《伤寒论》《金匮要略》问诊研究

Study on the Consultation of Treatise on Febrile Diseases and Synopsis of the Golden Chamber

问诊是医者重要诊病技能。善问者,有条不紊并处处直指要害;不善问者,天马行空且杂乱无序。文章试结合《伤寒论》《金匮要略》来探讨问诊在临床中的应用,分别从问以获知发病诱因、问以知治疗史、问以知既往史、问以获知现症、问以指导辨证、问以知药后情况这六方面展开。在此基础上,挖掘问诊背后的思维,归纳出整体观、联系观、主次观、恒动观、除外观等思维观念。最后,介绍自拟问诊思维歌诀以助记忆,并提醒临床问诊应主动运用。希望文章所做出的工作成果能有益于中医临床。

Consultation is an important diagnostic skill for doctors.Those who are good at asking questions are methodical and crucial everywhere,while those who are not good at asking questions are unconstrained and disorderly.This article attempts to explore the clinical application of consultation in combination with Treatise on Febrile Diseases and Synopsis of the Golden Chamber,respectively from six aspects:asking to know the predisposing factors of the disease,asking to know the treatment history,asking to know the past history,asking to know the current symptoms,asking to guide syndrome differentiation,and asking to know the situation after the medication.On this basis,it also explored the thinking behind the consultation,and summarized such thinking concepts as the holistic view,the connection view,the primary and secondary view,the constant movement view,and the external appearance view.Finally,it introduced the self-designed interrogation thinking formula to help memory,and reminded clinical interrogation that it should be actively used.It hoped that the results of this article could be beneficial to the clinical practice of traditional Chinese medicine.