基于辨识病机探讨中医精准辨证论治  

Exploration of Precise Syndrome Differentiation and Treatment Based on Identifying Pathogenesis

作　　者：林传权[1] 谢海媚 黄也 陈蔚文[1] 李强[1] LIN Chuan-Quan;XIE Hai-Mei;HUANG Ye;CHEN Wei-Wen;LI Qiang(Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510405

出　　处：《广州中医药大学学报》2020年第8期1589-1593,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81973723,81403297);广州中医药大学“薪火计划”项目(编号:XH20170113);广东省科技计划项目(华南中医药协同创新中心)(编号:2014B090902002)。

摘　　要：针对辨证方法分类繁多、不易把握,及证候本质未得到很好把握、证候研究未有实质性进展等现状,结合分析中医有关中医辨证的经典理论,提出病机为辨证的核心,辨证应首重病机分析,治病之要在于辨识病机基础上的精准辨证论治思路。结合临床验案,提出"先辨病位,再别病性,位性合参,把握动态病机"的病机辨识方法,同时精准把握治疗时机并因势利导,解除病机,以便尽快掌握辨证论治的精要,执简驭繁,实现更精准辨证论治,提升对中医治疗疑难杂症的疗效。By reviewing the status of numerous kinds of syndrome differentiation methods,disunion in syndrome differentiation and undefined essence of the syndrome, and by analyzing the classical theory of syndrome differentiation in the field of traditional Chinese medicine,we suggested that the key for syndrome differentiation is to identify the pathogenesis,syndrome differentiation should be based on the identification of pathogenesis,and then the thoughts for precise syndrome differentiation achieved by identifying pathogenesis was discussed. Through the analysis of the proven case,the methods of distinguishing the pathogenesis by ensuring the location of disease firstly,identifying the nature of disease secondly,conjointly analyzing the location and nature of disease,and identifying the dynamic pathogenesis have been put forward. By precisely grasping the therapeutic opportunity and guiding treatment of the disease in the light of syndrome’s general trend,precise syndrome differentiation and treatment can be achieved,and the clinical efficacy for the treatment of the difficult and complicated cases with Chinese medicine will be enhanced.

关 键 词：辨证论治 辨识病机 病位 病性 动态病机 

分 类 号：R241[医药卫生—中医诊断学]