从《伤寒论》探析仲景辨证运用经方思维方法

Thought Methed on Syndrome Differentiation and Application of Classical Prescription of ZHANG Zhongjing from "Treatise on Cold Pathogenic Diseases"

[目的]探析仲景辨证运用经方的思维方法。[方法]列举相关文献,引述历代名家对《伤寒论》经方的见解,理论联系实践,条文对应临床,对仲景辨证运用经方的思维方法进行论述及总结提炼。[结果]《伤寒论》充分体现出仲景的辨证思想,可从中提炼出方证对应、抓主证及辨证论治法。抓主证指在面对有特异性的证时可以采用抓主要特征的方法;方证对应指方药与疾病病机和症状体征相契合,是辨证论治的前提;辨证论治指在疾病某一阶段,根据患者症状体征总结得出证型,再根据证型病机特点立法处方,选择相应方药的循序渐进的治疗法则,以及通过病机分析法对经方进行扩展应用的思维模式。三者构成仲景辨证思维方法的主线。[结论]张仲景著《伤寒论》辨证准确,方证合一,对后世医家进一步发挥与完善辨证论治有着深远影响,其辨证思维方法对后世多有启发,值得进一步研习。

[Objective]To discuss the syndrome differentiation and treatment of classical prescription of ZHANG Zhongjing. [Method] Listing relevant literature and quoting physicians＂ views on book and combining theory and practice to discuss and distill from the application of thinking methods of syndrome differentiation. [Results] ＂Treatise on Cold Pathogenic Diseases＂ fully reflects the syndrome differentiation thoughts, where can be concluded syndrome differentiation and treatment and the method of treatment. Catching the main syndrome means when facing with a specific syndrome can be used to catch the main character of method. And the correspondence between recipe and syndrome is the prescription consistent with the pathogenesis and symptoms of disease which is a prerequisite for syndrome differentiation and treatment. Meanwhile, syndrome differentiation and treatment is a principle of step by step treatment that according to the symptoms and signs of patients, sum up syndrome type, and then prescribe and select drugs at some stage in the disease. And it is also a thinking mode of classical prescription extended application by pathogenesis analysis. Those constitute the three main lines of the thinking method of differentiation. [Conclusion] Accurate differentiation and the prescription are consistented with the syndrome type of ＂Treatise on Cold Pathogenic Diseases＂ exert far-reaching influence on the use and perfect syndrome differentiation and treatment,which inspire future generations of doctors. Therefore, it deserves further study. Syndrome differentiation of application thought of classical prescriptions profoundly promotes the development of Chinese traditional medical thinking： the theorv has urofound significance for clinical uractice.