雅韵怡情和乐平心:中医音乐治疗基础理论建构

Great charm brings a joyful heart and elegant music results in peace of mind:Theoretical restructuring of basic theory on music therapy of traditional Chinese medicine

目的:中国是音乐治疗的发源地之一,自《内经》始音乐治疗就是中医治疗学的有机组成部分,中医音乐治疗作为新兴学科,亟待构建一个较为系统的融传统与现代于一炉、更便于指导临床应用的有中医特色的理论框架,基于此而提出有关思路。方法:收集古代典籍中记载的中医乐疗史料,纵览现代研究的文献和相关学科的成果,从中医音乐治疗的哲学基础、治则治法、作用机制、运用特点等方面进行探讨,推本溯源,梳理发生发展的脉络,探赜索隐,析出理论框架的刍形。结果:乐者,道也。音乐本于“太一”,中医乐疗理论的源头是阴阳五行学说;乐者,治也。音乐是一种和合之气,中医乐疗当属于八法中之“和”法;乐者,意也。音乐治疗的基础来自于音乐、情志、脏气共鸣互动;乐者,药也。用乐如用药,亦有归经、炮制、升降浮沉、寒热温凉、个体差异及不良反应,辨证施乐中比类选曲的方法恰是“同质原理”的要求,可视为用乐的“反佐”。结论:中医音乐治疗基础理论建构存在不少问题有待于进一步阐明,必须以中医理论为指导,总结文献,拓展应用,创新方法,在传统民族音乐的基础上,吸收外来音乐的精华,不断充实和完善中医乐疗曲库,提高临床应用的可操作性和实验研究的规范性,探索自身发展的规律。

AIM： China is known as one of the cradles of music therapy. Music as a therapy in traditional Chinese medicine （TCM） traces back to the time of Huangdi Sutra on Medicine （Huang Di Nei Jing）. Now music therapy in TCM, as an emerging subject, calls for the coristruction of systematic theory framework with traits of TCM, which is able to reconcile the traditional with the modern and facilitate appropriate clinical instruction. To achieve the goal, some thoughts are shared below. METHODS： Both historic documents and the results of modern study on music therapy in TCM were collected. A study was carried out in different aspects, such as the philosophical basis, methodology, mechanism, application and so on to initiate the construction of the theory framework. RESULTS： Music is Taoistic, which is originated from “the Essential One”（Tai yi）in Taoism. The theory of music therapy in TCM is based on the Yinyang theory and the five-element doctrine. Music is sanative. It is kind of Qi which promotes the harmony inside. Thus music therapy is in accordance with the “He”（harmony） principle, and is one of the eight principles in TCM. Music is emotional. Music therapy induces the resonant interaction among music, emotion and organs in the body. Music is medicine. The use of music is the same way as the use of medicine in principle and procedure such as attributive channels, processing, upbearing-downbearing-floating-sinking, cold-hot-warm-cool, individual differences and side effects. The way of selecting music according to diagnosis is right by the request of “Homophile principle”, and it is regarded as the“opposite help”by the use of music. CONCLUSION： Many problems in construction of the theory of music therapy remain open. Under the guidance of TCM theory, we should summarize the literature, expand the applications, and.employ innovative methods. It is necessary to enrich and perfect the music database by extracting the excellent national and international music, enhance the maneuverability in clinical practice and the standardization of experimental study, and find out the intrinsic laws of the development of music therapy.