主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2018, Vol. 41 ›› Issue (12): 973-977.doi: 10.3969/j.issn.1006-2157.2018.12.001

• 理论研究 •    下一篇

《伤寒论》辨病审证的原创性思维*

刘敏,王雪茜,王庆国#   

  1. 北京中医药大学中医学院 北京 100029
  • 收稿日期:2018-07-02 发布日期:2019-01-14
  • 通讯作者: 王庆国,男,博士,终身教授,研究方向:经方防治常见病疑难病的研究,E-mail:wangqg@bucm.edu.cn
  • 作者简介:刘敏,女,博士,副教授
  • 基金资助:
    *第六批全国老中医药专家学术经验继承项目,北京中医药大学名师工作坊项目

The original thinking in disease diagnosis and syndrome differentiation in Shanghan Lun*

Liu Min, Wang Xueqian, Wang Qingguo#   

  1. Liu Min, Wang Xueqian, Wang Qingguo# (School of Chinese medicine, Beijing University of Chinese Medicine, Beijing 100029, China
  • Received:2018-07-02 Published:2019-01-14

摘要: 《伤寒论》中蕴含的中医原创思维方法是其成为经典的重要因素,其在辨病审证方面的原创性思维主要有8个方面:辨病求本,本在阴阳,把阴阳作为辨识病证的第一要务;病证结合,辨证析机,首开病证结合论治之先河;四诊合参,动态分析,脉症从舍,“观其脉证,知犯何逆、随证治之”意义深刻;去粗取精,去伪存真,挖掘提取可以代表病证实质的脉症;同中见异,异中求同,同一病证病机不同采用不同方药,不同病证病机相同采用同一方药;以常衡变,知常达变,是中医辨证思维的基本特征之一;重视主症,甚则“但见一症便是,不必悉具”,若主症与病机不符,应以病机为本;掌握规律,见微知著,预判病势。因此,《伤寒论》是中医学临床原创思维的重要载体,是中医学原创思维的宝贵财富。

关键词: 原创性思维, 伤寒论, 辨病审证

Abstract: Original thinking is what makes the book Treatise on Cold Damage (Shang Han Lun) become a TCM classic. There are eight aspects of original thinking about disease diagnosis and syndrome differentiation in the book. The first one is searching for the primary cause of disease in treatment, which is yin and yang. The second one is combining the differentiation of disease and syndrome, differentiating the syndrome and analyzing the pathogenesis, and Treatise on Febrile Disease is the first precedent in this regard. The third one is the combined use of the four diagnostic methods, the dynamic analysis of analyzing the pathogenesis and the choice between the pulse and the symptom, so the clause “observe the pulse and signs, know what mistakes have been made, and treat according to the presenting pattern” is of profound significance. The fourth one is selecting the essential by discarding the dross and retaining the true by eliminating the false, excavating and extracting the pulse and the symptoms which could represent the essence of the pathogenesis. The fifth one is seeking differences within the similarity and seeking difference from commonness. If the pathogenesis is the same in different diseases, we can choose the same treatment, and vice versa. The sixth one is knowing commonness of the diseases for the change, whid is the basic feature of TCM thinking when identifying syndromes. The seventh one is attaching great importance to the primary symptom. Sometimes one symptom is sufficient for diagnosis and not all signs and symptoms need to be present. If the primary symptom seems to contradict the pathogenesis, we should follow the pathogenesis. The eighth one is grasping the rules in the development of the disease from the first small beginnings, and predicting the tendency of disease. Thus, Treatise on Febrile Disease is of precious value with enormous evidence for presenting original thinking of TCM.

Key words: Original thinking, Treatise on Febrile Disease, disease diagnosis and pattern identification

中图分类号: 

  • R222.2