由“误下”浅谈《伤寒论》的避误思维  

Discussion on the thought of avoiding misdiagnosis in Shanghan Lun based on ‘mistreatment of purgation’

作　　者：朱梦鸷[1] 张喜奎[2] ZHU Meng-zhi;ZHANG Xi-kui(Fujian University of Traditional Chinese Medicine,Fuzhou 350122,China;The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou 350003,China)

机构地区：[1]福建中医药大学,福州350122 [2]福建中医药大学附属第二人民医院,福州350003

出　　处：《中华中医药杂志》2021年第9期5240-5242,共3页China Journal of Traditional Chinese Medicine and Pharmacy

摘　　要：如今医学仍无法做到百分百的正确诊断,误诊无法避免地影响着疗效。误诊发生的重要因素之一是临床思维的偏差,因此培养正确的临床思维能有效降低误诊概率。《伤寒论》作为中医辨证论治的奠基之作,将中医理论和临床实践结合,其中蕴含大量的临床思维。通过梳理《伤寒论》中"误下"的原因和结果,文章总结张仲景规避误诊思维在于把握"随证治之"和"顾护脾胃"两大关键治则,并重视"诊、辨、治"统一、阴性症状的鉴别和治疗过程中的医患配合。Even now, medicine still can’t achieve 100% correct diagnosis, and misdiagnosis inevitably affects the medical effect. The deviation of clinical thought is one of the important factors in the occurrence of misdiagnosis, therefore cultivating correct clinical thought can effectively reduce the probability of misdiagnosis. Shanghan Lun, as the foundation of traditional Chinese medicine therapy with syndrome differentiation, combines traditional Chinese medicine theory with clinical practice, which contains a great deal of clinical thought. Through combing the causes and results of ‘mistreatment of purgation’in Shanghan Lun, this article concludes that ZHANG Zhong-jing’s thought of avoiding misdiagnosis is to grasp the two key treatment principles: ‘treatment with syndromes’ and ‘protecting the spleen and stomach’, and attach importance to ‘the unification of diagnosis, differentiation and treatment’, the identification of negative symptoms and the cooperation of doctors and patients in the process of treatment.

关 键 词：伤寒论 误诊 误下 临床思维 

分 类 号：R222.2[医药卫生—中医基础理论]