《伤寒论》病、证、症、方关系浅谈

Brief Discussion About the Relationship Between Disease and Syndrome and Symptom and Prescription in Treatise on Cold Damage Diseases

在疾病的治疗上,辨证论治不是针对单一症施治,而是针对一组有机联系在一起的"症"的整体施治,因而辨证论治不是对症治疗,而是对证候治疗。中医治病多采用复方,它兼顾了证候的内在联系即病机,在实践上就不仅针对了证候,而且也包含了疾病的病因、病理。所以,辨证论治就不但对证候有效,也会对疾病有效。时间与空间具有不可分性,故"证中有病,病中有证"。"方"的具体应用是根据"证"来确定的,而不是依据"症"和"病"确定的,疾病的病因病机相同就可以选用相同的方剂进行治疗,反之亦然。《伤寒论》中的"病""证""症"的内涵之间存在交叉与独立,"方"的选择应用是依据"证"的不同而最终确定的。

In terms of treating diseases,therapy based on syndrome differentiation is not aimed at single symptom,but a group of symptoms which have organic links,so it is not aimed at symptoms,but syndromes. Compound prescription is often used in TCM,because it takes into account pathogenesis which is internal link of syndromes. In clinical practice,it not only considers syndromes,but also disease cause and pathology. Therapy based on syndrome differentiation in not only effective on syndromes but also diseases. Time and space are not separable,so syndromes and diseases have close relationships. The exact use of prescriptions are based on syndromes,not on symptoms and diseases. If different diseases have same cause and pathogenesis,the same prescription can be used,and vice visa. In Treatise on Cold Damage Diseases,the connotations of diseases,syndromes and symptoms have interaction and independence. The choice of a prescription is finally based on different syndromes.