渊源,研究总结赵炳南中医皮肤科学术思想特色。通过总结中医皮外科古籍文献和温病学名家著作的有关论述,明确中医皮肤科学理论发展的脉络及对赵氏思想的影响,明确赵炳南对中医皮肤病学发展和创新的贡献。通过分析研究《赵炳南临床经验集》、《简明中医皮肤病学》等著作及有关文献报道资料,深入总结赵老皮肤病辨治的基本理论和方法,并尽可能地条理化、系统化,便于指导临证或实际应用。本论文主要内容分为三大部分。第一部分是对赵炳南中医皮肤科的学术渊源进行研究。明以前是中医皮肤科理论与实践不断积累的时期,明清两代是中医皮外科学发展的鼎盛和争鸣时期,外科三大主要学术流派即产生于明清。明清时期中医皮外科学所取得的成就是赵炳南皮肤科学术思想的最重要的源泉。赵炳南不但继承了历代皮外科治疗上的精华,且有颇多创新,形成了自己皮外科治疗的独特风格。论文中对《赵炳南临床经验集》中所记载的31个主要皮肤病病种进行文献溯源,分析总结赵炳南论治不同皮肤病的特点与历代主要中医皮外科古籍文献和名家的关系,以期更好地明确赵炳南皮肤科学术思想之渊源,明确赵炳南对中医皮肤病学发展和创新的贡献。论文第二部分是对赵炳南中医皮肤科的学术思想进行研究总结,主要从五个方面论述了赵炳南的学术思想特点。一是坚持中医辨证论治特色,对皮肤病证候进行了规范。《赵炳南临床经验集》记载了11类共31种皮肤病的诊治方法,每一病种都有中医辨证。《简明中医皮肤病学》中介绍了中医基础理论及中医对皮肤病的辨证论治,在皮肤病各论中详细记载了对各种皮肤病的中医辨证分型及论治方法。二是始终以中医整体观指导对皮肤病的辨证治疗。赵炳南将中医整体观作为一种指导思想贯穿于皮肤病诊疗的全过程。他认为应从整体观出发研究皮肤病的发病规律,从整体角度分析皮肤科病证及其变化。三是强调阴阳辨证,擅长运用调和阴阳法治疗皮肤病。阴阳是八纲中的总纲,是辨证的基本大法,赵炳南在医学实践中重视运用阴阳辨证治疗临床疑难杂症。赵老指出调和阴阳法在皮肤科疾病中占有重要位置,并喜用鸡血藤、首乌藤、钩藤、天仙藤等藤类药物为调和阴阳基本方药加减运用于皮肤病临床。四是重视运用卫气营血辨证诊治皮肤病。赵炳南对温病学说有颇深研究,率先将温病学的成就用于皮肤科中。他深入研究卫气营血辨证理论,将之与皮肤病临床紧密结合。尤其是善于运用卫气营血辨证治疗丘斑疹类皮肤病及急性感染性皮肤病。他以卫气营血学说为指导,创制出有关皮肤病治疗的一系列经验方,临床应用,疗效显著。五是治疗皮肤病,常以治湿为根本,治热为关键。赵炳南在诸多皮肤病的致病因素中,对湿邪与热邪尤为重视。赵炳南把温病学说关于湿热病的思想灵活用于皮肤病治疗中。在长期反复临证实践的基础上,赵老形成了对于湿热性皮肤病辨证施治的看法。论文第三部分是对赵炳南中医皮肤科治法和方药特点进行研究。主要从以下五个方面进行了论述。一是赵老在中医皮外科临床领域潜心研究,博览群书又学古不泥,在长期和大量的医疗实践中,对中医皮、外科的理论提出了一些创新的见解,在理法方药等各个方面,均颇有创新。二是在长期临床实践中,赵老通过大量病例,总结出了许多疗效显著的经验方,有些已形成系列。其立法周全详察,组方科学严谨,对后学者极具指导意义。三是对赵炳南部分常用效验方之特点进行分析,主要包括全虫方、秦艽丸、多皮饮、五皮五藤饮、祛湿健发汤等。四是对赵老临床药物运用特点进行分析。通过分析其应用清热解毒药、祛风药、对药、组药、引药的特点,以总结其用药经验,为中医皮肤科的临床用药提供资料。五是分析总结赵老治疗皮肤病时运用外治法、外用药的特点。赵老对中医外用药的配制和使用尤有独到之处,他汲取百家之长,不断研究创新,形成了系统的外治法、外用药方案,还逐渐形成了自己的特色外治疗法。更多还原

【Abstract】 The academic thoughts and experience of famous old doctor is a valuable asset to traditional Chinese medicine.Inheritance,mining and the spread of the academic thinking of famous old doctors of traditional Chinese medicine is an important way to accelerate the development and innovation of TCM.Professor Zhao Bingnan(1899-1984) is the famous dermatology expert of TCM,the founder and pioneer of modern.He made outstanding contributions for the development of TCM dermatology.But we are lack of the deep research for his great and profound academic thought.This kind of situation in largely limits the inheritance and promotion of his academic essence.Further researching Zhao Bingnan TCM dermatology had important significance to the sustainable development of TCM dermatology."TCM dermatologist Zhao Bingnan academic schools and inheritance" is one major project of Beijing Chinese medicine scientific development fund projects "51510" in 2006."The research of academic origin and academic thoughts of Zhao Bingnan TCM dermatology" is responsible by WenBing department of clinical research foundation of Beijing university of Chinese medicine.My topic is part of the subject.This study aims to explore the academic thoughts origin y and to research the academic thought characteristic of Zhao Bingnan TCM dermatology.Clearing the development of TCM dermatology and its influence to Zhao Bingnan.Clearing the development and the innovation of Zhao Bingnan TCM dermatology.Through the analysis of"Zhao Bingnan clinical experience" and "The concise TCM dermatology" and the relevant research reported in the literature material,in-depth summary his basic theory and method,make these to be methodical,systematic.This thesis mainly divided into three major contents.The first part is to research the academic origin of Zhao Bingnan TCM dermatology.The theory and practice of TCM dermatology accumulated before the Ming dynasty and developed during the Ming and Qing dynasties.TCM surgery has three main academic schools which produced in Ming and Qing dynasties.TCM dermatology achievements during the Ming and Qing dynasties are the most important source of Zhao Bingnan TCM dermatology academic thoughts. Professor Zhao inherited its essence and had much innovation.He formed his unique style of skin treatment.This thesis explored the origin of 31 main skin diseases which are recorded in "Zhao Bingnan clinical experience".Analyzing and summarizing the different characteristics of Zhao Bingnan TCM dermatology and the major Chinese famous ancient physicians.The second section of the thesis is to research and summarize the academic thoughts of Zhao Bingnan dermatology.From five aspects discussed Zhao Bingnan academic thoughts characteristic.The first is to insist the syndrome differentiation and treatment of TCM and regulate skin disease syndrome.The diagnosis and treatment of diseases of 31 main skin diseases are recorded in "Zhao Bingnan clinical experience".Every disease has TCM syndrome differentiation. "The concise TCM dermatology" introduced the basic theory of TCM and TCM syndrome differentiation and treatment of the disease.The second is always on the TCM overall view of the diagnosis and treatment of diseases guidance.Zhao Bingnan regarded the TCM overall view as a guiding ideology in the skin treatment.He thought we should study the regularity of skin disease on the TCM overall viewThe third is to emphasize the differentiation of Yin and Yang and applying treatment of Yin and Yang to treat skin disease.In his medical practice Zhao Bingnan paid attention to his treatment of Yin and Yang.Fourthly,he attached importance to use differentiation of Wei-Qi-Ying-Xue in treatment of skin diseases.Zhao Bingnan had a deep research in theory of epidemic febrile disease and first used these in dermatology.He especially good at using differentiation of Wei-Qi-Ying-Xue in diagnosis and treatment of macula and acute infectious skin diseases.Fifthly,he often emphasized to treat moist and to treat heat in treating skin disease. He applied the theory of epidemic febrile disease for treatment of skin diseases.In the third part of this thesis is to study the characteristics of treatments and formulas.Mainly from the following five aspects.First,Professor Zhao concentrated on the study of dermatology.He put forward some innovative ideas to the theory of TCM dermatology.In each aspect of TCM dermatology,he was quite an innovation.Second,in the long-term clinical practice,through a large number of cases,Professor Zhao summarized the experiences of much remarkable curative effect.These extremely significance for later doctors.Third,characteristics of Professor Zhao’s some common prescription are analyzed, including Quanchong Fang,Qinjiao Wan,Duopi Yin,Wupi Wuteng Yin,Qushi Jianfa Tang,etc.Fourth,this thesis analyzed Professor Zhao’s characteristics of clinical medication.Through the analysis of the application of heat-clearing and detoxifying Chinese medicine,expelling the wind Chinese medicine,paired Chinese medicine,group Chinese medicine and guide Chinese medicine,summarizing his experience for clinical medication.Fifth,analyzing and summarizing Professor Zhao’s experience Of TCM external therapy and the drug for external use.He learned experience from others,continuously researched and innovated and gradually formed its own characteristics of TCM external therapy.更多还原