董湘玉教授情志病學(xué)術(shù)觀點(diǎn)及臨床經(jīng)驗(yàn)總結(jié)
發(fā)布時(shí)間：2018-08-28 12:03
【摘要】：董湘玉教授,籍貫四川省平昌縣,畢業(yè)于貴陽(yáng)中醫(yī)學(xué)院,曾師老中醫(yī)許玉鳴先生,主任醫(yī)師、碩士生導(dǎo)師、師承碩博士導(dǎo)師,是全國(guó)第五批老中醫(yī)藥專(zhuān)家學(xué)術(shù)經(jīng)驗(yàn)繼承工作指導(dǎo)教師,貴州省第一屆名中醫(yī)。她苦研《內(nèi)經(jīng)》、《傷寒論》、《金匱要略》等經(jīng)典著作,注重前賢醫(yī)家之說(shuō),仲景之學(xué),從“中醫(yī)基礎(chǔ)理論”課、“內(nèi)經(jīng)”課教師開(kāi)始,臨證驗(yàn)學(xué)。從脾胃病臨床入手,漸感所遇脾胃病患者,多為情志所擾。遂逐其奧,探求情志疾病醫(yī)理,發(fā)現(xiàn)運(yùn)用傳統(tǒng)中醫(yī)心理學(xué)理論指導(dǎo)臨床,所效者眾,但業(yè)內(nèi)實(shí)踐者少。孜孜以求,近四十載如一日,勤讀書(shū),多臨證,著書(shū)立說(shuō),為中醫(yī)心理學(xué)默默奉獻(xiàn),是現(xiàn)今《中醫(yī)心理學(xué)》臨床應(yīng)用的踐行者。她開(kāi)創(chuàng)貴州中醫(yī)心理學(xué)先河,在全國(guó)率先創(chuàng)辦貴陽(yáng)中醫(yī)學(xué)院中醫(yī)醫(yī)學(xué)、心理學(xué)雙學(xué)位辦學(xué)模式,使中醫(yī)心理專(zhuān)業(yè)學(xué)生既有心理學(xué)學(xué)位又有中醫(yī)臨床學(xué)位,將中醫(yī)心理醫(yī)生和臨床醫(yī)生二合一,廣獲贊譽(yù),為中醫(yī)心理專(zhuān)業(yè)培養(yǎng)了大批實(shí)用型人才,桃李滿(mǎn)天。侍診中,感受到董老不僅具有深厚的醫(yī)學(xué)知識(shí)和豐富的臨床經(jīng)驗(yàn),而且在工作、生活中和藹可親,作風(fēng)嚴(yán)謹(jǐn),一絲不茍,是我們學(xué)習(xí)的榜樣。三年的侍診和學(xué)習(xí),不僅看到了董老師對(duì)中醫(yī)事業(yè)的求索專(zhuān)研,更是感受到董老扎實(shí)的中醫(yī)內(nèi)涵和獨(dú)特的診療技術(shù),本文主要從三個(gè)方面進(jìn)行闡述。第一方面是對(duì)董老學(xué)術(shù)淵源的概述及歸納董老對(duì)于中醫(yī)心理學(xué)的認(rèn)識(shí)及貢獻(xiàn)。董老不僅吸納了《內(nèi)經(jīng)》、《傷寒》、《金匱》中對(duì)情志疾病有關(guān)的理論體系、診療特點(diǎn)及情志與五臟關(guān)系方面的學(xué)說(shuō),且對(duì)中醫(yī)心理學(xué)思想進(jìn)行了挖掘和歸納并實(shí)踐于臨床,為中醫(yī)心理學(xué)的理論研究及推廣、教學(xué)默默奉獻(xiàn),成果斐然,餞行“形神合一”思想指導(dǎo)情志疾病臨床辨證論治。第二方面是對(duì)董老學(xué)術(shù)思想和臨床經(jīng)驗(yàn)的總結(jié)。跟師學(xué)習(xí)三年,隨診和整理董老病案,認(rèn)為董老學(xué)術(shù)思想：一是重視中醫(yī)心理學(xué)的臨床應(yīng)用(情志疾病的治療)。崇尚仲景學(xué)說(shuō),“方證相應(yīng)”、“病機(jī)相從”使用經(jīng)方來(lái)治療情志疾病。二是重視“氣機(jī)”對(duì)于情志疾病的重要性。在辨證中處處以“氣機(jī)”為核心。三是在具體治療中,老師注重藥療、意療、放松療法相結(jié)合,始終貫穿“心身同治”學(xué)術(shù)思想。四是診法合參重問(wèn)診。形成了對(duì)于情志疾病特有的治病求本的辨證論治思想體系。臨床用藥上講求“藥證相應(yīng)、依法化裁”,善用“氣藥”。如重視中醫(yī)心理學(xué)的臨床應(yīng)用(情志疾病的治療)。她不但在理論研究領(lǐng)域碩果累累,而且勤于實(shí)踐,用自己的行動(dòng)證明了中醫(yī)心理學(xué)的臨床實(shí)效性,重視“經(jīng)方”對(duì)于情志疾病治療的有效性研究,并通過(guò)自己幾十年的臨床實(shí)踐,總結(jié)出了一套運(yùn)用“經(jīng)方”藥物治療情志疾病的理論體系,即“方證相應(yīng)”、“病機(jī)相從”學(xué)說(shuō),并用大量的實(shí)例證明了她理論的實(shí)效性。重視“氣機(jī)”對(duì)于情志疾病的重要性。董老認(rèn)為現(xiàn)代生活方式和社會(huì)環(huán)境特點(diǎn),凡情志疾病的發(fā)生,無(wú)論外感或內(nèi)傷皆源于“氣機(jī)”失衡,認(rèn)為情志疾病以“氣機(jī)調(diào)暢”為重。在辨證中處處以“氣機(jī)”為核心。通過(guò)調(diào)“氣”來(lái)調(diào)和臟腑陰陽(yáng)的平衡,達(dá)到陰平陽(yáng)秘,臟腑氣血功能和諧的目的。善用疏理氣機(jī)、滋陰、活血化瘀、調(diào)和陰陽(yáng)法等方法調(diào)和“氣機(jī)”,治療各種中醫(yī)情志疾病。在具體治療中,老師注重藥療、意療、放松療法相結(jié)合,始終貫穿“心身同治”學(xué)術(shù)思想,講究形神合一。所以在辨證治療上是整體考慮,治療上也是將藥物治療和情志放松療法配合使用方能起到良好的效果。如順情從志、說(shuō)理開(kāi)導(dǎo)、情志相勝、移精變氣、行為治療、占?jí)粜g(shù)、攝心術(shù)等等診法合參重問(wèn)診。通過(guò)“問(wèn)診”與患者進(jìn)行良好的互動(dòng)和溝通,運(yùn)用詢(xún)問(wèn)、引導(dǎo)、舒解、共情等技巧和方法,讓患者樂(lè)于配合,事半功倍。問(wèn)診尤重大便與睡眠。通過(guò)詢(xún)問(wèn)大便情況來(lái)掌握疾病的性質(zhì)。故通過(guò)詢(xún)問(wèn)大便性狀、頻率、顏色可反映脾、胃、腸,氣機(jī)運(yùn)轉(zhuǎn)情況,脾、胃、腸氣機(jī)暢順與否,對(duì)于情志疾病的轉(zhuǎn)歸、和預(yù)后都有著至關(guān)重要的作用,對(duì)于病情的判斷尤為重要；董老問(wèn)診,也十分重視詢(xún)問(wèn)睡眠情況。因?yàn)樗吲c人體衛(wèi)氣的循行和陰陽(yáng)的氣機(jī)變化和盛衰有十分密切的關(guān)系。陰陽(yáng)失調(diào),必然影響心神,神志不安乃致失眠,情志疾病多半都會(huì)有睡眠的障礙和不調(diào)。而且通過(guò)對(duì)于“夢(mèng)境”的分析,也能運(yùn)用“釋夢(mèng)”的方法,分析出情志疾病的根源,有助于情志疾病的診療,所以老師臨證時(shí)每每重視患者睡眠情況的詢(xún)問(wèn)。臨床用藥上也有獨(dú)特之處。講求“藥證相應(yīng)、依法化裁”,善用“氣藥”。所謂“藥證相應(yīng)、依法化裁”是指經(jīng)方中的每一味藥,常常都有它的位置,它的主治。認(rèn)識(shí)了藥物主治,以藥測(cè)證,才會(huì)知道方劑的加減；處方時(shí)依據(jù)每首“經(jīng)方”所含的“法”,就是“經(jīng)方法則”進(jìn)行化裁。通過(guò)對(duì)“經(jīng)方”治療疾病內(nèi)含的“法則”的認(rèn)識(shí),有針對(duì)性的選擇相應(yīng)的藥物達(dá)到治療的目的。也許藥味不盡相同,但是“法則”正確,一樣可以收到很好的效果；老師在治療情志疾病時(shí),時(shí)刻不忘調(diào)理氣機(jī),行氣導(dǎo)滯,董老認(rèn)為人的五臟六腑,肌肉筋骨均以氣血為紐帶相互聯(lián)系成為整體,如果運(yùn)行暢順,沒(méi)有瘀滯身體就能平和健康,反之則疾病叢生。基于這個(gè)觀點(diǎn),老師用藥的時(shí)候,每首方子都不忘行氣藥物的運(yùn)用。第三方面是繼承與創(chuàng)新。鑒于董老治療“不寐”在臨床有明顯的特色,取得了較為滿(mǎn)意的療效。故對(duì)臨床侍診時(shí)收集的“不寐”病案,用“中醫(yī)傳承輔助系統(tǒng)”軟件,對(duì)其組方規(guī)律進(jìn)行分析和總結(jié)。達(dá)到深入了解處方人對(duì)疾病的認(rèn)識(shí)、組方的思路和用藥的特點(diǎn),對(duì)中醫(yī)藥的學(xué)術(shù)繼承與創(chuàng)新有重要意義。采用規(guī)則分析、改進(jìn)的互信息法、復(fù)雜系統(tǒng)熵聚類(lèi)、無(wú)監(jiān)督的熵層次聚類(lèi)、等數(shù)據(jù)挖掘方法,總結(jié)出董老治療“不寐”的新方和用藥內(nèi)在規(guī)律,為實(shí)現(xiàn)傳統(tǒng)經(jīng)驗(yàn)數(shù)據(jù)化做出了有益的嘗試。
[Abstract]:Professor Dong Xiangyu, a native of Pingchang County, Sichuan Province, graduated from Guiyang College of Traditional Chinese Medicine, Mr. Xu Yuming, a senior doctor, a master's supervisor, a master's supervisor, and a master's supervisor, is the fifth group of experts of traditional Chinese medicine in China to inherit their academic experience, and the first Chinese medicine teacher in Guizhou Province. Classic works, pay attention to the theory of former doctors, Zhong Jing's learning, from the "basic theory of traditional Chinese medicine" class, "internal classics" class teachers, clinical experience. But there are few practitioners in this field who have been working hard for nearly forty years. They have studied diligently, had more clinical symptoms, written books and written their opinions. They are silently dedicated to the psychology of traditional Chinese medicine, and are practitioners of the clinical application of Psychology of Traditional Chinese Medicine. Students majoring in medical psychology have both a degree in psychology and a degree in clinical medicine. They have combined traditional Chinese medicine psychologists with clinicians and won wide acclaim. They have trained a large number of practical talents for the specialty of Chinese medicine psychology. Three years of attendance and study, not only saw Mr. Dong's pursuit of the cause of Chinese medicine, but also felt that Mr. Dong's solid connotation of Chinese medicine and unique diagnostic and therapeutic techniques, this article mainly from three aspects to elaborate. The first aspect is an overview of Dong's academic origins and This paper summarizes Dong Lao's understanding and contribution to the psychology of traditional Chinese medicine.Dong Lao not only absorbed the theory system related to emotional diseases, diagnosis and treatment characteristics, but also the theory of the relationship between emotions and the five viscera in < Neijing >, < typhoid fever >, < Jinkui >. The second part is the summary of Dong Lao's academic thought and clinical experience. After three years'study with his teachers, he followed up and sorted out Dong Lao's medical records. Advocate Zhongjing theory, use classical prescriptions to treat emotional diseases, and emphasize the importance of Qi-Qi. Put Qi-Qi at the core of syndrome differentiation. Thirdly, in the specific treatment, the teacher pays attention to the combination of medication, intention therapy and relaxation therapy, and always runs through "the same treatment of mind and body". Academic thinking. Fourthly, diagnostic methods combined with consultation. Formed a unique thought system of syndrome differentiation and treatment for emotional diseases. In clinical medication, it emphasized "corresponding medicines and syndromes, tailored according to law", and made good use of "Qi medicine". For example, it emphasized the clinical application of psychology of traditional Chinese medicine (the treatment of emotional diseases). She not only made great achievements in the field of theoretical research, but also made great achievements. And diligent in practice, with their own actions to prove the clinical effectiveness of traditional Chinese medicine psychology, pay attention to the effectiveness of "Jingfang" for the treatment of emotional diseases, and through their own decades of clinical practice, summed up a set of "Jingfang" drug treatment of emotional diseases theoretical system, that is, "recipe and syndrome correspond" and "pathogenesis follow" study. Dong Lao believed that the occurrence of all emotional diseases, whether external or internal, originated from the imbalance of Qi and Qi. He believed that emotional diseases were mainly caused by Qi and Qi. "Qi" is the core. Through "Qi" to balance the Yin and Yang of viscera and viscera, to achieve the purpose of Yin and Yang secretion, viscera and blood function harmony. Combination, always run through the "mind-body treatment" academic thinking, pay attention to the unity of form and spirit. So in the treatment of syndrome differentiation is considered as a whole, treatment is also the combination of drug treatment and emotional relaxation therapy can play a good effect. The patient is willing to cooperate and get twice the result with half the effort through good interaction and communication with the patient through "inquiry". It is especially important to inquire about stool and sleep. It is very important to judge the prognosis and prognosis of emotional diseases, and it is also very important for Dong Lao to inquire about the sleep condition. Yang disorder, will inevitably affect the mind, restlessness is caused by insomnia, emotional diseases will mostly have sleep disorders and imbalance. And through the analysis of "dream" can also be used to "dream" method, analysis of the root causes of emotional diseases, help the diagnosis and treatment of emotional diseases, so the teacher always pay attention to the patient's sleep inquiries. Question. Clinical medication is also unique. Emphasis should be laid on "corresponding medication and syndrome, tailoring according to law" and making good use of "qi medicine". The "method" contained in it is to modify the "principle of classical methods". Through the understanding of the "rule" contained in the "prescription" for the treatment of diseases, we can select the corresponding drugs to achieve the purpose of treatment. Don't forget to regulate Qi and conduct Qi stagnation. Dong Lao thinks that the five viscera, muscles, tendons and bones are linked by Qi and blood as a whole. In view of the obvious clinical characteristics of Dong Lao's treatment of insomnia, satisfactory results have been achieved. Therefore, the "insomnia" medical records collected during clinical service were analyzed and summarized with the software of "Chinese Medicine Inheritance assistant system" to get a better understanding of the prescription's knowledge of the disease and the thinking of the prescription. It is of great significance for the academic inheritance and innovation of traditional Chinese medicine to summarize Dong Lao's new prescription and the inherent law of medication by using data mining methods such as rule analysis, improved mutual information method, complex system entropy clustering, unsupervised entropy hierarchical clustering and so on. Try.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R249;R277.7
本文編號(hào)：2209339
[Abstract]:Professor Dong Xiangyu, a native of Pingchang County, Sichuan Province, graduated from Guiyang College of Traditional Chinese Medicine, Mr. Xu Yuming, a senior doctor, a master's supervisor, a master's supervisor, and a master's supervisor, is the fifth group of experts of traditional Chinese medicine in China to inherit their academic experience, and the first Chinese medicine teacher in Guizhou Province. Classic works, pay attention to the theory of former doctors, Zhong Jing's learning, from the "basic theory of traditional Chinese medicine" class, "internal classics" class teachers, clinical experience. But there are few practitioners in this field who have been working hard for nearly forty years. They have studied diligently, had more clinical symptoms, written books and written their opinions. They are silently dedicated to the psychology of traditional Chinese medicine, and are practitioners of the clinical application of Psychology of Traditional Chinese Medicine. Students majoring in medical psychology have both a degree in psychology and a degree in clinical medicine. They have combined traditional Chinese medicine psychologists with clinicians and won wide acclaim. They have trained a large number of practical talents for the specialty of Chinese medicine psychology. Three years of attendance and study, not only saw Mr. Dong's pursuit of the cause of Chinese medicine, but also felt that Mr. Dong's solid connotation of Chinese medicine and unique diagnostic and therapeutic techniques, this article mainly from three aspects to elaborate. The first aspect is an overview of Dong's academic origins and This paper summarizes Dong Lao's understanding and contribution to the psychology of traditional Chinese medicine.Dong Lao not only absorbed the theory system related to emotional diseases, diagnosis and treatment characteristics, but also the theory of the relationship between emotions and the five viscera in < Neijing >, < typhoid fever >, < Jinkui >. The second part is the summary of Dong Lao's academic thought and clinical experience. After three years'study with his teachers, he followed up and sorted out Dong Lao's medical records. Advocate Zhongjing theory, use classical prescriptions to treat emotional diseases, and emphasize the importance of Qi-Qi. Put Qi-Qi at the core of syndrome differentiation. Thirdly, in the specific treatment, the teacher pays attention to the combination of medication, intention therapy and relaxation therapy, and always runs through "the same treatment of mind and body". Academic thinking. Fourthly, diagnostic methods combined with consultation. Formed a unique thought system of syndrome differentiation and treatment for emotional diseases. In clinical medication, it emphasized "corresponding medicines and syndromes, tailored according to law", and made good use of "Qi medicine". For example, it emphasized the clinical application of psychology of traditional Chinese medicine (the treatment of emotional diseases). She not only made great achievements in the field of theoretical research, but also made great achievements. And diligent in practice, with their own actions to prove the clinical effectiveness of traditional Chinese medicine psychology, pay attention to the effectiveness of "Jingfang" for the treatment of emotional diseases, and through their own decades of clinical practice, summed up a set of "Jingfang" drug treatment of emotional diseases theoretical system, that is, "recipe and syndrome correspond" and "pathogenesis follow" study. Dong Lao believed that the occurrence of all emotional diseases, whether external or internal, originated from the imbalance of Qi and Qi. He believed that emotional diseases were mainly caused by Qi and Qi. "Qi" is the core. Through "Qi" to balance the Yin and Yang of viscera and viscera, to achieve the purpose of Yin and Yang secretion, viscera and blood function harmony. Combination, always run through the "mind-body treatment" academic thinking, pay attention to the unity of form and spirit. So in the treatment of syndrome differentiation is considered as a whole, treatment is also the combination of drug treatment and emotional relaxation therapy can play a good effect. The patient is willing to cooperate and get twice the result with half the effort through good interaction and communication with the patient through "inquiry". It is especially important to inquire about stool and sleep. It is very important to judge the prognosis and prognosis of emotional diseases, and it is also very important for Dong Lao to inquire about the sleep condition. Yang disorder, will inevitably affect the mind, restlessness is caused by insomnia, emotional diseases will mostly have sleep disorders and imbalance. And through the analysis of "dream" can also be used to "dream" method, analysis of the root causes of emotional diseases, help the diagnosis and treatment of emotional diseases, so the teacher always pay attention to the patient's sleep inquiries. Question. Clinical medication is also unique. Emphasis should be laid on "corresponding medication and syndrome, tailoring according to law" and making good use of "qi medicine". The "method" contained in it is to modify the "principle of classical methods". Through the understanding of the "rule" contained in the "prescription" for the treatment of diseases, we can select the corresponding drugs to achieve the purpose of treatment. Don't forget to regulate Qi and conduct Qi stagnation. Dong Lao thinks that the five viscera, muscles, tendons and bones are linked by Qi and blood as a whole. In view of the obvious clinical characteristics of Dong Lao's treatment of insomnia, satisfactory results have been achieved. Therefore, the "insomnia" medical records collected during clinical service were analyzed and summarized with the software of "Chinese Medicine Inheritance assistant system" to get a better understanding of the prescription's knowledge of the disease and the thinking of the prescription. It is of great significance for the academic inheritance and innovation of traditional Chinese medicine to summarize Dong Lao's new prescription and the inherent law of medication by using data mining methods such as rule analysis, improved mutual information method, complex system entropy clustering, unsupervised entropy hierarchical clustering and so on. Try.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R249;R277.7
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3 王宇;遲淑清;;試論女性倫理沖突與情志疾病[J];醫(yī)學(xué)與社會(huì);2007年04期
4 付娟;;論中醫(yī)對(duì)情志疾病的診治方法[J];吉林中醫(yī)藥;2009年08期
5 劉斯文;;結(jié)合經(jīng)典論著淺談中醫(yī)情志疾病[J];繼續(xù)醫(yī)學(xué)教育;2012年10期
6 鄭翔;;情志疾病辨治偶得[J];黑龍江中醫(yī)藥;1985年02期
7 唐學(xué)游;;鳴高立異 灼見(jiàn)粲然——淺析何鴻舫治療情志疾病特色[J];中醫(yī)雜志;1995年07期
8 劉慶憲;馬曉玲;;抑郁癥相關(guān)情志疾病論析[J];中華中醫(yī)藥學(xué)刊;2010年04期
9 尚貞一,馬長(zhǎng)春,李晶;中醫(yī)對(duì)情志疾病的認(rèn)識(shí)[J];長(zhǎng)春中醫(yī)學(xué)院學(xué)報(bào);1999年03期
10 禾子;;音樂(lè)按摩,養(yǎng)生之良方[J];健康;2010年12期
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