“微观辨证”的产生及其发展

Origin and development of microcosmie syndrome differentiation

“微观辨证”概念的提出是中医临床诊治、循证医学发展和中医证候学发展的需要。“微观辨证”产生的可能性是由于中西医结合和现代科学技术的发展。“微观辨证”有其优越性和局限性,“微观辨证”的发展尚存在一些问题,诸如:中医证候尚未规范化、微观指标单一性与整体性的矛盾、微观指标与证候对应的非特异性、疾病对“微观辨证”产生的影响、“证”本质研究与临床治疗脱节等。并提出“证”是疾病发生发展过程中某一阶段的病理过程,由若干相关的主、客观指标组成,这些客观指标应包括宏观与微观、整体与局部等多个方面的内容。

The suggestion of microcosmic syndrome differentiation is to meet the needs of clinical diagnosis and treatment of traditional Ohinese medicine （TOM）, the needs of evidence based medicine and the needs of the development of syndrome differentiation in TOM. The possibility of microcosmic syndrome differentiation might be the development of integration of traditional Ohinese and Western medicine as well as modern science and technology. Microcosmic syndrome differentiation has its superiority and limitation. There are some problems in developing microcosmic syndrome differentiation, such as lack of standard for syndrome differentiation, contradiction between single microcosmic index and the entirety, non-specificity of the relationship between microcosmic indexes and syndromes, and the influence of disease on microcosmic syndrome differentiation, discrepancy between the essence study of TOM syndromes and the clinical practice. It is suggested that the concept of TOM syndrome is a certain pathological process during the onset and development of disease, composed of some subjective and objective indexes. The objective indexes include the macrocosmic and the microcosmic indexes, the entirety and the part.