异病同治,辨主证为要

Identifying the main pattern as the key to treating different diseases with the same method

异病同治是中医辨证论治原则的一种具体体现。不同疾病发展到同一阶段出现相似的证,或是一人身兼数病,在疾病发展过程中共同表现出的最显著的证候(主证),就可采用相同的治疗方法。中医治病主要着眼于证的区别,而异病同治实质上是抓主证,通过辨别主诉中的一组证候,作为确定治法、处方遣药的依据。本文从异病同治与证的概念及二者之间的关系方面进行阐释,明确抓主证在异病同治中的重要性,同时列举了异病同治的相关例证,以期拓展临床诊疗思路。

Treating different diseases with the same method is an exemplification of the principle of treatment based on pattern differentiation in traditional Chinese medicine（ TCM）. Different diseases that develop to the same stage showing a similar pattern,or several concomitant disorders showing the shared pattern（ main pattern）,can be treated with the same method. TCM mainly focuses on the difference among patterns in the treatment of diseases,and the essence of treating different diseases with the same method is to identify the main pattern among the clustered symptoms and use them as the evidence to support the choice of treatment and prescription. In this paper,the concept of pattern and treating different diseases with the same method,and the relationship between them are explained. Priority is given to grasping the main pattern in treating different diseases with the same method. At the same time,relevant examples are listed in order to help understand how this method can be used in clinical diagnosis and treatment.