中医学教学课件：01 绪论

TraditionalChineseMedicine1IntroductionSectionⅠ

HistoricalevolutionofTCM

1.TheoriginofTCM

2.InitiationanddevelopmentoftheoreticalsystemofTCM

SectionⅡBasiccharacteristicsoftheoreticalsystemofTCM1.ConceptionofHolism

整体观念2.TreatmentDeterminationBasedonSyndromeDifferentiation辨证施治2SectionⅠ

HistoricalevolutionofTCM1.TheoriginofTCM

Productionactivitiesandsocialpracticecreatthemedicine

Shennongtastedhundredsofgrassesandfoundherbs

神农尝百草一日而遇七十毒《淮南子·修务训》

Bianstoneisthesproutofacupuncture

砭石治病，即针刺萌芽，开创针刺疗法

Inventionofthemetallurgyimprovetheneedlinginstrument

冶金术发明，针具不断改进

Thediscoveryandusingofthefireproducedthemoxibustion

火的发现与使用，产生灸法32.InitiationanddevelopmentoftheoreticalsystemofTCM

TheculturalandsocialbackgroundoftheformationofthetheoreticalsystemofTCM1)TheinfiltrationofancientphilosophyThetheoriesofYin-YangandtheFiveelementspenetratedintoallfieldsofthesociety,eveninmedicine

阴阳五行学说2)Theinfluenceoffarmingculture特定地理环境条件生产方式

生活方式文化形态

农耕、放牧、航海世界文化原型农耕放牧渔猎航海5TheculturalandsocialbackgroundoftheformationofthetheoreticalsystemofTCM

黄河及长江中下流域——适宜耕作

（中国古代文化特点）农耕文化影响、渗透中医学

长于观察，经世致用崇尚祖先，敬仰天地6TheculturalandsocialbackgroundoftheformationofthetheoreticalsystemofTCM3)Specificgeographicalenvironment

特定的地理环境东及东南濒临浩瀚太平洋西南高不可攀世界屋脊西及西北杳无人烟戈壁荒漠北部人迹罕至西伯利亚7TheculturalandsocialbackgroundoftheformationofthetheoreticalsystemofTCM

内陆腹地，区域广泛，土地辽阔交通极不发达，国际间文化交流困难避免固有文化间断和异化得以沿着自身文化轨迹发展8EvolutionofTCM1Thefoundationoftheoreticalsystem理论体系奠基时期——春秋战国至东汉《Huangdi'sInternalClassic》《黄帝内经》Theearliestextantmedicalmasterpiece.

PlainQuestions

素问MiraculousPivot灵枢9EvolutionofTCM1Thefoundationoftheoreticalsystem

《Huangdi'sInternalClassic》Systematicallyexpoundthehumanbodyphysiology、pathology、diagnosis、treatmentandprevention系统阐述人体生理、病理、诊断、治疗乃至预防

PrimarilyestablishthetheoreticalsystemframeworkofTCM

初步确立中医学理论体系框架

Combinethehumanbodyandthenature、socialenvironment、mentalactivitiestogether

将人体与自然、社会环境、心理活动等因素结合综合考虑

Containtherudimentofthehumanbody-socal-psychologicalmedicalpatternsinthemodernworld

蕴含当今世界医学人体—社会—心理医学模式结构的雏形1Thefoundationoftheoreticalsystem

理论体系奠基时期——春秋战国至东汉《Shennong'sClassicofMedicinalHerbs》《神农本草经》

Theearliestextant

pharmacologymasterpieceRecord365medicines,252plantmedicines,67animalmedicines,46mineralmedicinesincluded

载药365种，植物药252种、动物药67种、矿物药46种Presentfourproperties,fiveflavorsandsevenrelationsofmedicinalcompatibilityetc.pharmaceuticaltheoriesforthefirsttime首次提出了四气、五味和七情等药物学理论FoundatethebasicframeofthetheoryofChinesemateriamedica

奠定了中药学理论的基本框架11EvolutionofTCM1Thefoundationoftheoreticalsystem

理论体系奠基时期——春秋战国至东汉《TreatiseonColdPathogenicandMiscellaneousdiseases》Theearliestextantclinicalmedicinemonograph

《伤寒杂病论》是目前我国现存最早的一部临床医学专著

Establishtheruleoftreatmentdeterminationbasedonsyndromedifferentiation确立辨证施治法则

SettlethefoundationforChineseMedicinetherapy奠定了中医治疗学的基础12EvolutionofTCM1Thefoundationoftheoreticalsystem

理论体系奠基时期——春秋战国至东汉《TreatiseonColdPathogenicandMiscellaneousdiseases》东汉张仲景《TreatiseonColdPathogenicDiseases》——《伤寒论》《SynopsisofGoldenChamber》——《金匮要略》Inthebook,thetheory,principle,formula,medicinalareallgiven.Itiscalled"theancestorofformula".理法方药具备，为“方书之祖”EvolutionofTCM2.Developmentofclinicaldepartments临证各科逐步完备时期——晋唐variousclinicalbranches分支学科出现Sphygmology:《PulseClassic》

byWangShuhe,theearliestmonographofpulseloreextant

脉学，王叔和《脉经》现存最早脉学专著Thetheoryofetiologyandpathogenesis:《GeneraltreatiseonCausesandManifestationsofAllDiseases》byCaoYuanfang

病因病机学，巢元方《诸病源候论》14EvolutionofTCM针灸学，皇甫谧《针灸甲乙经》妇产科学，昝(zan)殷《产宝》儿科学，太医署设学制5年少小科，《颅囟经》问世外科学，刘涓子《刘涓子鬼遗方》15EvolutionofTCM

专科蓬勃发展，专著相继问世《备急千金要方》《千金翼方》《外台秘要》形成世界医学中心16EvolutionofTCM3.Contentionofahundredschoolsofthought学派涌现，理论提高时期——宋、金、元

儿科、妇科、针灸、法医、免疫接种等学科日趋成熟陈无择“三因观点”《铜人腧穴针灸图经》

宋慈王唯一陈自明17EvolutionofTCMFourgreatphysiciansintheJinandYuandynasties金元“四大家”刘完素“寒凉派”张从正（子和）“攻下派”李东垣“补脾派”朱丹溪“滋阴派”朱丹溪18EvolutionofTCMFourgreatphysiciansintheJinandYuandynastiesLiuWansu——schoolofcoldmedicine

EnlightenedbytheoriesofpathomechanismandfivecircuitsandsixclimatesinPlainQuestions,heraisedthetheorythatdiseasesmostlyarisefrom"fire",believingthat"exogenouslycontractedsixclimaticagentswouldbetransformedintofire";"extremelyhyperactivityofthefiveemotionscanallleadtoproductionoffire".Sohepreferredtousecoldandcoolmedicinalsandprescriptionsintreatmentofdisease.EvolutionofTCMFourgreatphysiciansintheJinandYuandynastiesZhangCongzheng——schoolofeliminatingpathogen

Heheldthataperson'sillnessismainlycausedbyinvasionofpathogenicqi,oncethepathogenicqiwasdispelled,theillnesswilldisappear;soheadvocatedthateliminationofpathogenicqiisthekeymatterintreatmentofdisease.Histherapiesaremainlydiaphoresis,emesisandpurgationinordertogettheaimofeliminatingthepathogenandsafeguardingthevital.EvolutionofTCMFourgreatphysiciansintheJinandYuandynastiesLiDongyuan——schoolofstrengtheningthespleen

Hebelievedthattheoccurrenceofdiseaseismostlyrelatedtotheendogenousinjuryofthespleenandstomach.Heemphasizedthespleenandstomachbelongtotheearthinthefiveelementsthatisthemotherofeverything,serveasthesourceofgeneration;ifthespleenandstomachgetdisordered,manydiseaseswillappearconsequently.Healsoexpoundedalotthetheoryofascending-descendingofqidynamicofthespleenandstomach,andputfirstthenourishingthespleenandstomachintreatmentofdisease.EvolutionofTCMFourgreatphysiciansintheJinandYuandynastiesZhuDanxi——schoolofnourishingyin

HeblendedtheopinionsofthethreeschoolsofLiu,ZhangandLi,andhewasgoodatdiagnosisandtreatmentofmiscellaneousdiseases,withmanyoriginalideas.Hegavefurtherexplanationofministerialfire（相火）theory.Hebelievedthebasicpathologicalchangeofdiseaseisthat"yangiseverexcessivewhileyiniseverindeficiency",andadvocatedtheremediesofnourishingyinandreducingfire.EvolutionofTCM4.Theschoolofwarmdiseasesemerged温病学崛起和成熟时期——明、清温病学理论体系形成吴又可《瘟疫论》提出“戾气”致病叶天士《温热论》卫、气、营、血辨证吴鞠通《温病条辨》三焦辨证李时珍——《本草纲目》载药1892种235.Mordentimes近代中医学研究与发展时期——近代和现代民国时期，国民政府扼杀中医，大批志士奋起抗争新中国，中医学事业飞跃发展，各种研究获可喜成果24TheWHOTraditionalMedicineStrategy2014-2023ThegoalsofthestrategyaretosupportMemberStatesin:harnessingthepotentialcontributionofTMtohealth,wellnessandpeoplecentredhealthcare;promotingthesafeandeffectiveuseofTMbyregulating,researchingandintegratingTMproducts,practitionersandpracticeintohealthsystems,whereappropriate.1.ConceptionofHolism整体观念

Socalled"wholeness"signifiestheunityandintegrityofathing.Chinesemedicineholdsthatthehumanbodyisanorganicwholeinwhichallconstituentpartsarestructurallyinseparable,functionallycoordinativeandinteractive,andpathologicallyinter-influencing.Anditalsorecognizesmaniscloselyrelatedwithnaturalandsocialenvironments,manmaintainsitsnormllifeactivityinthepracticeofactiveadaptingandtransformingnature.

Thiskindofthinkingoftheintegrityofthebodyitselfandtheunityofman'sinternalandexternalenvironmentsistheconceptionofholismofChinesemedicine.SectionⅡBasiccharacteristicsoftheoreticalsystemofTCM1)Humanbodyasanorganicwhole人是一个有机整体生理上相互联系形神合一

fivezang-viscera以五脏为中心病理上相互影响组织结构相互沟通精气血物质相同脏腑机能密切联系心理与生理机能有机结合271.ConceptionofHolism

整体观念2)Unityofmanandnature人与自然统一人与环境统一人与地域统一3)Closerelationofmantosociety人与社会统一

职业地位经济条件不同文化背景差异

天人合一身心机能差异劳心者中虚筋柔骨脆劳力者中实骨劲筋强281.ConceptionofHolism

整体观念291.Terminology

专有名词disease病：acompletemorbidprocessincludingspecificcause,modeofonset,typicalclinicalpresentation,developinglawandoutcome,forexample,commoncold,dysentery.symptom症，症状：adiscomfortfeltsubjectivelybythepatient,suchaspain,dizziness,nauseaetc.患者主观感觉到的不适sign征，体征：theabnormalchangespresentedobjectivelybythemorbidbody,forexample,maculeandpacule,redtongueetc.病体客观表现出的异常变化2.TreatmentDeterminationBasedonSyndromeDifferentiation

辨证施治1.Terminology

专有名词syndrome证(候)：apathologicalsummaryinagivenstageofadiseaseinitscoursemadebythedoctor,whichincludesthecauseofdisease(wind-cold,stagnantblood),focusofdisease(externally,internally,inaviscus,inameridian),natureofdisease(cold,heat),situationofdisease(mild,severe,chronicandacute),andrelationshipbetweenthepathogenicandthevital(deficiencyandexcess).Itmarkstheessenceofpathologicalchangeatpresent.疾病本质，疾病过程中某一阶段的病理性概括(病因、病机、病位、病性、病变趋势)312.TreatmentDeterminationBasedonSyndromeDifferentiation

辨证施治Syndromedifferentiation

辨证：Toanalyze,differentiateandrecognizethesyndromeofadisease.辨，即甄别。证，即证候。所谓辨证，将四诊所收集的症状、体征病史资料，进行分析综合，辨清疾病的原因、性质、病位、以及邪正之间的关系，概括、判断为某种性质的证。Treatmentdetermination论治：Toconsiderandformulatethecorrespondingtherapeuticprincipleandmethodaccordingtotheresultofsyndromedifferentiation.根据辨证结果，确定治疗方案。2.TreatmentDeterminationBasedonSyndromeDifferentiation

辨证施治Differenttreatmentsforthesamedisease同病异治：forthesamediseasebecauseofdifferenttimesandgeographicareasofattack,aswellasthepatient'sreactions,orbecauseofdifferentstagesofdevelopmentinwhichthediseaseis,theconclusion