基于“张仲景杂病诊疗体系”的中医本科生临证思维建构

Discussion on the Construction of Clinical Syndrome Thinking Based on "Zhang Zhongjing's Miscellaneous Disease Diagnosis and Treatment System"

目的:探讨基于"张仲景杂病诊疗体系"的中医本科生临证思维建构。方法:对《金匮要略》中体现的"仲景杂病诊疗体系"特点的相关内容进行总结,以期能够切实指导本科生在《金匮要略》学习中初步建立中医临证思维方法。结果:找到了中医本科生临证思维体系的建构(临床决策)的方法,利于本科生中医临证思维的初步建构以发蒙、解惑。结论:深刻理解以及锻炼学生对《金匮要略》中仲景杂病"诊疗体系"的整体把握,使学生更加深刻理解经方的组方思想、能够敏锐地把握每个具体方证的适应证。张仲景《金匮要略》作为中医高等院校本科生临床基础课程中的重要学科,因其方约而多验,文简而难通,为学生所不易理解和掌握。本文从《金匮要略》"仲景杂病诊疗体系"构成要素(包括病、证、理、法、方药),中医本科生临证思维体系的建构,以及中医本科生对《金匮要略》的学习对于中医临证思维体系建构(临床决策)的意义等几方面,基于对《金匮要略》"杂病诊疗体系"的系统归纳与学习,以期于本科生中医临证思维的初步建构以发蒙、解惑。

Objective ：To study the construction of traditional Chinese medicine undergraduate clinical syndrome thinking based on ＂ Zhang Zhongjing＇s miscellaneous disease diagnosis and treatment system＂. Methods：Effectively guided undergraduate students initial establishment of TCM clinical syndrome thinking in the learning of Jingui Yaolue（ Synopsis of Golden Chamber） through summarization the characteristics of Zhang Zhongjing＇s miscellaneous disease diagnosis and treatment system which were reflected in Jingui Yaolue. Results ： Profound understanding and overall grasp of ＂Zhang Zhongjing＇s miscellaneous disease diagnosis and treatment system＂ in Jin- gui Yaolue make the students more deeply understanding the formulating prescription thought of classical prescription, and keenly grasp indications of each specific prescription and syndrome. Jingui Yaolue as an important subject in TCM colleges and universities under- graduate clinical foundation courses, because of the prescription is always concise and empirical formula, and the article is brief and dif- ficult to understand, so it is not easy for students to understand and grasp. This article states from the components of ＂Zhang Zhongjing＇ s miscellaneous disease diagnosis and treatment system＂ in Jingui Yaolue （including disease, syndrome, pathogenesis, method and for- mulas） and the construction of TCM undergraduate clinical syndrome thinking system, and the significance of TCM undergraduate students learning from Jingui Yaolue on the construction of Chinese medicine clinical syndrome thinking system （ clinical decisions）. Conclusion：Base on systematical summarization and studying ＂ Zhang Zhongjing＇s miscellaneous disease diagnosis and treatment sys- tem＂ in Jingui Yaolue and get inspired, solving puzzles for preliminary construction of traditional Chinese medicine undergraduate clini- cal syndrome thinking.