本文選題：黃元御　切入點(diǎn)：中醫(yī)　出處：《北京中醫(yī)藥大學(xué)》2016年博士論文

【摘要】：黃元御(1705～1758),名玉路,字元御,一字坤載,號(hào)研農(nóng),別號(hào)玉楸子,山東昌邑人,清代乾隆年間著名醫(yī)學(xué)家。黃元御學(xué)問(wèn)深湛,著作宏富,先后寫成《傷寒懸解》《金匱懸解》《四圣懸樞》《四圣心源》《長(zhǎng)沙藥解》《傷寒說(shuō)意》《素靈微蘊(yùn)》《玉楸藥解》《素問(wèn)懸解》《靈樞懸解》《難經(jīng)懸解》醫(yī)著十一部,《道德懸解》和《周易懸象》哲學(xué)著作兩部。黃元御成就卓著,但因其針砭時(shí)弊,言辭激烈,故其學(xué)術(shù)沉寂200余年,研究者殊少。近年來(lái)學(xué)術(shù)界逐漸重視其學(xué)術(shù)貢獻(xiàn),關(guān)注并研究其醫(yī)學(xué)思想的學(xué)者越來(lái)越多,但系統(tǒng)研究黃元御的學(xué)術(shù)思想,尤其是研究其臨床運(yùn)用的論文依然偏少。因此,整理其學(xué)術(shù)思想,發(fā)掘其臨床價(jià)值,對(duì)提高中醫(yī)藥臨床效果,具有十分重要意義。目的通過(guò)對(duì)黃元御著作全面整理,分析,歸納,闡釋,深入研究挖掘黃元御的學(xué)術(shù)思想,分析提煉其臨床運(yùn)用思路,拓展其理論運(yùn)用領(lǐng)域,以期有效發(fā)揚(yáng)黃氏學(xué)術(shù)特色,提高臨床療效。方法運(yùn)用文獻(xiàn)學(xué)、考據(jù)學(xué)、臨床案例總結(jié)研究方法,搜集、整理古今相關(guān)研究文獻(xiàn)資料,全面研讀黃元御現(xiàn)存醫(yī)學(xué)著作及相關(guān)參考資料,提煉黃氏學(xué)術(shù)思想。通過(guò)實(shí)地調(diào)研,走訪黃氏生前活動(dòng)主要區(qū)域,走訪相關(guān)學(xué)者專家及黃氏后人尤其是學(xué)術(shù)傳承人,了解其所處時(shí)代背景及生平事跡,以期補(bǔ)充其生平資料,分析其學(xué)術(shù)思想產(chǎn)生原因。咨詢專家,拜訪一些對(duì)黃元御學(xué)術(shù)思想有深入研究的專家學(xué)者,聽(tīng)取意見(jiàn)和建議,進(jìn)一步理清研究脈絡(luò),拓展研究思路。在臨床跟師以及實(shí)踐中體悟黃元御醫(yī)學(xué)思想的臨證運(yùn)用思路。結(jié)果論文主體分為七章,主要有以下成果：第一章,黃元御生平著作及學(xué)術(shù)傳承。本章全面系統(tǒng)分析黃元御的生平、黃元御的人生履歷以及學(xué)術(shù)思想形成時(shí)間,其次根據(jù)研究文獻(xiàn),整理了黃元御的著作版本及其內(nèi)容與特色。最后文獻(xiàn)考證了黃元御學(xué)術(shù)傳承人,并分析其傳人在其基礎(chǔ)上的學(xué)術(shù)創(chuàng)新及貢獻(xiàn)。第二章,黃元御學(xué)術(shù)思想形成背景。本章分別從黃元御思想形成的地域背景、時(shí)代背景、以及家學(xué)淵源和個(gè)人抱負(fù)方面分析；重點(diǎn)論述清儒學(xué)以及乾嘉漢學(xué)對(duì)其學(xué)術(shù)思想的形成深刻影響；此外從儒家立功、立德、立言方面分析黃元御的個(gè)人抱負(fù)是其學(xué)術(shù)思想形成重要因素。第三章,黃元御學(xué)術(shù)思想原本。本章詳細(xì)考查黃元御學(xué)術(shù)思想形成因素,認(rèn)為黃氏學(xué)術(shù)思想形成主要有兩個(gè)來(lái)源：一是中國(guó)古代哲學(xué)思想,一是四圣經(jīng)典著作。古代哲學(xué)尤其是河圖的生化,洛書的制化思想,《周易》的象數(shù)思想,以及老子道論思想,為黃氏學(xué)術(shù)思想形成根本源泉；黃氏學(xué)說(shuō)形成另一本源是《黃帝內(nèi)經(jīng)》、《難經(jīng)》、《傷寒雜病論》等經(jīng)典著作。此外前代醫(yī)學(xué)流派,尤其是明代的慎齋學(xué)派的學(xué)術(shù)思想對(duì)黃氏學(xué)說(shuō)形成也起了舉足輕重的作用。第四章,黃元御學(xué)術(shù)思想概論。本章詳細(xì)分析了黃元御主要學(xué)術(shù)思想：一、崇土扶陽(yáng)。黃元御十分重視中土脾胃的作用,提出脾胃為五臟氣機(jī)之樞軸,內(nèi)傷雜病的治療,強(qiáng)調(diào)中土,恢復(fù)脾升胃降之常,陰平陽(yáng)秘,從而達(dá)到痊愈的目的。二、土樞四象,一氣周流。黃元御對(duì)脾胃中氣在人體氣機(jī)變化的核心作用非常重視,建立了“土樞四象,一氣周流”的醫(yī)學(xué)生理模型。三、五行生克重氣不重形。黃氏精通陰陽(yáng)五行學(xué)說(shuō),將四圣著述中有關(guān)藏府、經(jīng)絡(luò)、氣血、津液、皮肉、筋骨、毛發(fā)孔竅、精神等之陰陽(yáng)屬性,歸納闡述得透徹入微,其對(duì)于五行生克重氣不重形,其五行學(xué)說(shuō)以氣而立論。四、六經(jīng)氣化。黃元御精研《內(nèi)經(jīng)》運(yùn)氣氣化和《傷寒論》六經(jīng)理論,從而將二者融合,形成六經(jīng)氣化的思想,認(rèn)為六經(jīng)之病皆為氣化之病,以運(yùn)氣理論全面闡釋傷寒六經(jīng)的生理特點(diǎn)和病理特征,并自創(chuàng)相應(yīng)的調(diào)理六氣之偏的藥方。五、溫病按《傷寒論》六經(jīng)分證。黃元御對(duì)溫病的辨證皆按《傷寒論》六經(jīng)分證方法,對(duì)其證候進(jìn)行分證歸類；根據(jù)各經(jīng)主要癥狀表現(xiàn),辨證施治。第五章,黃元御臨床思路與特點(diǎn)。本章詳細(xì)梳理黃元御醫(yī)學(xué)思想,理清了黃元御辨證思路及臨床特點(diǎn)：黃氏非常重視人體氣機(jī)升降,多從氣機(jī)升降的角度分析生理病理,創(chuàng)造性發(fā)明六氣樞軸升降辨證法；黃元御善于以脈象確定病位病性,把復(fù)雜的脈法化繁為簡(jiǎn),提綱挈領(lǐng),對(duì)比研究,易于掌握；黃元御提出陽(yáng)衰水寒、土濕木郁之說(shuō),認(rèn)為“濕”、“寒”是疾病產(chǎn)生和死亡的重要因素,其機(jī)理就是“水勝土負(fù)”,主張人體常宜維持“土勝水負(fù)”的內(nèi)環(huán)境；在治療方面,用一氣周流調(diào)臟腑虛實(shí),用五行及脈象定位指導(dǎo)臨床用藥。此外,本文還對(duì)黃元御自創(chuàng)方劑及其臨床運(yùn)用進(jìn)行分析討論,有助于把握黃元御臨床思路。第六章,黃元御學(xué)術(shù)貢獻(xiàn)及其影響。本章對(duì)黃元御學(xué)術(shù)貢獻(xiàn)及影響進(jìn)行分析,認(rèn)為黃元御最大的學(xué)術(shù)成就有兩方面：一是考注詮釋經(jīng)典,對(duì)四圣之書詳悉詮解并有發(fā)揮；二是獨(dú)創(chuàng)新說(shuō),建立六氣樞軸辨證體系以辨氣機(jī)升降,根據(jù)六經(jīng)分類以辨證溫病。其影響一是對(duì)火神派形成產(chǎn)生重要影響,二是對(duì)后世醫(yī)家重陽(yáng)抑陰、重視脾土、重視氣機(jī)升降產(chǎn)生深刻影響。第七章,黃元御學(xué)術(shù)思想之現(xiàn)代價(jià)值。本章通過(guò)將黃元御學(xué)術(shù)思想與現(xiàn)代疾病診療對(duì)照,認(rèn)為黃氏學(xué)說(shuō)對(duì)現(xiàn)代疾病治療有重要指導(dǎo)作用：黃元御強(qiáng)調(diào)陽(yáng)衰、善用泄水補(bǔ)火、扶陽(yáng)抑陰為治療大法,對(duì)于治療現(xiàn)代人陽(yáng)虛導(dǎo)致的疾病有很好的指導(dǎo)作用；對(duì)于以氣機(jī)升降失調(diào)為主的脾胃疾病,運(yùn)用黃氏創(chuàng)立的“一氣周流”“土樞四象”“左升右降”的中氣升降理論來(lái)指導(dǎo)臨證辨證施治,必將有助于完善和豐富脾胃病的理論體系,拓展治療的思路,對(duì)提高臨床療效有極大的指導(dǎo)意義；黃元御在外感病以及傳染病方面辨證治療思想方法,必將對(duì)中醫(yī)治療這方面疾病開(kāi)辟一些新的思路,為中醫(yī)預(yù)防和治療此類疾病提供依據(jù)。此外本章探討了黃氏學(xué)說(shuō)在針灸中的創(chuàng)新運(yùn)用,研究了其六經(jīng)氣化思想在針灸同名經(jīng)和表里經(jīng)的取穴以及一氣周流的左升右降在針灸中調(diào)氣的指導(dǎo)意義。結(jié)論本論文創(chuàng)新成果主要體現(xiàn)在以下幾個(gè)方面：第一,首次系統(tǒng)梳理黃元御的學(xué)術(shù)著作版本及其內(nèi)容特色,同時(shí)根據(jù)文獻(xiàn)資料總結(jié)出黃氏醫(yī)學(xué)流派的傳承情況；第二,全面分析了黃元御的學(xué)術(shù)思想的形成背景以及學(xué)術(shù)源流；第三,詳解黃元御主要核心醫(yī)學(xué)思想,全面分析總結(jié)出黃元御醫(yī)學(xué)思想臨床運(yùn)用思路,為其理論到臨床架起橋梁,從而利于其學(xué)術(shù)思想的臨床推廣；第四,詳細(xì)總結(jié)了黃元御的學(xué)術(shù)影響以及現(xiàn)代研究意義,創(chuàng)新性地提出黃氏思想與針灸臨床的有機(jī)結(jié)合,拓展了黃元御學(xué)術(shù)思想的臨床運(yùn)用范圍。
[Abstract]:In recent years , the academic thought of Huang Yuanyu was studied , and its clinical value was analyzed , summarized and explained , and the academic thought of Huang Yuan was studied . This chapter systematically analyzes Huang Yuanyu ' s life history and academic thoughts formation time .
This paper focuses on the study of Confucianism and Qian Jihan ' s influence on the formation of his academic thoughts ;
In the third chapter , Huang Yuanyu ' s academic thought was originally composed of two sources : one is the ancient philosophy thought and one is the four holy classics .
In this chapter , Huang Yuanyu ' s theory of Yin and Yang is discussed in detail .
In this chapter , Huang Yuanyu ' s theory of syndrome differentiation and its clinical characteristics are discussed in detail .
Huang Yuanyu is good at determining the disease position with pulse image , and complicated pulse method is simplified , and the comparison study is easy to master ;
Huang Yuanyu pointed out that " wet " and " cold " are the important factors of disease production and death , and the mechanism of " wet " and " cold " is the important factor of disease production and death .
In this chapter , the author analyses the contribution and influence of Huang Yuanyu ' s academic contribution and its influence .
The author thinks that Huang Yuan ' s theory plays an important role in the treatment of modern diseases by comparing Huang Yuanyu ' s academic thoughts with modern disease diagnosis and treatment .
For the spleen and stomach diseases mainly caused by the rising and descending of the inflators , the theory system of " left ascending and right descending " of " one - gas weekly flow " created by Huang - shi is used to guide the treatment of syndrome differentiation , which will help to perfect and enrich the theoretical system of the spleen and stomach disease , expand the thought of treatment , and has great significance for improving the clinical curative effect ;
This paper discusses the innovative application of Huang ' s theory in acupuncture and moxibustion , and studies the application of Huang ' s theory in acupuncture and moxibustion . It also discusses the application of Huang ' s theory in acupuncture and moxibustion .
Secondly , the formation background of Huang Yuan ' s academic thought and the academic source flow were analyzed comprehensively .
Third , detailed analysis of Huang Yuanyu ' s main core medical thought , the comprehensive analysis summed up the clinical application of Huang Yuanyu medical thought , the theory to the clinical erection of the bridge , thus being beneficial to the clinical popularization of his academic thought ;
The fourth , summarizes the academic influence of Huang Yuanyu and the significance of modern research , puts forward the organic combination of Huang ' s thought and the clinic of acupuncture and moxibustion , and expands the scope of clinical application of Huang Yuanyu ' s academic thought .

【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R249
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本文編號(hào)：1672170