从历史看中医诊法的二元结构.docVIP

 从历史看中医诊法的二元结构# 5 10 15 20 25 30 35 40 摘要：目的：理解古代诊法研究著作的思想，为诊法的现代化研究提供思路。方法：分析古 代的诊法专著与临床著作，探寻古代医生的诊法研究思想。结果：古代的诊法研究有两个支 撑点：1.人体感觉器官的感知研究；2.诊法的诊断特异度研究。中医诊法在二元结构中不断 地通过肯定、否定而推陈出新。结论：古代有关诊法的研究与思考，对诊法的现代化研究具 有重要的参考价值。 关键词：中医诊断学；中医诊法；感觉；特异度；脉；症 中图分类号：R241 Looking Historically at the Dual Structure of Traditional Chinese medicine Diagnostic Methods LIANG Rong (Department of TCM Diagnostics, Beijing University of Chinese Medicine, Beijing 100029, China) Abstract: Objective: To discuss the research value of the TCM diagnostic methods in the TCM medical history. Methods: To investigate the diagnostic methods research ideas and features of ancient TCM practitioners by analyzing ancient TCM diagnostics monographs and medical records. Results: There were two main aspects found in historical TCM diagnostics. First of them was saying that TCM diagnostic methods were based on the perception research of the sensory organs, and the other was the research of diagnostic specificity found in TCM diagnostic information. There proved that TCM diagnostic methods in the dual structure may constantly innovate from affirmation and negation, and these points played as the leading role in modern Chinese medicine diagnostics. Conclusions: This study of TCM medical history in TCM diagnostics methods is valuable for the modernization TCM diagnostics. Based on this research, the most knowledge could be drawn out of the ancients, and may accelerate the modernization of TCM diagnostic method research. Key words: TCM Diagnostics; TCM Diagnostic Methods; Sensation; Specificity; Pulse; Symptoms 0 引言 诊断学是临床医学的基础，其中的“诊”又是“断”的基础。古代的医生在诊法方面进 行了深入地观察与思考，并以文字的方式，留下了宝贵的知识。 在中医现存最早的医学专著《黄帝内经》中，已有四诊，即望诊、闻诊、问诊、切诊内 容的记载[1]。至晋代，出现了以诊法为书名的专著《脉经》。但以《伤寒论》这部临床著作 为标志，使我们看到了中医诊法的另一种研究思路，呈现出诊法的二元结构。这个二元结构 支撑着诊法学基础研究与临床诊断规律研究两个点。前者偏重于科学体系，后者偏重于技术 体系。这两个研究点既独立，又结合，不断地推动着中医诊法知识体系的成长。以下基于古 代的四诊著作与临床著作，阐述作者的观点。 -1-  1 诊法著作的四诊研究 四诊是根据诊法信息的采集来源所进行的分类。人通过身体的感觉器官与内、外环境进 行交流，中医最大限度地利用了人体所有的感觉器官来采集疾病的信息。四诊再细划分，还 可分为利用医生的