《伤寒论》定量辨证思维  

The quantitative dialectical thinking of Treatise on Febrile Diseases(伤寒论)

作　　者：张新亮[1] ZHANG Xinliang(The department of internal medicine for Zhongshan University of Traditional Chinese Medicine, Zhongshan 528400,Guangdong,Chin)

机构地区：[1]广东省中山市中医院内科,广东中山528400

出　　处：《实用中医内科杂志》2018年第5期50-52,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：《伤寒论》定性辨证和定量辨证是对多样、具体疾病的抽象概括。张仲景用定量辨证思维定量病证,有证可循、灵活多变,具有整体连贯性和系统性,对发病时间、症状表现、脉象、以方(药)测证、量词、数词等定量病证各有侧重,得到广泛认可。发病时间:"一二日" "四五日" "八九日" 等表示病情变化。症状表现:辨证最主要的依据,风寒表证、头痛或身痛诸痛,恶风或恶寒,无汗占据一定分量。脉象:病机均为阳虚饮逆的67条和160条"沉紧"与"甚微"均从脉搏应指程度而言,分别表示阳虚不甚或阳气已大虚。量词、数词文字描述:用量值描述症状是一种模糊数学方法,以症状定量方式辨量值,如寒象量级包括大寒、振寒、恶寒、微寒等;大、小陷胸汤,大、小承气汤中的 "小" "大",直接用表示定量的量词 "少" "多",少与多、小与大虽然无法对数量精确定量,但定量概念却比较明确。以方(药)测证:药物试探定量,每一方剂都是伤寒体系中定量分析和定性分析的具体表现,在诊断性治疗时应用广泛,小承气汤试探,药后 "转失气" 和 "如不转失气" 表示阳明腑实证程度。定性辨证是疾病本质的抽象表现,定量辨证则表示相互差异和内在联系;定性辨证容易掌握,简单明确,是抽象和粗略的;定量辨证是对复杂多样、精细具体的,比较接近疾病变化的客观状态描述,是对定性辨证的发展和补充。定性辨证结合定量辨证,才能提高中医学辨证体系的科学性、严密性。临床更应重视定量辨证,只询问症状有无,没有量值概念思维,对辨证论治准确性造成影响。深入研究和挖掘《伤寒论》中的定量辨证思维方法,对于促进中医学辨证体系的发展非常重要。Treatise on Febrile Diseases（伤寒论） qualitative syndrome differentiation and quantitative syndrome differentiation are abstract generalizations of various and specific diseases.ZHANG Zhongjing uses quantitative dialectical thinking to quantify disease syndromes,which can be followed by evidence,flexible and changeable,with overall coherence and systematicness,with emphasis on onset time,symptom manifestation,pulse,prescription（medicine） test,quantifier,numerals and other quantitative disease syndromes.Be widely accepted.Onset time： ＂one day＂,＂four to five days＂,＂eight to nine days＂ and so on to indicate the disease condition change.Symptoms： the main basis of syndrome differentiation,wind-cold syndrome,headache or body pain,bad wind or cold,no sweat occupies a certain weight.Pulse： 67 of 67 and 160 of ＂tight＂ and ＂minimal＂ of the pathogenesis of Yang-deficiency drink are,respectively,indicating that Yang deficiency is not even true in terms of the degree to which the pulse should be directed.Yangqi has become a big empty.Quantitative description of symptoms is a fuzzy mathematical method used to quantify symptoms,such as Greater cold,etc.Da/Xiaoxianxiong decoction（大、小陷胸汤）,Da/Xiao,and so on.Da/Xiao in Xiaochengqi decoction（大、小承气汤）,the quantifier ＂less＂,＂more＂,＂less＂ and ＂more＂ is used directly.Although small and large cannot accurately quantify quantity,the quantitative concept is relatively clear.Prescription（drug） test： drug testing and quantification,each prescription is the specific manifestation of quantitative analysis and qualitative analysis in typhoid system,widely used in diagnostic treatment,Xiao Chengqi decoction（小承气汤） test,after the drug ＂loss of Qi＂ And ＂if not to lose Qi＂ to indicate the positive degree of Yangming Fushi（阳明腑实）.Qualitative syndrome differentiation is the abstract manifestation of the essence of disease,quantitative syndrome differentiation means mutual differenc

关 键 词：伤寒论 定量辨证 定性辨证 发病时间 症状表现 脉象 以方测证 药物试探 诊断性治疗 数词 量词 沉紧 甚微 小承气汤 阳明腑实 

分 类 号：R222.2[医药卫生—中医基础理论]