【作者】 马艾菲；

【导师】 张雪亮；

【作者基本信息】 中国中医科学院 ， 中医基础理论， 2009， 硕士

【摘要】 《理瀹骈文》是作者吴师机几十年的膏方穴位敷贴的经验总结和学医的临床感悟。吴师机不拘古法,变内服为外治,有理有据,有法有方的阐述外治之理,敷贴之方。本文旨在对《理瀹骈文》中穴位敷贴方法的理、法、方、用进行的系统研究,以期对穴位敷贴有较为全面的了解,并扩展穴位敷贴方法在养生学中的应用。中医理论指导中医实践,内服外治都是在中医理论的指导下进行的,运用穴位敷贴必须通晓中医理论。阴阳学说贯穿在中医各个理论体系当中,是中医理论和病因病机的基础,同样也是穴位敷贴外治法的理论基础。穴位敷贴的给药途径是经皮肤给药,药物通过皮肤腠理吸收,因此在药物的选择上有外用药使用的自身特点,另外膏方有制成不变的特点,因此在膏方的基础上又有掺药、敷药的使用。敷贴穴位的选择,在遵循针刺选穴原则的基础上,还要考虑药物的吸收作用。在膏方的应用上,可将一种膏方看成是一味药,根据病证阴阳、表里、寒热、虚实的不同,选用一膏或多膏敷贴使用,然而必须医理明晰,方可运用灵活,法不受理掣,方不受法限。讲于未然,试于当然,救于已然,防于复然是穴位敷贴临证应用的四个方面,在现代穴位敷贴的文献中主要是穴位敷贴“救于已然”方面的应用,而且病证亦不如吴师机在《理瀹骈文》中介绍的丰富。在穴位敷贴的应用病证和运用领域还需继续扩展和普及。内服外敷都是以药作用于人,药之性味作用于人体,可对人体阴阳变化产生影响,敷贴之法虽为外治亦需辨证慎用,不可犯虚虚实实之戒。《理瀹骈文》将穴位敷贴疗法系统化、理论化,从理论指导到临证应用均有详细阐述。吴氏运用膏方敷贴治病,不同膏方配合使用,多种方法相结合,临证运用灵活多变。普及穴位敷贴疗法并将其应用到养生防病领域是今后穴位敷贴发展的方向。现代生活方式造成的多种慢性病、常见病将为穴位敷贴疗法提供新的发展空间。更多还原

【Abstract】 Li Yue Pian Wen is Wushiji’s experience summary of point-application and clinical realization about decades. Wushiji is not be limited by paleo-methods, he changed oral administration to external applying, expoundsd external therapy through theory and bases, prescription and methods. The text aim at systematic researching and study on the theory , methods , herbs and application of point-application in Li Yue Pian Wen, in order to have one overall understanding to point-application, and to estend it to health preservation.Theory of Chinese Medicine guides clinical Chinese medicine, internal and external administration are used in Chinese Medicine theory. It is prerequisite to mastership theories of TCM. The theories of zang fu, qi xue jin ye, meridians and etiology and pathogenesis are all on the base of Theory of Chinese Medicine. Yin-yang doctrine impenetrate every theoretical system, and it is theory basis of point-application.The administration route of point-application is percutaneous drug delivery. It is different to absorb herbs through skin and viscera mucosa. So It has its own characteristics for external application in herbs choice. It is not be changed when herbal paste made, so herbs grains are added into herbal paste. Points selection is based on the principle of acupuncture points and herbs absorbing.In using herbal paste,to regard a herbal paste as a herbs, we can use one or more herbal pastes according to disease and syndrome’s yin-yang, superficies and interior, cold and heat, asthenia and sthenia.Internal and external administration are all to use herbs, the nature and flavor of medicines herbs can influence human body’s yin-yang. Point-application is must to be careful used.In Li Yue Pian Wen, point-application is a systematic and theorized external method. It was expounded in theory and clinical application. Wu treated diseases by using herbal pastes-application, match usaging of different herbal pastes, combining multiple methods. Developmental direction of point-application is to put it into health keeping field. Chronic diseases and common diseases will provide new development space for point-application.更多还原