从“五辨”思维浅谈瘀证辨识  

Identification of Blood Stasis Syndrome from“Five Recognition”Perspective

作　　者：杨运劼 赵晓果 郑敏麟[1] 周楚 阮诗玮[3] YANG Yunjie;ZHAO Xiaoguo;ZHENG Minin;ZHOU Chu;RUAN Shiwei(Fujian University of Traditional Chinese Medicine,Fuzhou 350108,China;Ningde Municipal Hospital of Ningde Normal University,Ningde 352100,China;Fujian University of Traditional Chinese Medicine Affiliated People's Hospital,Fuzhou China)

机构地区：[1]福建中医药大学,福建福州350108 [2]宁德师范学院附属宁德市医院,福建宁德352100 [3]福建中医药大学附属人民医院,福建福州350004

出　　处：《中医药信息》2023年第12期47-52,共6页Information on Traditional Chinese Medicine

基　　金：全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号)。

摘　　要：瘀既为病理产物,又为致病因素,且易兼夹他邪为患。其发病隐匿,辨识困难,致病广泛,病情复杂,故有“怪病多瘀”之说。笔者试从“五辨”思维出发,即从“辨象、辨位、辨势、辨体、辨机”角度对瘀证进行辨识。结果发现,瘀之象为辨证之基础,瘀之位为辨证之核心,瘀之势为辨证之重点,瘀之体为辨证之本源,瘀之机为辨证之根本,故从“象、位、势、体、机”五个方面对瘀进行辨识是瘀证诊断的关键,不仅体现宏观思辨与微观辨证相结合,同时能更深层次地完善对中医证候的认识,不断提高中医的诊断水平。Blood stasis is not only a pathological product but also a pathogenic factor,and it is prone to be accompanied by other pathogenic factors.The onset of blood stasis is occult,blood stasis is difficult to identify and causes a wide range of diseases,and the condition caused by blood stasis is complicated.Therefore,there is a saying that"strange diseases are often caused by blood stasis".We try in the paper to identify stasis syndrome starting from"five recognitions"perspective,sign recognition,position recognition,seriousness recognition,physique recognition,and mechanism recognition.We found that the signs of blood stasis is the foundation of syndrome differentiation,the position of blood stasis is the core of syndrome differentiation,the seriousness of blood stasis is the key points of syndrome differentiation,the physique of blood stasis is the origin of syndrome differentiation,and the mechanism of blood stasis is the foundation of syndrome differentiation.Therefore,identification of blood stasis from the five aspects,signs,position,seriousness,physique,and mechanism,is the key to the diagnosis of blood stasis syndrome.This idea not only combines macro speculation with micro syndrome differentiation,but also improves the understanding of traditional Chinese medicine syndrome at a deeper level and continuously improves the diagnostic level of traditional Chinese medicine.

关 键 词：瘀 五辨 病象 病位 病势 体质 病机 

分 类 号：R255[医药卫生—中医内科学]