节点文献
梦的中医辨证研究
【作者】 池孟修；
【导师】 陈家旭；
【作者基本信息】 北京中医药大学 ， 中医诊断学， 2014， 博士
【摘要】 中医诊断学的主要内容是辨证论治,辨证论治是中医的特色与优势,对患者进行四诊的收集,再加以分析诊断辨别不同的证候分型,是临床进行立法处方的依据。然而,由于中医学自身的主观诊断特点和学科发展的不均衡,导致证候的定义、证名的表述以及各具体证候诊断标准都存在很大的模糊性。开展证候规范化研究,对于发展中医理论,提高临床诊治水平均具有很重要的意义,是中医学向客观化迈进的先决条件。梦,是睡眠中特有的主观体验,是一种人的意识的外显现象。梦具有多样的不同表现形式与性质,这主要有两种来源一是：个体天生体质的差异性以及后天经验的多样性；二是外来刺激的种类以及其强度。寐梦,自古就引起人们极大的好奇、关注和研究。有关文字记载的历史就有数千年之久,其研究一直围绕着天文、哲学、军事、政治、中医学等方面。对于梦境中所出现的感官感觉,自身思考,影像及声音的描述,我们称之为梦象。梦象在反映出人体的健康状况上有一定程度的价值。对于梦本质与疾病的关系中医学有较早的认识,也因此积累了较丰富的理论和经验。所以梦象是对病人的病变部位及病变性质进行的一种重要依据,更进一步还可以预示出疾病的愈后、发展与演变方向。首先,研究中医梦诊,首先必须了解梦的成因,先决条件就是如何入寐生梦。中医对于睡眠的研究多围绕中医理论中的五行、五神(神、魂魄为主)、营卫、阴阳、脏腑等学说,并结合临床治疗睡眠障碍进行研究。其中针对五神中的神、魂、魄进行的探讨,对于神直接影响到机体的作用,以及心藏神,心为五脏六腑之大主,心为君主之官,统御着五脏六腑。心神直接抑制或增强影响的大脑的思维,对内控制着各个脏腑的运行与内源性情绪的刺激,对外抵御外来的刺激,不论是六淫邪气或是人与人之间的言语情绪刺激。皆会影响于机体的平衡。以此来讨论心神的在中医梦学中实质的意义。其次,藉用西方医学中的生理学与病理学角度来探讨致梦的因素,讨论生理之梦与病理之梦的区别。透过了解西方梦学大师弗洛伊德与分析心理学大师荣格,来探讨意识、前意识、潜意识(无意识)与个人无意识、集体无意识与梦的关联。西方运用实事求是及注重经验分析的科学原则来剖析梦,弗洛伊德解析梦的核心内容主要关注性方面的内容,尤其是那些童年性经验,后天被压抑且被遗忘的童年时期的经验,弗洛伊德在解析梦上就是去挖掘分析这些经验。荣格早期传承了弗洛伊德的梦论,但后来荣格发现了弗洛伊德梦论的局限性以及都是以性为最终的结论,因此荣格提出了意识、个人无意识、集体无意识。对于弗洛伊德的梦论做出了修正,认为弗洛伊德主要是从个人经验去探索、寻找梦的意义。而荣格不仅仅是从个人的意识、无意识,更从整个种族角度、经验去探索梦的含意,进而提出了集体无意识这个概念,集体无意识主要是由无数的原型(archetype)所组成的,梦中梦象讯息是透过“集体无意识->原型->原始意象“的方式表现、显化出来,因此集体无意识是一种更高更宽广的存在,而梦是人们透过原型意象窥探原型得以感受到这集体无意识存在的一种方式。最终,从中医的取象比类的研究方式与西方经验分析的科学原则,结合讨论神与意识之间的关系；魂魄与前意识、潜意识的对应关系；日常的梦(生理或病理的梦)、原型的梦(信息的梦)之中寻找有临床价值的诊断方法,并着找出其逻辑架构；以容格原型的角度来比对有中华文化特色的原型,并提取出有助于中医临床诊断价值的原型。本论文主要运用西方梦学思维特色寻求中医梦诊的新思路,运用意识、个人无意识、集体无意识的角度来观察中医梦的本质,并且比对其逻辑结构,结合中华民族的文化特点、中医梦诊,对应的其逻辑关系,衔接中国解梦,探讨中华原型的临床价值与意义。进而架构中医梦学的诊断框架,为中医诊断规范化研究尽一份心力。
【Abstract】 Syndrome differentiation is the core of TCM diagnosis, and advantage. By collecting and analyzing patient through four ways of diagnosis, and differentiating different syndromes is the core principle of prescribing formulas. However, because of the subjective and unbalance in subject development, causing the terminology and its explanation to be vague in standards. Starting the research of terminology is very important for the development of TCM theory, and is significant for TCM moving towards objective.Dream is a unique subjective experience. It is human’s conscience explicit phenomenon. Dream has variety of styles and nature. The main origin composes of: different in subjects’unique character and later experience, as well as different types and depth of exterior stimulant. Dream always has attracted human’s interest, attention, and research. Literal documented history traces back thousands of years ago. Dream’s research is surrounded by astronomy, philosophy, military, politic, and TCM. The sensations experienced in dreams are called dream signs, dream signscan reflect human’s health status to a certain degree. TCM’s acknowledgment towards dream and pathology has been long and therefore has vast theory and experience. dream signsis a important evidence to predict patients’ illness both in location and nature. Moreover, even the outcome of the illness.First of all, to study TCM dream diagnosis, one must understand how dream is caused. TCM has vast of research towards sleep surrounding TCM theory such as five elements、 five-sprit、Ying wei、Ying Yang、zang fu etc., combining with clinical treatments towards sleeping disorder. In it, the discussion towards five-sprit god-mind、hun、po, and god-mind’s effect towards the body’s function, and heart harbors god-mind is king of five-zang and six-fu, ruling the organs。God-mind directly inhibits and strong then the mind of the brain, controlling the function of all organs and stimulant of internal emotions. All external stimulants either by six-ying Exogenous or social communication all affect body’s balance.Secondly using western physiology and pathology’s point of view to discuss dream. to discuss normal and ill dreams. By understanding The master of western dream Freud and and master of Analytical psychology Carl Gustav, to discuss conscience、pre conscious、 sub-conscience、personal conscious and personal unconscious、collective unconscious and dream signs connection。The west uses evidence and experience to scientifically analyze dreams. Freud explains dreams through sexual experiences, especially those in childhoods. Suppressed and abandoned childhood experience is what Freud focuses on to explain dreams. Carl Gustav uses Freud’s theory yet later finds all outcome leads to sex. Therefore Carl Gustav come up with conscious、personal unconscious、collective unconscious. Carl Gustav made amendments to Freud’s dream theory, and thinks Freud only discuss from personal experience. Carl Gustav discusses dream through personal conscious、unconscious, and from whole racial experience, suggests collective unconscious concept, collective unconscious is combined by different archetype. The dream-signs express and manifest its message through collective unconscious->Archetype->Original Images.Therefore collective unconscious is a higher and more vase existence. And dream is just a way of Archetype to observe the conscious Archetype is a way to feel the existence of collective unconscious.Lastly, through TCM’s image comparison method to join with western’s scientific principle. To discuss the relationship between God mind and conscience; soul and pre conscious、sub conscious co relations. Daily dreams(physical or pathological)、Archetype dream(Dream with message) ways to clinically diagnosis. And finding the logical structure. Carl Gustav Archetype’s point of views to compare with Chinese’ Archetype, and finding the valuable Archetype of TCM diagnosis.This essay uses new ideas through western dream theory to discuss TCM dream diagnosis. Through conscience、personal unconscious、collective unconscious’s point of view to observe TCM dreams core, and to compare it’s logical structure. Combining Chinese culture character with TCM dream diagnosis, it’s logical relation, with Chinese dream explanation, to discuss Chinese Archetype’s clinical values and meaning, therefore building the TCM dream diagnosis structure, and aiding TCM diagnosis in standardization.