决策与判断在中医诊疗中的思辨

Speculations of decision-making and judgment in the clinical diagnosis and treatment with traditional Chinese medicine

中医临证思辨,不仅要运用中医思维及现代检测指标,还要涉及社会、心理、认知、心智等学科,决策与判断中的方法涉及最多,如期望效用理论、因果归因理论等。文章将决策与判断的相关理论运用到中医的诊疗思维过程中进行分析和总结,力求探讨中医诊疗思维的规律,并通过经验的运用与扩展,提出处方时遵循的原则:勿用有毒之品、固护脾胃之气、巧用引经药物、注意寒热反佐、给邪出路排毒,以确保临床的安全性、有效性、实用性、经济性。

In the diagnosis and treatment practice of traditional Chinese medicine（TCM）, TCM theory and laboratory examination index are necessary, and the social, psychological, cognitive, mental and other disciplines are also involved. Decisionmaking and judgment method involve up especially among these disciplines, such as expectation and effects, cause and effect attribution, etc. This article tried to study how to use the theory of decision-making and judgment to apply in the clinical TCM thinking process, to analyze and summarize in the process. In order tofigure out some regularities in diagnosis and treatment of TCM, therapeutic principles were proposed when making prescription, by using the expansion of experience, such as avoid using poisonous herbs, protecting qi of the spleen and stomach, using messenger drug, using corrigent of cold and hot, providing outlet of evil factors af ecting health, and to ensure clinical safety, effectiveness, practicality and economy.