“微观中药西用”探讨

Exploration of Microcosmic Chinese Medicine Used by Western Medicine

"微观辨证"、"辨病论治"及"病证结合观",泛指"无病从证,无证从病模式"。如高血压病、高血脂、转氨酶增高等的中医治疗,可直接采用降血压、降血脂、降低转氨酶的中药组方,不必再借助"辨证论治"。中成药临床应用,西医不通过辨证用药,临床也取得一定疗效。青蒿素的发明,是从4万多种化合物及草药中筛选而来,而没有引用中医学理论。很多专病民间单方、验方亦均非经过很深的中医学理论而获得成功。种种迹象表明,不采用"辨证论治"组方也可治病。考虑原因与中药和西药治病的机理一致性有关:中药治愈或缓解病症是中药具有的现代药理学作用所产生的结果,通过改善病因、病机从而缓解病症。针对组成中药方剂能否直接引用具有现代药理学作用的中药,笔者提出"微观中药西用"的观点。"微观中药西用",即从患者的临床症状、体征及各种辅助科室检查阳性结果(统称为微观辨症指标)中,寻找和选用相对有效的现代药理作用的中药进行组方医病。由于省去中医复杂而神秘莫测的辨证,将会有更多的西医师运用其治疗疾病,以促进中药的广泛使用及普及,这样也必将扩大中西医结合的队伍,提高西医对中药使用的兴趣,有利于中西医结合事业的发展。

＂Microcosmic syndrome＂, ＂treatment based on syndrome differentiation＂, and ＂com- bination of disease identification and syndrome differentiation＂ generally refer to a mode： following the syndrome if with no disease identified, following the disease if with no syndrome type differentiated. For example, Chinese medical treatment of hypertension, high blood lipids, increased transaminase, and so on can directly use Chinese recipes, but no longer with syndrome differentiation. Clinical application of Chinese patent medicine can also obtain favorable clinical. Western doctors need not follow syndrome dif- ferentiation. The invention of artemisinin was screened from more than 40 000 kinds of compounds and herbs, but with no reference of any traditional Chinese medical theory. A lot of folk remedy and empirical recipes have obtained effective efficacy but unnecessarily with profound Chinese medical theories. Vari- ous evidences showed that disease can also be cured without syndrome differentiation. I held that it might be associated with the same mechanism of Chinese medicine and Western medicine. Any disease can be cured or alleviated by Chinese medicine is a result from its modern pharmacological effect, which is a- chieved by improving etiologies, and pathogeneses. I was inspired by whether we can directly use tradi- tional Chinese medicine with modern pharmacological effects to treat symptomatic disease. So I raised an idea of microcosmic Chinese medicine used by Western medicine, i.e., we find and use Chinese herbs with relatively effective modern pharmacological effect to treat diseases targeting at patients＇ clinical symptoms and signs, as well as various positive laboratory results （collectively called as microscopic dialectical indicators）. More Western doctors would use it to treat disease due to omission of complicated and mysterious syndrome differentiation. This will promote extensive application and expansion of Chinese medicine and pharmacy, enlarge the team of integrative medicine, improve Western doctors＇ inter-est in Chinese medicine and pharmacy, thus pushing the career of integrative medicine in a brand new development era.