从病机角度浅析《黄帝内经》审机论治的疾病诊疗体系

Analysis of the Diagnosis and Treatment System of Diseases in Inner Canon of Yellow Emperor (《黄帝内经》) from the Pathogenesis

从病机角度着眼,解析《黄帝内经》审机论治的疾病诊疗体系。凡欲诊病,先察病机,审察病机处于《黄帝内经》疾病诊疗中的核心;掌握住病机就掌握了疾病的本质和治疗的关键,面对临床复杂多变的病情局面,能够起到执简驭繁的作用。此外,《黄帝内经》对临证审机论治亦有重要的方法学启示,知晓其常、把握其变是审机论治的指导思想;求责"有、无、虚、实"是临证审察病机的思维范式;多维综合、全局遍历是审察病机的执行方法。最后,以"心痛"为典型案例,分析和呈现《黄帝内经》以病机为核心对"心痛"一证进行诊断治疗的全过程。

This study is to analyze the disease diagnosis and treatment system of Inner Canon of Yellow Emperor(《黄帝内经》) from the perspective of pathogenesis. In order to diagnose diseases, we should first examine the pathogenesis, which is at the core of the diagnosis and treatment of diseases in Inner Canon of Yellow Emperor. If we grasp the pathogenesis and control the nature of diseases and the key of treatment, in the face of the complex and changeable clinical situation, we can play a role in controlling the complexity. In addition, it also has important methodological enlightenment on the treatment of clinical trial mechanism,i.e. knowing its constancy and grasping its change is the guiding ideology of treatment;examining "the existence, nonexistence, deficiency and excess" is the thinking paradigm of clinical examination of pathogenesis;multidimensional synthesis and traversal is the implementation method of examination of pathogenesis. Finally, taking "heartache" as a typical case, the whole process of diagnosis and treatment of "heartache" was analyzed and presented based on pathogenesis in Inner Canon of Yellow Emperor.