基于《伤寒杂病论》探讨张仲景司内揣外的诊断学术思想  

Discussion of ZHANG Zhong-jing’s diagnostic academic thought of‘governing interior to infer exterior’based on Treatise on Cold Pathogenic and Miscellaneous Diseases

作　　者：董硕 周可林 陈家旭 DONG Shuo;ZHOU Ke-lin;CHEN Jia-xu(School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学中医学院,北京100029 [2]北京中医药大学东方医院,北京100078

出　　处：《中华中医药杂志》2021年第8期4480-4482,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金重点项目(No.81630104)。

摘　　要：司内揣外和司外揣内均出自《灵枢·外揣》,是两种相互依存的辨证诊断思路,历代医家均关注于司外揣内,而忽视了司内揣外的重要性。张仲景在《伤寒杂病论》中不仅将司内揣外的思路应用于诊断中,更是将整个司揣内外的学术思想应用于中医诊断思维之中。文章从中医诊断学角度通过探讨《伤寒杂病论》中张仲景司内揣外的学术思想,分析张仲景在临证中利用“司内”的方法辨证诊断的中医思维方法以及与现代微观辨证相结合在临床中的应用。Both‘governing interior to infer exterior’and‘governing exterior to infer interior’are derived from Lingshu•Waichuai,which are two interdependent diagnosis ideas.The doctors of the past dynasties have focused on‘governing exterior to infer interior’,but ignored the importance of‘governing interior to infer exterior’.ZHANG Zhong-jing’s Treatise on Cold Pathogenic and Miscellaneous Diseases not only applied the thoughts of‘governing interior to infer exterior’thinking in the diagnosis,but also applied the whole internal and external academic thinking into the diagnostic thinking of traditional Chinese medicine(TCM).This article discussed ZHANG Zhong-jing’s internal and external academic thoughts in Treatise on Cold Pathogenic and Miscellaneous Diseases from the perspective of TCM diagnostics,and analyzed ZHANG Zhong-jing’s TCM thinking method in clinical diagnosis using‘governing interior’method and modern microscopic differentiation.

关 键 词：司内揣外 仲景学术思想 伤寒杂病论 诊断思维 微观辨证 

分 类 号：R241[医药卫生—中医诊断学]