【作者】 张毅之；

【导师】 张横柳；

【作者基本信息】 广州中医药大学 ， 中医临床基础， 2010， 博士

【摘要】 我国历代诸多中医名家的学术思想和临证经验是中医学的宝贵财富,在理论、临床、本草、方剂等各个方面推动着中医学不断发展。何志雄教授是当代岭南伤寒名家之一,为我国当代杰出的中医理论家、教育家、临床大家。先生治学严谨,致力于《伤寒论》的研究数十春秋,对诸多理论问题阐发透彻,如伤寒六经实质、伤寒胃气学说等。先生在理论研究的同时,注重将理论研究成果用之于临床实践,擅用六经辨证辨治六淫外感疾病、脏腑辨证论治内伤杂病。对于经方的运用更是颇具心得,多有创见,常以经方治疗各种疑难病症,本师古而不泥古之风,临证多有加减而切中病情。先生临证之时重视保护调养胃气在外感内伤诸多病症中的运用,强调“人以胃气为本”,“胃气壮则五脏六腑皆壮”,以扶正祛邪为其重要的临证特色,积累了大量的宝贵经验,是当代岭南中医学的宝贵财富。本研究主要运用伤寒学的相关理论方法,通过搜集整理何志雄教授相关文献资料,采访与何老有关的人物从而获取口述材料,旁纳中医医史文献、中医各家学说的研究方法对何志雄教授主要学术思想和临证经验等内容作深入系统的整理和研究,以便于岭南伤寒学术的传承和发展。何老一生所积累的学术思想内容甚多,笔者在取材上多有取舍,旨在对重点内容进行系统深入的梳理和研究,故将何老有代表性的、理论体系完整的、具有较大的实用价值内容作重点研究,对于何老其它学术思想,在今后的研究工作中陆续开展。本研究主要为四个部分：第一部分为何志雄教授生平简述。通过细致的资料搜集,较为详细地描述出何老一生的人生际遇和走上中医之路并成为一代大家的外部史实。旨在以史实为依据,从中探讨外部环境因素对于何志雄教授走上中医之路的历史动因；从其人生际遇的客观史料窥探出何老立志中医,悬壶济世,并取得丰硕成果的促进因素。藉此对后人立志中医给予一定的启迪和鼓舞。第二部分为何志雄教授的学术精华。何志雄教授为当代岭南伤寒名家之一,对于《伤寒论》的理论阐发、临床运用等均取得了丰富的研究成果和经验体会。通过整理何志雄教授文献资料及有关口述材料,结合伤寒学相关理论方法,我们发现何志雄教授对于《伤寒论》六经实质的阐发是以脏腑经络有关理论为基础,以《黄帝内经》、《难经》等中医经典著作为理论依据,结合伤寒六经自身的内在独特性,对伤寒六经的实质进行了全面系统的论述。何志雄教授以数十年研究运用《伤寒论》之经验体会,认为胃气学说贯穿于《伤寒论》理论方法的始终,是《伤寒论》重要的内在组成部分之一。何老强调,学习伤寒使用经方的关键之一,在于对伤寒胃气学说的深刻把握,何老此论对当代伤寒学的研究具有较大的启迪意义。以伤寒胃气学说为门径,为研究伤寒,使用经方开辟了一条新的路径。第三部分为何志雄教授的临证经验。与岭南大多数医家一样,何志雄教授不但是一位中医理论家,教育家,更是一位临床实干家。何老注重中医理论与临证实践的内在一致性,强调中医之本在于理论发明,其生命力在于临床的简、便、效、廉,二者密不可分,均应加以重视。在治学育人之余,何老勤于临证,积累了大量的宝贵经验。通过研究,我们发现先生对于外感疾病常以六经辨证为指导,在六经辨治运用上积累了丰富的经验,其中以六经辨证辨治外感温病是其一大特色。对于内伤杂病又偏重于使用脏腑辨证,在具体运用中,何老又强调局部与整体、局部与局部的辩证统一关系。在外感内伤诸多病症的治疗上,先生首重患者脾胃之气的强弱,在处方用药中亦时时注重顾护中焦脾胃之气,切实提高疗效,对末学颇多启发。第四部分为何志雄教授运用经方的医案研究。何老是当代岭南“经方派”名家之一,一生研究伤寒,运用伤寒,于经方多有理论发明,运用上均积累了丰富的实践经验。通过搜集整理何老经方治验医案,在研究中我们发现,何老注重“方证相对”,强调运用经方的关键,首先在于对经方组方机理和加减变化的全面把握和深刻领会；其次在于娴熟地运用四诊,全面准确地搜集脉证表现,进而对病因病机的准确把握。何老对于“方证相对”的具体内容所强调的是病因病机与组方机理之间的内在一致性,同时注重临证时的灵活加减运用。通过深入系统地研究何志雄教授的学术思想,我们得出：先生为当代岭南伤寒的杰出代表,是当代岭南地区的“经方派”大家,为当代中医教育家、临床实干家。六经实质论是其重大的研究成果之一,是何老阐释《伤寒论》六经病证、经方研究的重要理论支持,直接影响到何老对伤寒胃气学说的深入探讨,运用六经辨治外感温病等各个方面；补土以扶正气是何志雄教授学术思想的中心和重点内容,贯穿于何老对于六经实质、六经病证、伤寒营卫学说等诸多理论阐述之中；同时补益脾胃的具体运用亦成为何志雄教授临证所常用的治疗方法,取得了丰硕的成果。通过研究何志雄教授一生的成才之路,我们发现中医经典著作所蕴含的深刻的科学内涵及唯物主义哲学思想是何老学术思想的根源,而近代科学思潮使先生具备崇尚实证的学术风格。何老朴实无华,注重实际的风格体现于其诸多论著之中。幼年艰苦的生活经历又铸就了先生坚韧不拔,奋发向上及虚怀若谷的人格品质。从先生的中医之路,我们可以深刻体会到,学习经典,运用经典是中医成才的必由之路；发展中医教育事业,开展中医普及工作是中医发展的内在根据。更多还原

【Abstract】 The academic thought and the clinical experience of the Traditional Chinese Medicine(TCM) doctors is the precious wealth of the TCM, they pushed forward the TCM advanced in many fields, for example of the theories, clinical, herbal medicine and prescription etc. He Zhixiong professor is one of the present eminent scholar of Shang Han Lun in south of the Five Ridges, and a outstanding theorists, educators and doctor in modern time. He had a Rigorous scholarship, and concentrated on studying of Shang Han Lun several spring autumn, elucidated many theory problem very clear, such as typhoid six through substantial, the typhoid stomach theory, six through Ying-Wei etc. He applied himself to the theory studies in the meantime, paied attention to a theory studies achievement to use it in clinical practice, and be good at using syndrome-differentiation of the six meridians to six exopathogens exogenous diseases. He had a lot of experience and insightful views. for the application of classical prescription or recipe, farther more, he used classical prescription or recipe to many difficult and baffling diseases, and had a style of taught by excellent ancient faculty but not textualism, and as a rule of pathogenetic condition to adjusted theclassical prescription or recipe to apply with the diseases. In clinical practice, he used to make a point of maintaining gastric qi in treatment of many diseases, and he emphasized "The human is take the gastric qi as the foundation ", "the gastric qi strong and the entrails strong", and he take strengthens the body’s natural resistance and removes harmful factors importantly as its near the card characteristic, gained in the massive valuable experience, all is the contemporary Lingnan traditional Chinese medicine precious wealth.This research mainly use the theory on exogenous febrile disease correlation theories and method, through collection and collation Professor He Zhixiong’s male related literature material, interviewed with what old concerned character, thus gains accounts orally the material, and using Chinese medicine medicine history literature, Chinese medicine various theory research technique, to research deepingly and systemicly the academic thought and clinical experience of Professor He Zhixiong, and is advantageous for the Lingnan theory on exogenous febrile disease academic inheritance and the development. He accumulates abundant of academic ideological content in his life time, and the author has the choices in the selection with the purpose of carries on system thorough combing to the key content and studies, so I highlighted study the contents of representative, the system info complete and has the great use value. I plan study other He Zhixiong’ s Academic thought One after another in research work from now on. This research has mainly four part:The first part is about He Zhixiong’ s male biography introduction. Through careful material collection, I describes in detail of the exterior historical evidence of He Zhixiong’s whole Life experiences and steps onto road of the TCM and becomes a generation of everybody. For the purpose of take the historical evidence as the basis, in order to discuss the external environment factor of historical agent regarding of Professor He Zhixiong steps onto road onto TCM, and from his life experience to track out the contributing factor that He Zhixiong Resolved TCM, Practiced medicine provides relief and obtained the rich fruit. Takes advantage of this to give the inspiration and the inspiration to those who resolves the Chinese medicine.The second part is the choice academic of He Zhixiong. Professor He Zhixiong is one of famous man in Lingnan Shanghan Lun, He has obtained the rich research results and the experience realized of the theory explains and clinical utilization of Shanghan lun. Through reorganizes Professor He Zhixiong’s literature material and accounts orally material, and union typhus study correlation theories and method, we found that Professor He Zhixiong explained the Six Confucian classics essence was based on the theory of entrails and meridian, take "The Medical Classic of the Yellow Emperor", "Difficultly after" and so on TCM classic as theory basis, and union Shanghan six pass through own intrinsic distinctive quality, to discuss all-sided and systemic the essence which six pass of Shangha. Based on the study of Shanghan Lun for many years, Professor He Zhixiong thought that gastric qi said the penetration in Shanghan Lun the theory and the method throughout and is the important part of Shanghan Lun.’He Zhixiong emphasizes that master gastric qi deeply is one of the key method of study Shanghan Lun and using classical prescription, and this has a big inspiration significance of the research of Shanghan Lun. Using the Shanghan gastric qi as a door and rood, for the research typhus, the use ancient Chinese medical classics opened a new way.The third part is about He Zhixiong’s clinical experience. As many Lingnan doctors, He Zhixiong is not only a theoretician, educationalist of TCM, but also a clinical man of action. He payed great attention the intrinsic uniformity of TCM theory and practice, farther more, he stressed that foundation of TCM lies in the theory invention and TCM vitality is simple, convenient, effect, inexpensive of clinic practise, those two inseparable and should perform to take seriously. After done scholarly research and teaching, he payed attendance to the clinic practise, and gained in the massive valuable experience. Through research we discover that he used to use syndrome-differentiation of the six meridians to treatment the exogenous diseases, and in the six Confucian classics distinguished govern in the utilization to gain in the rich experience, and dialectical distinguishes by the six Confucian classics treats external disease factors various diseases accompanied by fever is its big characteristic. As to tnternal injury various illnesses, he always use internal organs dialectical. At the practise, he emphasis the dialectical unification relations partial and overall, partial and partial. In the clinic treatments, he pay attention tothe patient’ s gastric qi in the treatment.The forth part is the research of He Zhixong’s Medical notes of classical prescription or recipe. He is one of the elitist school of classical prescriptions in Lingnan, studying and applying classical prescriptions in his life time, and have gained in the rich experience in the theory and application. Through collection and collation his classical prescription medical notes,, we find that he payed great attention on "the right relative between anagraph and symptom-complex" in our research, and he emphasized the key of applying classical prescription or recipe was that, the first is to formula master and deeply understand the mechanism and law of the using add and subtract change, the second is skilled using the four methods of examination in order to collecte clinical manifestation comprehensive and accurately, and grasp cause of a disease, mechanism accurately. Through in-depth research HeZhiXiong professor’s academic thoughts, we draw that he is a outstanding contemporary of Shanghan Lun in Lingnan, a famous man of the classical prescription or recipe, a Educator of TCM and a Clinical doer. Invigorating the spleen to strengthen body resistance is the center and the key content of HeZhiXiong professor academic ideas, and it through out the six channels essence, illness and Ying-Wei of Shanghan; and invigorating the spleen is He Zhixiong’s commonly used treatment, and have made great achievements. Through the study of HeZhiXiong professor life path, we found that the the scientific connotation and materialist philosophy in TCM classic is the basic of HeZhiXiong professor academic ideas, and the modern scientific socialism improve he has a positivism academic style. He Zhixiong is simple and unadorned, and practical style reflected in its many works. From his road of TCM, we find deeply that studying and use the TCM classic is the only road to a successful TCM doctor; and developing TCM education career and TCM popularization is the intrinsic basis of TCM developing.更多还原