| 摘要: | 中醫小兒變蒸學說之醫史文獻探討 研究生 陳美雲 指導教授 李世滄副教授 中國醫藥大學中國醫學研究所 中醫兒科古稱啞科，因其診斷之不易，其生理特點與衍生之病理變化及病程之發展，亦與成人迥然相異。研究變蒸學說，有助於對兒童正常生理及疾病之演化歷程多一份了解，更能準確掌握中醫醫療介入之時機與意義，鑑往知來，希冀對幼兒之醫療保健有所裨助。 此次研究將搜集到有關變蒸學說的72本書籍115篇文章加以分析，發現變蒸學說最早的理論架構，應是淳于意提出而早於王叔和時期。歷代醫家對在嬰幼兒發育期間，如出現輕微的發熱、汗出如蒸等症，而無明顯病態者，謂之變蒸，即變其情智，發其聰明，變生五臟陰精；蒸其血脈，長其百骸，蒸養六腑陽氣。 變蒸對小兒生理有正面的助益，胎毒現象即可藉此發散調控過程而自愈。然而在變蒸不解或錯誤施治之後，卻可轉為百病之源。在歷代治療方劑中以黑散與紫丸為最常用，而常用藥物則依序為甘草、人參、杏仁、麻黃、大黃、代赭石、茯苓、巴豆霜、生薑、赤石脂。而治療時需依照小兒臟腑稚嫩的特點辨證論治。 近年來，國內外的大量研究結果表明，我國古代的小兒變蒸學說與現代幼兒發展學說類似。現代對嬰幼兒的護育方法，則是變蒸學說的體現。而現代變蒸學說其主要重點應是提示幼兒的個別形質上審證差異之迫切性。 關鍵詞：中醫小兒 變蒸 審證差異; The Study of the Chinese Medical Classic Literature of the Biann Jeng theory Mei-Yun Chen Major Professor：Shin-Chang Lee Institute of Chinese Medical Science, China Medical University, Taiwan ABSTRACT In ancient China, pediatrics of traditional Chinese medicine (TCM) was always categorized as medicine with silence, because infants are unable to express themselves. Because of the physiological and pathological differences between children and adult, pediatric diagnosis poses special difficulties. Further investigating the theme that expounded the development of children according to the principles of TCM will help understanding deeply about the development of children physiologically and pathologically. Moreover, it will help to optimize the timing of TCM in aiding health of young children. From the past experiences cited in classical Chinese medical literatures, the use of Chinese medicine for the treatment of children is appropriate and effective. Based upon the literatures surveyed: seventy-two books with one hundred and fifteen articles, it is found that the most early Biann Jeng (變蒸) theory was brought forward by Chwen Yu Yih (淳于意)，before the time of Wang Shu-he (王叔和) and his Mai Jing (脈經). From the past experiences of ancient Chinese doctors, light fever and light sweating without any pathological evidences was observed during the growing stage of infants and young children. This phenomena was called Biann Jeng (變蒸). Biann means the normal progressive changes of emotion, wisdom and five-Zang-organ essence of young children. Jeng means the normal progressive changes of blood, physique and six-Fu-organ energy. The positive side of Biann Jeng (變蒸) to infant’s and children’s growth includes recovering from some neonatal diseases. However, if mistreated, Biann Jeng (變蒸) will become the origin of many diseases. Drugs of black-powder type or purple-pill type are commonly used in ancient treatment. Licorice, Ginseng, Almond, Chinese Ephedra, Rhubarb, Hematite, Poria Cocos and Flatstem Milkvetch seeds are usually chosen. Based upon the pathological characteristics of infants and young children, treatment according to diagnosis and differentiation between syndrome patterns is practiced. In recent years, studies around the world show similarities between Biann Jeng (變蒸) theory and condition of modern child development. The modern nursery techniques realizes the concepts in Biann Jeng (變蒸) theory. The key points of modern Biann Jeng (變蒸) theory includes emphasizing the importance of nursery and medication for infants and young children, alerting doctors with more attention while clinically treating upon infants and children according to different syndrome pattern. Key words: pediatrics of TCM, Biann Jeng, different syndrome pattern |
