证素的预测及其对“既病防变”的指导

Prediction of syndrome elements and its guidance to‘disease prevention’

预判疾病传变对中医临床遣方用药有重要指导价值,然而当前中医临证多以经验为主,对于疾病是否传、如何传尚无明确准则。证素辨证可将复杂的证拆解出病位和病性证素,笔者通过对证素间关系的梳理,认为两两证素之间主要存在"易""已"两个层次,"嗜""夹""致"3种关系,且分别代表了疾病的起因、过程和趋势,故而尝试从证素角度预测证素的发展演变趋势。同时,将阐释证素预测与六经传变、卫气营血传变间关联,并选取内伤和外感各1例医案,解析说明如何通过证素预测实现对疾病传变的预判,以更好指导临床"既病防变"。

Predicting the transmission of disease has an important guiding value for the clinical prescription and medication of traditional Chinese medicine(TCM). However, the current TCM clinical treatment is mainly based on experience. There is no clear criterion for whether the disease is transmitted or not. Syndrome elements differentiation can decompose complex syndrome into disease location and disease nature. Through the analysis of the relationship between the syndrome elements, authors believe that there are mainly two levels of ’easy’ and ’already’and three relationships of ’invasion’, ’cause’ and ’clamp’, which respectively represent the disease of causes, processes and trends. Therefore, we try to predict the development trend of the syndrome elements from the perspective of elements in order to anticipate the opportunity. At the same time, we will explain the relationship between the prediction of syndrome elements and the transmission of the six meridians, the Weiqi Yingxue, and select one case of internal injury and exogenous infection, and explain how to predict the disease transmission through syndrome elements prediction, so as to better guide the clinical ’disease prevention’.