本文關(guān)鍵詞： 王鴻度 營衛(wèi) 皮腠 神氣 學(xué)術(shù)思想　出處：《成都中醫(yī)藥大學(xué)》2016年博士論文　論文類型：學(xué)位論文

【摘要】：研究目的：營氣、衛(wèi)氣是人身的重要精微物質(zhì)。在《黃帝內(nèi)經(jīng)》中,關(guān)于營衛(wèi)來源、生成及運(yùn)行均有明確的論述,并得到歷代醫(yī)家重視�！峨y經(jīng)》、《傷寒論》均運(yùn)用并發(fā)揮了營衛(wèi)生會的理論。后世醫(yī)家,特別是明清眾多知名醫(yī)學(xué)家,不約而同地反復(fù)爭論這一理論,形成了“衛(wèi)氣清降而產(chǎn)陰精……營血溫升而化陽神”的結(jié)論,成為明清之際中醫(yī)學(xué)界蔚為壯觀的營衛(wèi)問題大論戰(zhàn)的重要理論成果。全國第五批名老中醫(yī)師承專家王鴻度教授繼承先賢學(xué)術(shù)觀點(diǎn),進(jìn)一步提出營衛(wèi)氣化完成新陳代謝,是營衛(wèi)問題的實(shí)質(zhì)。但既往中醫(yī)基本理論對其說理不清,甚至相互淆混。營衛(wèi)由攝入水谷精微在中焦生成,并逐級運(yùn)行到皮膚腠理,再返回體內(nèi)的過程,這一由內(nèi)向外、并由外之內(nèi)的過程,正是為了完成營衛(wèi)新陳代謝,包括營衛(wèi)的交感離合、相互轉(zhuǎn)化、合以大氣、變生神氣等環(huán)節(jié),并在這些環(huán)節(jié)中發(fā)揮其重要生理功用。本研究以王老師的“皮腠神氣變生機(jī)制”為核心,整理其學(xué)術(shù)思想淵源、立論依據(jù)及主要內(nèi)容等。同時結(jié)合王老師臨床治療周圍神經(jīng)性面癱和帶狀皰疹后遺留神經(jīng)痛的經(jīng)驗(yàn),說明此理論的實(shí)際運(yùn)用。為更好地認(rèn)識這一重要理論,又實(shí)施了“圍刺法治療帶狀皰疹后遺留神經(jīng)痛”的臨床實(shí)驗(yàn),從“淺針圍刺,激神止痛”角度,驗(yàn)證皮腠構(gòu)造、皮腠神氣以及帶狀皰疹后遺留神經(jīng)痛相關(guān)性,以臨床實(shí)驗(yàn)數(shù)據(jù)初步闡明其臨床療效。研究方法：1.跟師臨證：筆者在三年跟師過程中,堅(jiān)持跟師門診,在老師診療過程中細(xì)心觀察,用心體會老師臨證的過程,詳細(xì)記錄老師的望、聞、問、切收集的臨床資料,以利于診后的思考和總結(jié)。堅(jiān)持隨時記錄老師用藥的心得體會,堅(jiān)持多看、多想、多問,堅(jiān)持對老師典型的醫(yī)案進(jìn)行總結(jié),體會和揣摩老師的辨證心路和用藥依據(jù)。2.研讀經(jīng)典：在老師的指導(dǎo)下,多讀相關(guān)的經(jīng)典著作,全面理解老師的學(xué)術(shù)思想淵源,對經(jīng)典中的重點(diǎn)條文能理解到字的內(nèi)涵,且在此過程中參考?xì)v代注家之言,盡量做到融會貫通。3.研讀和探討老師論著中的學(xué)術(shù)觀點(diǎn)：對老師已經(jīng)發(fā)表的學(xué)術(shù)論文認(rèn)真研讀,領(lǐng)會其思想,并在平日的跟師過程中對其中不甚清晰的理論和思路及時向老師請教,使自己更好地體會老師的學(xué)術(shù)觀點(diǎn)和理論淵源。4.臨床運(yùn)用：將老師的理論和學(xué)術(shù)經(jīng)驗(yàn)運(yùn)用于臨床實(shí)踐,在老師皮腠神氣變生理論指導(dǎo)下,在臨床上,常常運(yùn)用治表以和里、調(diào)和營衛(wèi)的方法治療疾病,拓展了自己的臨床思路,且將這一理論用于指導(dǎo)臨床實(shí)驗(yàn)研究。研究內(nèi)容：1.王鴻度教授“皮腠神氣變生機(jī)制”的學(xué)術(shù)淵源和立論依據(jù)輯集《黃帝內(nèi)經(jīng)》及后世眾多醫(yī)家關(guān)于營衛(wèi)生會的論述中,探討營衛(wèi)之氣生會的意義,皮腠及皮腠間存在特殊構(gòu)造——“絡(luò)脈一孫脈”的生理功能；整理前賢營衛(wèi)升降之氣的氣化過程：包括交感、離合,以及合以大氣,變生皮腠神氣等。論證營衛(wèi)氣化是人體新陳代謝的重要過程；營衛(wèi)氣化的目的是“棄舊用新”,包含物質(zhì)、能量代謝以及神氣變生；皮腠是營衛(wèi)氣化的重要場所,因此也是神氣變生的加工廠。2.王鴻度教授“皮腠神氣變生機(jī)制”學(xué)術(shù)思想內(nèi)涵以及臨床經(jīng)驗(yàn)包括“皮腠神氣變生機(jī)制”的論據(jù)和論證、神氣主要性用等內(nèi)容。并選擇出周圍性面癱和帶狀皰疹后遺留神經(jīng)痛為例,系統(tǒng)整理和總結(jié)王鴻度教授應(yīng)用“皮腠神氣變生機(jī)制”于針灸常見病的臨床經(jīng)驗(yàn),包括對病因病機(jī)、病證分期的新認(rèn)識,治則治法的選用,方藥和穴位的選擇配伍等等。3.“皮腠神氣變生機(jī)制”運(yùn)用于治療帶狀皰疹后遺留神經(jīng)痛的臨床實(shí)驗(yàn)觀察。帶狀皰疹后遺留神經(jīng)痛的疼痛因年齡、體質(zhì)等因素有較大差別。帶狀皰疹后遺留神經(jīng)痛臨床主要表現(xiàn)為刺痛、或灼熱樣疼痛或皮膚的異常感覺,筆者在王老師的指導(dǎo)下,以“淺針圍刺,激神止痛”為法,選圍刺法治療這種典型的皮腠感覺異常的病證,進(jìn)行隨機(jī)對照臨床觀察,且測量帶狀皰疹后遺留神經(jīng)痛在治療前后的疼痛程度、情緒、睡眠以及血清中P物質(zhì)的含量,以科學(xué)檢測數(shù)據(jù)驗(yàn)證圍刺法對于帶狀皰疹后遺留神經(jīng)痛的有效性。結(jié)論：1.王鴻度教授在營衛(wèi)氣化理論的基礎(chǔ)上,論證營衛(wèi)之氣在皮腠經(jīng)由絡(luò)脈—孫脈這一特殊結(jié)構(gòu),交感氣化,并合以大氣,以變生神氣的過程,概括為“皮腠神氣變生機(jī)制”。這一機(jī)制是對營衛(wèi)氣化學(xué)說的補(bǔ)充,也是對中醫(yī)關(guān)于營衛(wèi)生理認(rèn)識的升華。而皮腠神氣是人體生理調(diào)衡及中醫(yī)眾多外治方法的作用基礎(chǔ)。2.王鴻度教授運(yùn)用該理論指導(dǎo)臨床,形成了對周圍性面癱、帶狀皰疹后遺留神經(jīng)痛等的獨(dú)具特色臨床診療經(jīng)驗(yàn),取得良好的療效,這一理論也啟發(fā)了筆者的深入思考和理解。3.運(yùn)用“皮腠神氣變生機(jī)制”為指導(dǎo),觀察圍刺法治療帶狀皰疹后遺留神經(jīng)痛的臨床實(shí)驗(yàn)觀察,以血清中P物質(zhì)的定量測定作為觀察指標(biāo)之一,客觀地論證了皮腠神氣的變化與疼痛產(chǎn)生的相關(guān)性,以及經(jīng)皮治療的有效性。
[Abstract]:Objective: To study the camp gas, Wei Qi is an important nutrient substance. People in "Neijing", on Ying Wei source, production and operation are clearly discussed, and get the attention of successive dynasties. Nanjing >, < > was applied in Treatise on Febrile Diseases and play the health camp theory. Doctors later. Especially in Ming and Qing Dynasties many well-known medical experts, invariably debate this theory, formed a "Wei Qi and Yin ofqingjiang. Camp blood temperature rise and Yang God" conclusion, become the important theoretical achievements of the Ming and Qing Dynasties traditional Chinese medicine Wei Ying Wei problem spectacular big debate over fifth. Number of old Chinese Medicine expert Professor Wang Hongdu inherited from the sages academic point of view, put forward to complete the Ying Wei gasification is the essence of Ying and Wei The new supersedes the old., the basic theory of traditional Chinese medicine. But the previous reasoning is not clear, even confusion mixed. Ying Wei generated by the intake of cereal essence in middle Jiao, and gradually. The skin striae, back in the process, from inside to outside, and from within the process, it is in order to complete the transformation of The new supersedes the old. Ying Wei, sympathetic clutch, including Ying Wei, in the atmosphere, air and other aspects of life change, and play an important physiological function in the process of this. Study on Wang's "skin cou air variable mechanism" as the core, finishing its academic origins, theoretical basis and main content. At the same time according to the clinical treatment of peripheral nerve paralysis and Wang postherpetic neuralgia, experience shows that the actual use of this theory. For a better understanding of this important theory in clinical trials, and the implementation of the "Wai Needling Treatment of postherpetic neuralgia", from "shallow needle waici, angle of bowel God pain, verify the skin cou structure, skin cou air and postherpetic neuralgia related to clinical practice. The experimental data clarify its clinical curative effect. Methods: 1. with clinical division: the author in three years with the division process, adhere to with the teacher in the teacher clinic, diagnosis and treatment process of careful observation, experience the process of teacher certificate, a detailed record of the teacher's look, smell, ask, cut to collect clinical data. For after thinking and summary. To find the record at any time teacher use experience, to see more, think more, ask more, insist on the typical case the teacher summed up the experience and try to figure out the teacher's psychological differentiation and medication on the basis of.2.: in the study of classical teacher under the guidance of reading related classics, comprehensive understanding the teacher's academic ideological origins, the key provisions of the classic of understanding to the word meaning, the note reference words and in the process, try to achieve mastery.3. reading and Discussion on the academic point of view: the teacher of teachers have been published The papers carefully read, understand their thoughts, theories and ideas and in everyday with the teacher in the process of which is not very clear in time to ask the teacher, to better understand the teacher's academic viewpoints and theoretical origin of the clinical application of.4.: the theory of teacher experience in academic and applied in clinical practice, the teacher in the skin cou was changed under the guidance of the theory, in clinical treatment, often used to and in the method of regulating Ying and Wei to treat disease, expand the clinical thinking of their own, and this theory will be used to guide the clinical and experimental research. The research contents: 1. Professor Wang Hongdu "the skin cou metaplasia air mechanism" of the academic origin and argument on the basis of the anthology < Neijing > and later many doctors will discuss about the camp health, explore the Yingqi and Weiqi students the significance of physiological function has special structure of skin and skin -- "cou cou collaterals a sun pulse of the whole; The gasification process of the gas lift and former Ying Wei: including sympathetic, clutch, and in the atmosphere, air. That variable hides cou Ying Wei gasification is an important process of human The new supersedes the old.; Ying Wei gasification is to abandon the old with the new, including material, energy metabolism and air change; the skin is cou an important place for Ying Wei gasification, and therefore air change students "Professor.2. Wang Hongdu leather processing factory with variable mechanism be" academic thoughts and clinical experience including "skin cou air variable mechanism" argument, mainly by air content. And the choice of the peripheral facial paralysis and postherpetic neuropathic pain as an example, the system summarizes professor Wang Hongdu used "the skin cou air change mechanism" on the clinical experience of acupuncture of common diseases, including the pathogenesis of the disease, a new understanding of staging, selection of therapeutic methods, prescription and acupuncture points The clinical observation of the choice of compatibility and so on.3. skin cou metaplasia air mechanism employed in the treatment of postherpetic neuralgia. Postherpetic neuralgia pain due to age, have great differences in physical factors. Postherpetic neuralgia clinical manifestations were tingling or burning pain or abnormal sensation the skin, the king under the guidance of teachers, in order to "light around needle thorn, bowel pain God" method, choose confining needling method for treatment of skin cou the typical syndrome of abnormal feeling, conducted randomized controlled clinical observation, measurement and postherpetic neuralgia left in the degree of pain before and after treatment, mood. Sleep as well as the content of substance P in serum, with scientific detection data validation waici method is effective for postherpetic neuralgia. Conclusion: 1. professor Wang Hongdu based on the theory of Ying Wei gasification demonstration, Ying Qi and Wei Qi in Through the skin cou collaterals - Sun veins of this special structure, and sympathetic gasification, to the atmosphere, to change the students with the process, summed up as "skin cou air variable mechanism. This mechanism is to supplement Qi chemical said, but also on the Chinese camp on health physical understanding of sublimation. An effect of.2. on skin striae of Professor Wang Hongdu using treatment methods of human physiological balance and many outside of the traditional Chinese medicine theory to guide clinical, formation of peripheral facial paralysis, postherpetic neuralgia and other unique clinical experience, good curative effect, this theory also inspired the author's deep thinking and understanding.3. the use of" air variable skin cou mechanism "as the guide, the clinical observation of peri needling method for treatment of postherpetic neuralgia, with quantitative substance P in serum as observed indexes of objectively demonstrates the skin cou gas become God The association with pain and the effectiveness of percutaneous treatment.

【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2016
【分類號】：R249

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