“证”及“辨证”含义的发展演变

Development and evolution of ‘syndrome' and ‘syndrome differetiation'

"证"的概念在中医发展过程中不断演变。自《伤寒论》开始,其内涵即开始放大,有病证并提的趋势。此后,愈至晚近,中医愈重视辨证,证的概念也愈宽。故"证"早已是中医临床思维的核心对象。舍去证的概念,不讲辨证论治,意味着中医自我否定。明清以来,整理出了作为纲领的"证"概念。所以,"证"概念的本意有两个。辨证论治时所得之"证",是对患者当时的病位、病性或病理的综合判断,即病的目前正邪斗争反应状态,也就是医生要治的对象。作为纲领的"证",是中医的最基本的病性或病理概念。

The concept of syndrome in the process of development of traditional Chinese medicine （TCM） continues to evolve. Since the beginning of the Treatise on Febrile Diseases, its meaning began to enlarge, and there was a tend to pay more attention on disease and TCM syndrome. After that, until recently, TCM payed more attentions to syndrome differetiation. So syndrome has already been a core object clinical thought of TCM. Surrendering the concept of syndrome and syndrome differentiation meaned denial of TCM. Since Ming and Qing dynasties, the programme of syndrome concept was finished. Therefore, syndrome＇s concept intended to have two aspects. The syndrome in treatment based on syndrome differentiation include disease position, nature of disease or pathology of synthetic judgments of a patient, which is the currently state of healthy energy and evil struggling, and it is also what the doctor needs to object. Syndrome, as the programme, is the most basic concepts of nature of disease or pathology of TCM.