内科疑难病的中医临床思维特点与辨治方法探讨

To Investigate the Clinical Thinking Characteristics and Treatment Methods of the Difficult Internal Medicine Disease of TCM

内科疑难病的病机特点是病邪胶着、病性错杂、病位深痼、病势峻厉或淹缠;临床上应坚持辨病论治与辨证论治相结合,把握病机特点,尝试多种方法;突破君臣佐使观念,突破配伍禁忌,突破方剂大小;不避毒性药物,不避超大剂量,不避非常规用法。目前疑难病治疗一般责之风、气、痰、瘀、毒、虚等因素,但是总结临床经验,实事求是,必须突破一切疑难病治风、治气、治痰、治瘀、治毒、治虚等思维禁锢,避免坠入一法一方"包治百病"的思维误区。

The pathogenesis characteristic of the difficult internal medicine disease is the miscellaneous pathogenic factors, mixed disease, embedded disease or severe flooding; The clinic should insist on the treatment based on syndrome differentiation combined with disease differentiation, grasp the characteristics of the pathogenesis and try a variety of ways; We should break through the concept of monarch, minister, assistant and guide in TCM prescription, incompatibility, and formula size; Don＇t avoid using toxic drugs, large doses, abnormal usage. Currently, the treatment of difficult internal medicine disease is owe to the wind, Qi, phlegm, stasis, poison, virtual and other factors. However, suming up clinical experience, seeking truth from facts, we should break through all the treatment of the difficult internal medicine disease of wind, phlegm, stasis, Qi, poison, empty and other thinking imprisoned, to avoid falling into a method of ＂ guarantee to cure all diseases＂ myth of thinking.