从“五辨”思维探讨经方运用思路与方法  

Discussion on the Thinking and Methods of Application of Classic Prescriptions from the Perspective of“Five Differentiation”

作　　者：王永涛 孟虎彪 刘继法 徐鹏 张宇 谷劼楠 彭彬 徐世杰[1] WANG Yongtao;MENG Hubiao;LIU Jifa;XU Peng;ZHANG Yu;GU Jienan;PENG Bin;XU Shijie(Institute of Basic Theory of Traditional Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Institute of Information on Traditional Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Institute of Clinical Basic Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院中医基础理论研究所,北京100700 [2]中国中医科学院中医药信息研究所,北京100700 [3]中国中医科学院中医临床基础医学研究所,北京100700

出　　处：《中国中医药信息杂志》2024年第6期163-166,共4页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：中国中医科学院科技创新工程项目(CI2021B001);中国中医科学院中医基础理论研究所基本科研业务费自主选题项目(YZ-202220)。

摘　　要：李灿东教授提出中医“五辨”思维,即辨症、辨证、辨病、辨人、辨机。本文探讨基于“五辨”模式的经方运用思路与方法。“辨症论治”是经方运用的快捷之法,包括探寻特异性症状或症状群、依据特殊舌象;“辨证论治”是经方运用的常用之法,要辨证之主次兼夹与寒热真假;“辨病论治”是经方运用的固有之义,主要是辨明六经病和专病专方两类;“辨人论治”体现经方运用的个体化差异,须审年龄、性别,辨体质、腹证;“辨机论治”是经方运用的巧妙之法。临证时应坚持“五辨”一体的运用模式,在5个维度综合考量经方,以提高运用的准确性、有效性,揭示和完善经方的学术体系,更好地指导经方的临床运用。Professor Li Candong puts forward the“five differentiation”thinking in TCM:symptom differentiation,syndrome differentiation,disease differentiation,person differentiation and mechanism differentiation.This article discussed the thinking and method of application of classical prescriptions based on the mode of“five differentiation”.Treatment based on symptom differentiation is a quick method of application of classic prescriptions,which includes searching for specific symptoms or symptom groups and according to special tongue images.Treatment based on syndrome differentiation is a commonly used method in classic prescriptions,distinguishing between primary and secondary syndromes and the authenticity of cold and heat.Treatment based on disease differentiation is the inherent meaning of classic prescriptions,which is mainly to distinguish six meridian diseases and special prescriptions for specific diseases.Treatment based on person differentiation embodies the individual differences in the use of classic prescriptions,which include age,gender,constitution and abdominal syndrome.Treatment based on mechanism differentiation is an ingenious method used by classic prescriptions.When practicing clinical medicine,we should adhere to the integrated mode of“five differentiation”in the application of classic prescriptions,comprehensively considering the five dimensions,in order to improve the accuracy and effectiveness of the application of classic prescriptions,reveal and improve the academic system of classic prescriptions,and better guide their clinical application.

关 键 词：辨症 辨证 辨病 辨人 辨机 经方 运用方法 

分 类 号：R249[医药卫生—中医临床基础]