【作者】 廖迈传；

【导师】 汪悦；

【作者基本信息】 南京中医药大学 ， 中医内科学， 2009， 博士

【摘要】 研究背景:痹证是临床常见病与多发病,也是疑难杂病之一。其学说源于《内经》,而明确指出痹证除有肢体与关节等局部的冷、痛、热、肿、挛急等特征外,并指出外邪出现在不同脏腑而临床特点也不一,病因为“风寒湿三气杂至”。后世多据《内经》的痹证之定义为:泛指机体正气不足,卫外不固,邪气乘虚而入,使气血凝滞,经络痹阻,引发相关系统疾病的总称。通过本课题的研究,来探讨古代是如何治疗风湿病,而从中对那些有疗效治法方药加于继承并发扬光大。而在众多医家中,我选择了医圣张仲景,是因为风湿病较有系统的治疗始于张仲景。研究目的:希望通过研究张仲景的对风湿病的治疗,如从病因病机,辨証论治,以及其方剂,治法等丰富内容,去发掘并研究仲景治疗风湿病的方法是否对现代的风湿病有更好的疗效。本课题对仲景治疗痹证特色及其对后世医家的影响,作有系统性的整理,归纳,分析,并找出其治痹的一般规律。历代医家治疗痹证的丰富知识与治疗思路与方法,有不少是受仲景的影响。尢其在方剂和药物应用方面更为明显。而我们可以学习历代名医的辨证论治等的特色,并把它用来指导临床,而提高对痹证治疗的效果,而为治疗痹证的水平打下坚固基础。研究方法:从文献研究看仲景治疗风湿病的沿革与影晌,利用现代电脑网络设备,如《中国知识资源总庫》等数据厍为主要检索源,同时采用文献追溯的方法,整理历代医家相关论述,痹证自《内经》作为一个古老病名,历代医家都十分重视并研究相关的资料,历代医家的认识和临床经验对当今的辨证论治都有参考价值。自先秦两千年来,逐渐完善,痹证的发病规律与辨证要点,总结出丰富的临床用药经验,并留下大量文献史料。本文探讨关于仲景治疗痹证的特色,痹证的源流及各时代对痹证论述的特色与其代表性人物并加于说明不同时期治痹的特点,这对今后研究痹证的治疗有重要意义。结果:希望通过研究张仲景对风湿病的治疗,如从病因病机,辨証论治,以及其方剂,治法等丰富内容,去发掘并研究仲景治疗风湿病的方法是否对现代的风湿病有更好的疗效,此外,找出仲景对痹证治疗及对后世有哪些影响。更多还原

【Abstract】 Background: Bi -syndrome is one of the common clinical syndromes and complicated diseases. The theory of Bi -syndrome originated from "Emperor Neijing"; it refers to the disease manifested as painful, cold, heat, stiffness. Main causes are pathogenic of wild, cold and dampness that may eventually invade organs that appeared in different morbidities and symptoms. Therefore, according to the concept of "Emperor Neijing" posterity physicians defines Bi-syndrome mainly due to weakness and the dysfunction of defensive on body surfaces, resulting in the invasion of pathogens. The consequences include clogging of the Qi and blood circulation, obstruction of meridian, and related morbidity. In clinical practice, it is referred to the disease manifested as soreness, numbness, heaviness, and limited movement of joints, muscles tendons and bones, or red, swollen, and painful joints with hot sensation in severe conditions, which is most commonly caused by Qi and blood obstruction due to the invasion of external pathogenic wind, cold, dampness and heat amongst the channels and collaterals.Object: Through the study of Zhongjing’s treatment of the rheumatism, such as, causes and transformation of disease, etiology and pathogenesis and prescription, and checked whether Zhongjing treatment was useful to later generations. To study about Zhongjing’s treatment of Bi-syndrome characteristic and influences later generations, to make a system and put it in order, summed up and analysed, find a general rules. A lot of ancient physicians were influence by Zhongjing, especially in prescription and medicine, it would be worth to study them.Methods: The research of the history of rheumatism documents, to extract from the computer network, such as, (www.cnki.net) etc. The study began from " Emperor Neijing" till today, a total of over 2000 years of history, accumulating the wisdom and books of many ancient physicians including the concepts and criterions of Bi-syndrome, causes and transformation of diseases, diagnosis, treatments and prescription etc.Result: After collecting data which is related to Bi-syndrome, we then filtrated, sorted and analyzed it. Its historical origin, development and characteristics in different phases were retrospect and studied. In this article which will be beneficial to make profound exploration on the treatment and use experience for reference and enlighten clinicians.更多还原