审证求机 知常达变——周仲瑛教授谈中医临床辨证的思路与方法

Flexible Analysis of Pathogenesis in Syndrome Differentiation——Prof. Zhou Zhong-ying's Talk about Syndrome Differentiation

辨证的基本要求是审证求机 ,包括求病因、病位、病理因素 (第二病因 )、脏腑病机、八纲属性、标本缓急、证 (病 )势转归和预后等。审证求机的核心是求病理因素 ,文章着重对求病因、求病理因素和脏腑病机的思路与方法进行了阐发。在审证求机中做到知常达变、圆机活法 ,才能真正掌握中医辨证的实质和灵魂 ,周仲瑛教授总结出中医的辨证有“五性” ,临床能熟练掌握证的“五性” ,就能做到知常达变。“五性”即证的特异性、可变性、交叉性、夹杂性、非典型性 (初期性证、过渡性证、隐伏性证和轻型性证 )。文章对中医证候规范化与辨证灵活性的关系、“内生六淫”

The basic requirement in syndrome differentiation is to analyze pathogenesis, including the analysis of the following: cause, location, pathological factor (the secondary cause), Zang Fu pathogenesis, eight principles, acute or chronic case, superficiality or origin, tendency of transformation, and prognosis. The core of pathogenesis analysis is the analysis of pathological factor. This paper expounds the way to analyze cause, pathological factor and Zang Fu pathogenesis. Only by flexible application of the principles, can one masters the essence of syndrome differentiation. Prof. Zhou Zhongying has summed up the methods of syndrome differentiation and believes that there are five specific features. If one can keep the five features in mind, he will be able to analyze pathogenesis flexibly. The five features are peculiarity, variability, crossing, complication, and atypical cases (initial cases, transitional cases, insidious cases, and light cases). The paper later discusses the relation between syndrome standardization and flexible syndrome analysis. The clinical significance of the theory 'six interior pathogens' in the diagnosis and treatment of internal injuries is also discussed.