从病例谈“经方”之“精”

Viewpoint regarding "concise" of "classical formula" from case

"经方"以其确切的临床疗效为人称道,然而许多研习"经方"者却停留在简单的症状、方剂对号入座的粗浅形式上,未能精细而深入的探索"经方"的内涵。"经方"的临床疗效与魅力所在,主要在一个"精"字,分而论之,包括"方证"指向精确,"经方"结构精炼,"辨证"过程精细等多方面。"方证"指向精确,但需要医家结合患者的体质特征、症状特点,乃至饮食口味,情志喜好等多重因素综合考虑,才能更为准确的把握方证特点。"经方"结构精炼,尤应注意其组方及各种加减变化的法度,不循张仲景之法,反而影响临床疗效。"辨证"过程精细,医家应依中医之法,别阴阳、审证候、辨类方,循序渐进,综合考虑,如此才能准确选择恰当方剂,提高临床疗效。

"Classical formula" are praised for their exact clinical efficacy,but many scholars of " classical formula" still remain in the simple symptoms and the superficial form of formula matching,failing to explore the connotation of " classical formula" in a subtle and in-depth way. The clinical curative effect and charm of " classical formula" mainly lie in " concise". " Concise" can be divided into many aspects,including " correspondence of formula and syndrome" infers pointing accuracy, " Classic formula" infers structure refining,and " pattern differentiation" infers process elaborating,ect. " Correspondence of formula and syndrome" requires doctors to take into account multiple factors such as physical characteristics,symptom features,diet taste and emotional preference of patients,so as to grasp its essence more accurately. " Classic formula" implies paying special attention to its composition and various methods of addition and subtraction. Not following Zhang Zhongjing’s method and gilding the lily will affect the clinical efficacy. " Pattern differentiation" indicates doctors should separate Yin and Yang,examine syndrome features and distinguish the categories following the method of traditional Chinese medicine with comprehensive observation and comprehensive consideration in-depth so as to accurately select the appropriate prescription and improve the clinical efficacy.