基于“治未病”理论的《金匮要略》痉病诊治思维步骤分析

Analysis of Thinking Steps of Diagnosis and Treatment of Spasm Disease Based on Theory of Treatment of Not-Disease in Synopsis of Golden Chamber

为揭示《金匮要略》诊治疾病的原本思路,在隐性知识理论指导下,采用原著明确提出的"治未病"原则,以痉病为切入点,分析有方证原文诊治疾病的思路、思考的重点及解决问题的方案,结论认为"治未病"在原著不仅是一个疾病预防原则,还是一个最终决定方剂、药物选择的治疗原则,将痉病相关原文划分为"辨治已病"与"辨治未病"可揭示原著诊治该病的思维步骤。较之应用后世理论解释与重构经典的阐释学,借鉴采用隐性知识理论,研究结论更为接近经典原本的含义,这无论对于痉病诊治规律、《金匮要略》原著疾病诊治思维还是现代辨证论治思维步骤研究均有积极意义。

For revealing the original ideas of diagnosis and treatment of Synopsis of Golden Chamber, the thinking steps of diagnosis and treatment of disease, the focus of the thinking and the solution to solve the problem of syndrome of the spasm disease should be analyzed as the breakthrough point under the guidance of the tacit knowledge theory, and using the principle of preventive treatment of disease which was originally and clearly put forward. The conclusion is that the theory of preventive treatment of disease in the original is not only a disease prevention principle, but also a therapeutic principle which finally decides which pre- scriptions and drugs can be selected. So the original thinking of diagnosis and treatment of the spasm disease can be divided into two steps ： the diagnosis and treatment of disease already happened and the diagnosis and preventive treatment of disease. This conclusion which uses the tacit knowledge theory is more close to the meaning of the classic original than the conclusion which uses the hermeneuties of the explaining with the later theory or refactoring the original. And it has a positive significance for researching the rule of the diagnosis and treatment of the spasm disease, the thinking of the diagnosis and treatment of Synopsis of Golden Chamber and the thinking steps of modern theory of treatment according to syndrome differentiation.