先病后证,判明邪正消长态势是辨证的关键——论西医辨病和中医辨证模式的新思考

Disease Differentiation Should be Followed by Syndromes Differentiation,the Key Point of Syndromes Differentiation is to Judge the Growth and the Decline of Vital Qi and Pathogenic Qi ——The preliminary discussion on the mode of diseases diffe

正虚邪实是病证的本质。证的基本要素包括病位、病性、病因及邪正交争的态势。正气的虚损 ,不外阴 (精 )虚、阳 (气 )虚、(宗 )气虚、血虚、津液虚 ;邪气的类别 ,不外寒型、热型、风型、湿型、郁型。在新的病证结合体系中 ,强调辨病在先 ,辨证在后。即先用理化方法检测微观指标 ,确定病名 ;再审病程 ,定邪正 ,以脏腑定病位 ,审察邪正斗争的态势 ,确定证型。这种辨病辨证模式有利于揭示证的本质 ,建立证的微观辨证体系 ,寻找到治疗疾病的有效方药。

Vital qi deficiency while pathogenic qi prevailing is the essence of diseases and syndromes. The basic factors of syndromes include the site,the cause,the nature of the diseases and the changes of balance between vital qi and pathogenic qi. The deficiency of vital qi includes yin(jing)deficiency,yang(qi)deficiency,(zong)qi(gathering qi) deficiency,blood deficiency,body fluid deficiency;The types of pathogenic qi include cold,heat,dampness,wind,stagnation.In the new diagnostic practice combining differentiation of diseases and that of syndromes,It is emphasized that differentiation of diseases should be followed by that of syndromes. That's to say,First diagnose the diseases(western medicine) by inspecting the microcosmic index with the help of laboratory examination methods,then study the stage of diseases and judge whether vital qi is deficient or pathogenic qi is prevailing. Thus,the syndrome type (zheng xie)can be diagnosed by judging the site of diseases with viscera and organs (zang fu) and looking into the changes of balance between vital qi and pathogenic qi (xie zheng dou zheng).This mode that diseases differentiation is integrated with syndromes differentiation is advantageous to reveal the essence of syndromes. It's also advantageous to construct the system of the microcosmic differentiation of syndromes. It's also useful for us to find effective drugs and decoction.