试论《中医内科学》教学中病-症鉴别思维的培养  

Discussing the Cultivation of Disease-Symptoms Differential Thinking in the Teaching of TCM Internal Medicine

作　　者：强若男 孙慧怡[1] 屈祥科 暴雪丽 肖永华[1] 张轶斐 孙劲晖[1] QIANG Ruonan;SUN Huiyi;QU Xiangke;BAO Xueli;XIAO Yonghua;ZHANG Yifei;SUN Jinhui(Department of Spleen and Stomach,the First Clinical School of Beijing University of Chinese Medicine,Beijng 100700,China)

机构地区：[1]北京中医药大学第一临床医学院脾胃病科,北京100700

出　　处：《中国继续医学教育》2022年第24期177-182,共6页China Continuing Medical Education

基　　金：北京中医药大学教育科学研究课题(XJYB2017);中医药高等教育学会临床教育研究会临床教学科学研究课题(2021029)。

摘　　要：《中医内科学》是链接中医基础课程与临床各科的纽带,更是培养学生临床综合能力的基础。其中,病—症鉴别思维的培养是《中医内科学》教学的重要组成部分,也是中医临床思维构建的关键一环。但症状性疾病诊断则为鉴别思维的培养带来了极大的困扰,如何有效引导学生明晰病证与症状之间的区别和联系,培养病-症鉴别思维,是从理论培养过渡到实践教学中的难点之一。文章以“心悸”作为症状与病证之异同为切入点,论述《中医内科学》教学中灵活应用“定义精讲,内涵分析——诸症共参,归纳总结—医案导入,实战训练”的培养方法,通过帮助学生明晰病证与症状之异同,建立病—症鉴别思维,以期为中医鉴别思维的教学培养提供一定的思路及参考。Traditional Chinese Medicine(TCM) Internal Medicine is the important link between basic TCM courses and clinical disciplines. And it is the basis for cultivating students’ comprehensive clinical skills. The cultivation of disease-symptom differentiation thinking is an important part of the teaching TCM Internal Medicine, and it is also a key part of the cultivation of clinical thinking in TCM. However, the diagnosis of symptomatic diseases has brought great trouble to the cultivation of differential thinking. How to effectively guide students to clarify the differences and connections between diseases and symptoms, and to cultivate diseasesymptom differential thinking is one of the difficulties in the transition from theoretical training to practical teaching. The paper takes palpitation as the starting point of the similarities and differences between symptoms and syndromes.Some training methods are applied in in the teaching of internal medicine of TCM flexibly, including elaborating and analyzing the definition, summarizing common characteristics of various symptoms, case learning and clinical practice. These training may help students to clarify the similarities and differences between symptoms and syndromes, and establish the disease-symptom identification thinking. The paper may provide some ideas and reference for developing TCM differential diagnosis thinking.

关 键 词：中医内科学 症状 病证 心悸 症状性疾病诊断 中医鉴别思维 

分 类 号：G642[文化科学—高等教育学]