从《伤寒论》太阳病变证条文中的辨治谈中医避误之启发

Discussion on the Avoidance Of Mistakes In Chinese Medicine From the Perspective of Differentiation of Symptoms and Signs in the Taiyang Disease in Treatise on Febrile Diseases

太阳病已发汗,医家辨证不明,误行吐下温针等法而成变证。医家常由变证症状不变、病机不同致误;不明变证传变,汗下失序致误;此外,药物的煮服法从另一个角度反映了中医的辨证思维,临证中却常被医家忽略而致误。太阳病变证是中医临床误诊误治的一个缩影,笔者通过分析太阳病误后下利症同证异致误、变证传变误断、药物煮服方法避误3个方面,探讨太阳病变证相关条文的辨治对中医避误的启发。

Patients with Taiyang diseases has been sweating,While the doctor＇s failure to give clear diagnosis result in the deteriorated cases by mistakenly using emetic therapy,purgative method and acupuncture with warmed needle.Because the case with unchanged symptoms are accompanied by different pathogenesis after therapeutic error in Taiyang diseases,the doctor usually make error diagnosis and give unreasonable treatment. The deteriorated cases develop rapidly,and the error of the disorder is caused by ignoring the change of progress of diseases as well as using sweating and vomiting way reversedly. The deteriorated cases of Taiyang diseases are a microcosm of misdiagnosis and mistreatment in TCM clinical practice. In addition,Zhong-jing also paid special attention to the decoction and taking methods herbs,which is not only an indispensible part of the treatment with the change of syndrome,but also an adelomophous mirror of the clinical thinking. Unfortunately it is often neglected by the doctors. The deteriorate diseases with Taiyang is a microcosm of TCM clinical disease. Flexible differentiation in the deteriorated case of Taiyang diseases is important. In this paper,the author will explore the differentiation and treatment of the deteriorated cases items of Taiyang diseases and its inspiration in mistake avoidance through the analysis of the following the following three aspect： the error in Taiyang disease about the same symptom but different syndromes in dysentery and diarrhea,the progress of deteriorated cases treatment error caused by misdiagnosis; the strict ways of avoiding the error decoction and taking methods.