试辨张景岳“十问”之主体思想

Analysis of the Main Thought of ZHANG Jing-yue “Ten Inquiries”

张景岳"十问"是对临床诊断治疗过程的高度概括,体现其注重阴阳、神机的主体思想以及对于医患关系的思考。中医临床者须继承前人精华思想并把握其要点,在临床诊疗过程中有明确的诊疗思想并灵活地加以运用,既能充分领会古人精神,又能根据患者的实际情况做出相应的权变以切合临床实际。故从二纲六变,注重神机;继承经义,指导临证;重视医患,不失人情;意贵圆活,通权达变4个方面对张景岳"十问"主体思想作一分析,以期更好地把握其问诊思想,为临床实践服务。

＂Ten Inquiries＂of ZHANG Jing-yue is a high generalization of the process of the clinical diagnosis and treatment,which reflects that ZHANG Jing-yue attach great importance to Yinyang,the changes of the spirit of man,as well as the consideration of physician-patient relationship. The physician of Traditional Chinese Medicine should take full advantage of essential thought of predecessors,and grasp the main points and the essence. Physicians should have a clear thought of clinical diagnosis and treatment,while the frame of mind should be flexible. Physicians should fully comprehend the essence of predecessors,and make corresponding changes based on the actual situation of the patients in order to correspond to clinical actual situation. This paper analysed the ten inquiries of ZHANG Jing-yue from the two guiding principles and the six changes,while paying attention to the changes of the spirit of man; inheriting the theory of the TCM classics,while acting as the clinical guideline; attaching importance to physician-patient relationship with the interpersonal relationship not ignored; frame of mind should be flexible,while knowing commonness of the diseases for the change. The paper aimed to grasp the essence of the inquiry mind better for clinical services.