13 論 説 東洋医学の真髄となる弁証論治への理解について 廖 世新 キーワード : 要旨 ( IBS
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1 Research Reports of Suzuka University of Medical Science 鈴鹿医療科学大学紀要 No.23, 2016
2 13 論 説 東洋医学の真髄となる弁証論治への理解について 廖 世新 キーワード : 要旨 ( IBS
3 14 I. はじめに 21 CAM II. 東洋医学臨床における 弁証論治 の重要性 表 - 1 東洋医学と現代医学との相違点と相補性 現代医学 1 因果関係が明確な病因の究明 再現性 客観性 2 機械論的 ( 二元論 ) 心と身体の分離 肉体的な異常を重視する 3 対象を明確にする ( 病因の排除 ) 病的な原因 ( 細菌やウイル ) を排除するのは診療の最大目的である 東洋医学 1 整体観 ( 天人合一 心身一如など ) 2 バランスをとる治療法生体の正常からの偏位や歪みを元に戻そうとする 陰陽失調 陰陽平衡 3 自然治癒力を高める各個人の持ち合わせている自然治癒力を高め病変に対処する 元気を高め病邪を除く 4 弁証論治 ( 個人的な治療 ) ( オーダメイド治療 ) 表 - 2 小柴胡湯による間質性肺炎の経緯
4 15 芩 III. 弁証論治 及び弁証論治体系の形成
5 16 同病異治 同じ病気でも 証が違えば用いる処方 治療が異なる 異病同治 違う病気でも 証が同じであれば同じ処方 治療を施す 中病同 証異 治異 病異 証同 治同 同じ疾病でも 異なる証を呈し 治療も異なる 異なる疾病でも 同じ証を呈すれば 治療も同じ 1 外感風寒証 発散風寒例 1 脱肛葛根湯など 気中2 外感風熱証疏風清熱 2 胃下垂銀翹散など 下益補中益気湯 3 気虚外感証益気解表 3 子宮脱垂陥気弁証論治による異病同治補図 - 1 弁証論治による同病異治図 - 2 参蘇飲など 4 他の病 例 冒4 他の証感 表 - 3 古今 弁証方法 の経緯 1) 外感と内傷
6 17 2) 整体と具体 整体把握 具体分析 図 - 3 八綱弁証 病因弁証 気血津液弁証 は有余を評価する臓腑弁証 1 六経弁証 2 経絡弁表 / 裏 寒 / 熱 虚 / 実 陰 / 陽を大別に 外感 ( 外来の邪気 ) と内傷 ( 体内の素因 ) を判明 気 血 津液の不足また 証 3 衛三気焦営弁血弁証 4 現代中医学における弁証の流れ 証 5 3) 処方と証治 12
7 18 IV. 弁証論治 による IBS の治療例 IBS IBS g; 3.0g; 2.0g; 1.0g 2 9.0g; 6.0g; 4.5g 3 6.0g; 4.0g; 2.0g 1) 肝鬱気阻証 病因病機 虚実錯雑 1) 肝脾不和証 2) 肝鬱気阻証 5) 脾胃虚弱証 過敏性腸症候群 実 3) 胃腸食積証 (IBS) 4) 胃腸湿熱証 6) 心脾両虚証 7) 脾腎陽虚証 図 - 4 同病異治 による IBS の証タイプ 虚 2) 肝脾不和証 病因病機 1 3.0g; 2.0g; 1.0g 2 5.0g; 4.0g; 3.0g;
8 19 2.0g 3.0g; 1.5g 3) 胃腸食積証 病因病機 1 楂 6.0g; 3.0g; 2.0g; 1.0g 2 : 12.0g; 芩 9.0g; 6.0g 4) 胃腸湿熱証 病因病機 1 4.0g; 芩 3.0g; 2.0g; 1.0g 2 : 15g; 12g; 9g; 6g; 3g 5) 脾胃気虚証 病因病機 1 3.0g 1.5g 2 4.0g; 3.0g; 2.0g; 1.5g; 1.0g 3 5.0g; 4.0g;
9 20 3.0g; 2.0g; 1.5g 6) 心脾両虚証 病因病機 1 3.0g; 2.0g; 1.5g; 1.0g 2 4.0g; 3.0g; 2.5g; 2.0g; 1.5g; 1.0g 7) 脾腎陽虚証 病因病機 1 5.0g; 3.0g; 0.5g 2 3.0g; 2.0g 3 3.0g; 2.0g; 20.0g V. おわりに
10 21 参考文献 1 Biotherapy 21(6) Modern Physician 28(11) (2) EBM (10) (12) (10) (2) osaka (1)
11 22 Understanding of treatment based on syndrome differentiation as the essence of oriental medicine Shixin LIAO Key words: Integrated medicine, Oriental medicine, Traditional Chinese medicine treatment based on syndrome differentiation (TBSD), Acupuncture moxibustion, Irritable bowel syndrome (IBS) Abstract The author reexamined the side effects accident of Shosaikoto that occurred at 20 years ago reported in "Asahi Shimbun" on March 2, In the clinic of traditional Chinese medicine, it is thought that it is the most important thing to understand the fundamental principle of treatment based on syndrome differentiation (TBSD), which is the essence of oriental medicine. In this paper, the author discussed the importance of TBSD and its formation, the method and relevance of clinical application. Also due to the clinical experience, the author divided into seven syndrome differentiation for IBS, and established the treatment principle for each syndrome differentiation, described the treatment methods and prescriptions of Chinese medicine, acupuncture and moxibustion and Medicinal meal based on TBSD.
12 23 略歴 廖世新
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1-122013 1 2 1 2 20 2,000 2009 12 1 2 1,362 68.1 2009 1 1 9.5 1 2.2 3.6 0.82.9 1.0 0.2 2 4 3 1 2 4 3 Key words acupuncture and moxibustion Treatment with acupuncture, moxibustion and Anma-Massage-Shiatsu
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第 20 講 病理と病証 Ⅰ 教科書 P.68~70 総論 象 症 病 証の違い 病理と病証を学ぶにあたり まずは東洋医学特有の観念である 象 症 病 証 それぞれの定義を理解することが必要である 1. 象と症 * 象 とは臓腑機能の状態が外 ( 外から確認できる ) に現れたもの 例 :[ 顔色がよい 目に輝きがある 頭髪に艶がある ] 等 * 症 とは 症状 のことである 臓腑の機能失調に伴い外に現れる
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