整体观念与辨证施治--课件

整体观念与辨证施治整体观念与辨证施治Concept of entirety and individual treatment 医学课件1 整体观念整体观念是指人体内外环境的统一性、机体自身整体性的思想，称之为整体观念。The concept of entirety refers to the unity of the internal and external environment and the entirety of the body.医学课件2人体是有机的整体人体是有机的整体:Human body is an organic whole：人体是由若干脏器和组织器官所组成的，在生理上相互联系、相互协调，在病理上则相互影响。Human body consists of many visceral organs and organic tissues.They are connected with each other in physiology and pathology.医学课件3机体统一性是以五脏为中心，配以六腑，通过经络系统的作用而实现的，脏腑与脏腑、脏腑与形体各组织器官之间的生理、病理关系。The unity of body centers on the five viscera，with the cooperation of the six bowels and the meridians。医学课件4心合小肠，心主血脉，开窍于舌心合小肠，心主血脉，开窍于舌(heart is connected with small intestine,blood and pulses,tongue)肺合大肠，肺主皮毛，开窍于鼻肺合大肠，肺主皮毛，开窍于鼻(lung is connected with large intestine,skin and hair,nose)脾合胃，脾主肌肉、四肢，开窍于口脾合胃，脾主肌肉、四肢，开窍于口(spleen is connected with muscle,arms and legs,mouth)肝合胆，肝主筋，开窍于目肝合胆，肝主筋，开窍于目(liver is connected with gallbladder,tendon,eye)肾合膀胱，肾主骨，开窍于耳肾合膀胱，肾主骨，开窍于耳(kidney is connected with bladder,bone,ear)医学课件5 脏腑的功能失常，可以通过经络反映于体表，体表组织器官有病，可以通过经络影响到所属脏腑：脏和腑可通过经络的联系而相互影响。Viscera communicate with tissues by meridian。医学课件6 中医诊治疾病，可通过五官、形体、肤色和舌脉等外在变化而了解体内脏腑的虚实、气血的盛衰以及正邪的消长 TCM knows the deficiency and excessiveness of viscera,ascending and descending of qi and blood and the exuberance and debilitation of the healthy qi or pathogenic qi by face,body,tongue and other external changes。医学课件7 例如：临床上用清肝的方法，治疗暴发火眼；用清心、泻小肠火的方法，治疗口舌糜烂 用清胃的方法治疗实火牙疼；用宣肺的方法，治疗感冒咳嗽；用托里、内消等方法，治疗皮肤病、疮疡等。说明人体是一个不可分割的有机的整体。The human body is an indivisible organic whole.医学课件8人和自然界的关系The relationship between human and nature 人类生活在自然界，自然界的运动变化可直接或间接地影响着人体，而人体也必然相应地产生生理或病理上的反映。The nature plays a very important role on human body.医学课件9例如：自然界一年有春温、夏热、秋凉、冬寒四季的变化，人体受它的影响，随之发生生理的调节功能来适应。天气暑热时，人体就以出汗散热来适应。天气寒冷时，人体为了保温，腠理致密而少汗，多余的水液从小便排出。医学课件10 人体对自然界的适应机能还表现在对地理环境、居住条件以及一天中昼夜变化等各方面。一旦气候环境条件变化，超越了人体的适应机能，或人体的调节机能失常，不能对外界变化作出适应性调节就会发生疾病。The ability of human to maintain the nature displays in geography、living conditions、day-to-night change and so on.医学课件11季节性的多发病和流行病更是受自然环境的直接影响。Seasonal frequently-occurring disease and epidemic is directly affected by natural environment.如春季多温病；夏秋季多中暑、痢疾、疟疾等病：冬季多伤寒等。某些慢性病，如痹证、哮喘等往往在气候剧变或季节变换的时候病情加重。有些疾病还可因昼夜变换而影响病情发生变化，例如某些疾病在上午病情较轻，下午至夜问则加重。医学课件12中医认为，人们可以通过锻炼增强体质，改造自然，主动地增强对自然环境的适应力，从而有效地防治疾病。TCM believes that physical exercise and the flexibility of environment can prevent and control diseases.医学课件13辨证施治辨证施治是中医认识疾病和治疗疾病的基本原则，是中医学对疾病的一种研究和处理方法，也是中医学的基本特点之一。Individual treatment is not only the basic principle of understanding and treating diseases,but also is one of the basic characteristics of TCM.医学课件14辨证辨证是分析、辨别、认识疾病的证候Dialectic is the process to analyze、discriminate and recognize symptoms of a disease.论治论治是根据辨证的结果，确立相应的治疗法则。Treatment is to determine corresponding principles of treating diseases by the result of dialectic.辨证是决定治疗的前提和依据：论治是治疗疾病的手段和方法，也是对辨证是否正确的检验。医学课件15辨证和论治，是诊治疾病过程中相互联系不可分割的两部分，是理论和实践相结合的体现 Dialectic and treatment are two integral parts of the process of diagnosis and treatment of diseases,which are the combination of theory and practice.医学课件16辨证论治之所以是中医学的一个特点，是因为它既不同于一般的“对症治疗”，也不同于现代医学的“辨病治疗”。It is an important character of TCM that we should treat the patients according to the syndromes not the symptoms and the diseases.医学课件17一个病的不同阶段，可以出现不同的证候;不同的疾病，在发展过程中可能出现相同证候。同一疾病的不同证候，治疗方法就不相同；不同疾病证候相同，就可运用同一治疗方法。A disease can have different syndromes.we have different treatments to different syndromes.医学课件18“辨证”的“证”，是疾病的原因、部位、性质以及致病因素和抗病能力相互斗争情况的概括。Syndrome is the summary of cause、parts、nature of the disease and the conflict between pathogenic factors and the disease-resistant ability.医学课件19例如：同是痢疾病，在发病及发展过程中，应根据不同的证候施以不同的治疗方法又如：慢性肾炎、慢性心力衰竭都有水肿，而水肿阳虚证用温阳化气利水法治疗这就是“同病异治”、“异病同治”的辨证观。医学课件20辨证辨证是对四诊所得材料进行分析、综合、归纳，判断疾病的部位，性质，从而认识疾病的本质，为治疗疾病提供根据。Dialectic offers some bases for the treatment of diseases.医学课件21中医辨证有八纲辨证、脏腑辨证，六经辨证和八纲辨证、脏腑辨证，六经辨证和卫气营血辨证卫气营血辨证。Dialectic of TCM have syndrome differentiation of eight principles、viscera、the six meridians and prevention,qi,nutrition,blood各有特点和侧重，又是在中医基本理论指导下，互相联系，互相补充医学课件22八纲辨证八纲辨证是辨证的基本方法 Syndrome differentiation of eight principles is the fundamental method.通过四诊掌握材料之后，根据人体正气的盈亏，病邪的性质及其盛衰，疾病所在部位的深浅等情况，进行综合分析，归纳为阴，阳、表、里、寒、热，虚，实八类证候，就是八纲辨证。医学课件23八纲八纲是把人体的证候，分为表证与里证，寒证与热证，虚证与实证，阳证与阴证四个对立面，成为四对纲领，用以指导临床治疗。Eight principles is dividing syndromes into exterior and interior，cold and heat,deficiency and excess，yin and yang,four pairs of oppositions to guide clinical treatment.医学课件24表里表里是表示病变部位的浅深和病情轻重的两个纲领Exterior and interior are two programs that they indicate depth and the spot of pathological change.一般地说，证候表现在皮毛，经络的属表证，病情较轻；证候表现在五脏六腑的属里证，病情较重。医学课件25表证表证是指外感病的初起阶段，外邪六淫从皮毛、口鼻侵入机体后，产生的一系列症状，临床表现为发热、恶风寒、鼻塞、咳嗽、头身疼痛、苔薄白，脉浮等症状称为表证，具有起病急，病程短，病位浅的特点。Exterior syndrome is the beginning stage of exogenous disease.医学课件26里证里证是由表邪不解，内传入里，侵犯脏腑而发病，或外邪直接侵犯脏腑发病，或由各种原因导致脏腑功能失调，病从内生。里证的临床表现是多种多样的，但概括起来，是以脏腑的证候为主。Interior syndrome is mainly of viscera syndrome。医学课件27寒热寒热是辨别疾病性质的两个纲领。Cold and heat are the two programs to identify the nature of disease.寒证是感受寒邪，机体的机能活动衰减所表现的证候，热证是感受热邪或机体的机能活动亢盛所表现的证候。医学课件28寒证寒证临床表现为恶寒喜暖、口淡不渴、面色苍白、手足厥冷、小便清长、大便稀溏，舌淡苔白而润滑、脉迟等症状clinical manifestation of cold:a pale face,do not feel thirsty,hands and legs are cold,etc.医学课件29热证热证临床表现为发热喜凉，口渴喜冷饮，面红目赤小便短赤，大便干燥，舌红苔黄、脉数等症状clinical manifestation of heat:a red face and eyes,do feel thirsty,do like the cold things,etc.医学课件30虚实虚实是辨别人体的正气强弱和病邪盛衰的两个纲领Deficiency and excess are two programs to discriminate the strength and weakness of body energy and the ups and downs of disease.邪气盛则实，精气夺则虚虚证是指的正气虚弱不足的证侯，实证则是指的邪气亢盛有余的证候医学课件31虚证虚证多见久病，重病之后，身体虚弱，正气不足的证侯。Deficiency syndrome is weak and short of body energy after long and awful disease.虚证虚证临床表现精神萎糜，面色苍白、身倦无力、形体消瘦，气短、白汗盗汗、大便涪泻，小便频数或不禁，舌淡，少苔、脉象细弱等症状。虚证有虚证有气虚证、血虚证、阴虚证、阳虚证之分。医学课件32实证实证多见气滞、血瘀、痰、水、虫积等引起的病。Exess syndrome is caused of the Qi blood stasis,the stack of phlegm、water and worm.实证实证临床表现气粗、胸胁脘满、疼痛拒按、大便秘结、脉实有力等症状。医学课件33 阴阳是八纲的总纲表、热、实证属阳证，里，寒，虚证属阴证.Yin and Yang is the master of the eight principles.Exterior、heat and excess belongs to yang，interior、cold and deficiency belongs to yin。一切病证，尽管千变万化，但总起来，不外阴证与阳证这两大类。医学课件34 阴证阴证是体内阳气虚衰，阴气偏盛的疾病其病属寒，属虚，机体反应多呈衰退的表现Yin syndrome is a kind of expression that body function ebbs.阴证阴证临床表现为精神萎糜、面色暗淡，畏寒肢冷气短音低、口干不渴、或渴而喜热饮，便溏、尿清、舌质淡、苔白、脉沉迟徽弱等症状。医学课件35 阳证阳证是体内阳气亢盛，正气末衰的疾病，其病属热，属实。机体反应多呈亢盛的表现。syndrome is a kind of expression that body function excess。阳证阳证临床表现为精神烦躁，面赤身热，气壮声高、口苦口渴喜冷饮、大便秘给、舌质红绛、苔黄、脉滑数洪实等症状。医学课件36脏腑辨证脏腑辨证-五脏病证辨证-心病辨证-虚证与实证心血亏虚证心血亏虚证临床表现为心悸，心烦，易惊，失眠，健忘，头晕眼花，面色不华唇舌色淡，脉细弱。we have different treatments to different syndromes according to the method of viscera and bowels.医学课件37六经辨证六经辨证是用于外感病辨证的一种方法 Dialectic of six meridians is a method for external diseases.六经是太阳病、阳明病，少阳病，太阴病、少阴病，厥阴病的总称 六经辨证从病变部位分为太阳病主表，阳明病主里，少阳病半表半里，三阳病多热，三阴病多寒三阳病多实三阴病多虚。医学课件38 太阳经证太阳经证临床表现为恶寒，发热，头顶强痛，苔薄白，脉浮外邪伤害太阳经气，风邪伤害卫气，治宜调和营卫，桂枝汤主之。clinical manifestation of taiyang:do hate cold,do feel hot,coat of the tongue is white and thin,etc.医学课件39卫气营血辨证卫气营血辨证是对外感温热病辨证的一种方法。Dialectic of prevention-qi-nutrition-bloodis a method for external febrile diseases.卫气营血代表着温热病发展过程中的浅深不同的四个阶段。医学课件40卫分证卫分证是温热病的轻浅阶段，多见于温热病的早期，病位在皮毛与肺。prevention is the early stage of febrile diseases，the main location is in exterior and lung.卫分证临床表现为恶风寒或微恶风寒，发热口渴，咳嗽少痰或痰出不爽，苔薄黄，脉浮数。治宜疏风清热解表，方药选银翘散。医学课件41 Thank you！医学课件42