《黄帝内经》中医辨证方法的探讨  

Discussion on the Traditional Chinese Medicine Syndrome Differentiation Method in Huangdi Neijing

作　　者：李凯平[1] LEE Kaiping(HOHCS-CUHK CMC cum Training and Research Centre,Hong Kong 999077,China)

机构地区：[1]灵实-香港中文大学中医诊所暨教研中心,中国香港999077

出　　处：《光明中医》2022年第21期3870-3873,共4页GUANGMING JOURNAL OF CHINESE MEDICINE

摘　　要：为了认识《黄帝内经》有关“辨证”的具体方法,此文运用综合、分析与比较研究法探讨当中有关中医辨证方法的原文。结果发现此书在辨证上以“何气使然(生)”(“人身何部之气”受伤)为目标,并从“形而上”入手,运用了“揆度奇恒”“比类”及“病机推演”等3个方法,前两者的目的是从病者证候向上攀爬以探求“人身何部之气”(如各藏、府、经脉之气等)不正常地作用或相关形上原理;“病机推演法”的目的是从“人身某部之气”不正常地作用往下推衍至各个证候发生的演化全过程以验证医者在“揆度奇恒”与“比类”所得的“病机”或形上原理是否与病者一致。“比类”的运用有助于提升“病机”的“普遍性”与“根本性”,务求医者所得的形上原理是各个证候发生的共同依据;而“病机推演”则提升辨证结果的合理性,各个证候都是在“人身某部之气”不正常作用下按一定机制演化而成。Syndrome differentiation is the core of clinical practice in Chinese Medicine(CM).Through the study of the texts that are related to the method of syndrome differentiation from Huangdi Neijing,the research found that Huangdi Neijing set the qi of different part of human body or core pathogenesis,as the goal of syndrome differentiation.To approach the goal,Huangdi Neijing applied three methods included Kuiduo Qiheng,analogy and pathogenesis deduction method.The previous two methods aim to find out the metaphysical principles including core pathogenesis which cause the diseases,while the remaining one is used to derive the various syndrome developed from metaphysical principles for examining if the core pathogenesis that the CM doctor thinks is the same as the one that the patient gets.According to the findings,the article concludes that analogy can enhance the universality and fundamentality of core pathogenesis which supposed to be the common basis of various syndromes.Pathogenesis deduction method,however,can examine the rationality of the pathogenesis obtained from Kuiduo Qiheng and analogy or ensure each syndrome is developed from the core pathogenesis or the qi of a part of human body.

关 键 词：《黄帝内经》 辨证 病机 揆度奇恒 比类 

分 类 号：R221[医药卫生—中医基础理论]