张小萍教授脾胃气化学说的学术思想及临床应用的传承研究
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摘要
目前学术界对于脾胃理论的研究及临床应用,仅停留在对传统脾胃学说的应用及现代诠释上,学说上没有突破,研究上不够全面、深入、细致。尤其是脾胃气化理论,只涉及脾胃升降理论,很少涉及脾胃气机的出入。本人在跟师张小萍教授临床的过程中,发现导师不仅对于脾胃病的治疗,而且对许多内科杂症,处方用药都体现出脾胃气机的升降出入,亦即气化,并逐渐形成脾胃气化的学术观点。笔者在此基础上,根据导师的临床经验及思路,进一步总结、研究并形成理论上的创新——脾胃气化学说,并将导师将这一学说应用于临床各类疾病的学术思想作一总结整理。
     本研究通过跟随导师临床,如实采集、系统整理导师的典型医案、临证经验;并广泛查阅古今文献资料,结合导师的临床经验及用方、用药规律提出脾胃气化学说。并将脾胃气化学说与导师的临床经验结合起来,系统整理导师应用脾胃气化学术思想治疗肾系、肺系、脾胃、肝胆及外感等病症的临床经验、思辨特点及学术思想。
     本研究第一部分是对传统脾胃学说的认识及研究。主要从脾胃学说的渊源及形成、脾胃学说的历代研究、脾胃学说的理论基础、《脾胃论》的主旨与贡献、脾胃学说的现代研究等方面来阐述传统脾胃学说的主要内容、基本观点和现代研究。是脾胃气化学说的理论渊源及理论基础。
     第二部分是对张小萍教授脾胃气化学术思想的探讨。其主要内容可概括为:升降有度、纳化相因、燥湿相宜、出入有序。脾胃气化的关键,不外升与降、纳与化、湿与燥、出与入四个方面。大致说来,脾胃气化学说的内容主要包括:一、升降有度是脾胃气化功能的根本体现:主要从“脾宜升则健”是脾胃气化的关键、“胃宜降则和”是脾胃气化的基础、脾胃升降的辩证关系、脾胃气机升降失调的临床分型及治疗等方面加以论述;二、纳化相因是脾胃气化功能的基本条件:主要从胃纳是脾化的前提,脾化是胃纳的基础、调整脾胃的纳化关系是临床的重要环节、纳运化的辨证关系和临床意义、纳化失常的用药法度、纳化失常的病理及治疗等方面加以论述;三、燥湿相宜是脾胃气化功能的物质基础:主要从燥湿相宜是脾胃气化的有利环境、燥与湿的辨证关系和临床意义、燥湿失宜的用药法度、燥湿失宜的病理及治疗等方面加以论述;四、出入有序是脾胃气化功能的重要体现:主要从卫外营内是脾胃气化的重要功能、脾胃气机的出入是外感和内伤疾病相统一的枢纽、出入无序的用药法度、出入无序的病理及治疗等方面加以论述。
     第三部分是张小萍教授脾胃气化学术思想的临床应用研究。主要包括脾胃病注重脾胃气机的调达、脾胃气化与其他脏腑疾病的治疗、外感疾病及疑难、急重病症、治未病皆应重视脾胃、慢性胃炎、功能性消化不良、消化性溃疡、溃疡性结肠炎、返流性食道炎等疾病的临床用药规律、张小萍教授药对撷英、张小萍教授临床用药特点及典型医案等内容。
The present science for the research of the theory of spleen and stomach and clinical application, only stay on the application of the traditional theory of spleen and stomach and modern interpretation, no breakthrough theory, the study is not comprehensive, depth, and fine. Especially the spleen and stomach gasification theory, only involved lifting theory of spleen and stomach, rarely on the spleen and stomach and out of angry machine. I am in the process of clinical professor with ZhangXiaoPing division, tutor found not only for the treatment of disease of spleen and stomach, and for many medical illnesses, prescription drugs are reflects the rise and fall of angry machine in the spleen and stomach, i.e. the gasification, and gradually formed a taste of gasification academic point of view. The author in this basis, according to the clinical experience and ideas tutor, summarizes, research and form the theory innovation-taste gasification theory, and the theory will be entitled for clinical use each kind of disease's academic thoughts a summary is arranged.
     This study with teacher through clinical, truthfully collection, system to organize the typical teacher YiAn, clinical experience; And widely refer to the ancient and modern literature material, combination of clinical experience and mentor used square, drug laws of spleen and stomach gasification theories put forward. And will taste gasification doctrine and mentor's clinical experience in the combined, mentor application system to organize the spleen and stomach academic thoughts of gasification treating renal, lung, liver, spleen and stomach of conditions such as asthma and clinical experience, the speculation characteristics and academic ideas.
     This study is the first part of the traditional theory of the spleen and stomach know and research. Of the doctrine of the spleen and stomach, mainly from the origin and form of the doctrine of the spleen and stomach, the research of the doctrine of the spleen and stomach, theoretical basis, the taste of theory gist and contribution of the doctrine of the spleen and stomach, modern research aspects elaborated the traditional taste the main content of the theory, the basic concept and modern research. Of the doctrine of the spleen and stomach is gasification theory origin and theoretical basis.
     The second part is to ZhangXiaoPing professor gasification scientific idea of the spleen and stomach discussed. Its main content can be summarized as:lift regularly, the change mutually because of dry wet fitting in and out, and orderly. The key of the spleen and stomach gasification, rise and fall, but on the wet and dry, with the four, the. Broadly speaking, the taste of the doctrine of gasification content mainly includes:a, lift regularly is the fundamental expression function of spleen and stomach gasification:mainly from "spleen appropriate rise is health" is the key of the spleen and stomach gasification,"stomach appropriate drop" is the foundation of the spleen and stomach, spleen and stomach gasification lifting of the dialectical relationship between spleen and stomach, and the clinical classification of angry machine imbalance type and treatment are discussed; Second, because of the spleen and stomach, that is the basic condition of gasification function:mainly from the stomach is the premise of the spleen, stomach, the spleen is the foundation of the spleen and stomach, adjust the accept the relationship between clinical is the important link of the operation, the dialectical relationship between clinical significance, and the disorder of the drug laws, the disorder, the pathological and treatment are discussed; Three, dry wet fitting for gasification function of spleen and stomach is the material basis of:mainly from dry wet fitting for gasification is the favorable environment, spleen and stomach dry and wet the dialectical relationship between clinical significance, dry and wet ShiYi drug laws, the dry wet ShiYi pathological and treatment are discussed; Four, in and out of the spleen and stomach and order is the important embodiment of gasification function:mainly from outside the camp in the spleen and stomach is who the important function of spleen and stomach, gasification and out of angry machine is pathogenic internal injuries and diseases of the unification of the drug hub, in and out of disorder in and out of the pathology of disorder testimonies, and treatment are discussed.
     The third part is ZhangXiaoPing gasification scientific idea of the spleen and stomach, professor of clinical application research. Mainly includes the spleen and stomach disease of the spleen and stomach to angry machine of the spleen and stomach, and other diseases of the zang-fu organs and gasification treatment, pathogenic disease and difficult, the anxious heavy disease, cure is not ill all should attach importance to the spleen and stomach and chronic gastritis, functional indigestion, digestive ulcer, the ulcerous colitis, reflux esophageal infection such as disease clinical medication ZhangXiaoPing rules, professor of medicine XieYing, ZhangXiaoPing professor clinical medication features, typical YiAn, etc.
引文
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