“辨证论治”五种误用(下).doc

“辨证论治”五种误用(下) 　　摘 要：“辨证论治”一词自提出之后，由于未有准确而统一的概念，因而产生多种误用情况，主要可分为五大类，后三者包括：第三、关于“方证相对”而跳过了病机的问题，即是“对症治疗”，使中医理论倒退；第四、“方病相对”的分型论治，甚或“专病专方专药”的趋势，使中医的诊治简单化，忽略了疾病的时间状态；第五，证本质的研究，实际上所研究的并非“证”，而是指“中医病机的物质性研究”，由于微观研究并非“辨证”，所以“宏观辨证与微观辨证相结合”的说法，从概念上不可能实现。 　　关键词：证；证侯；辨证；辨证论治；辨证施治；误用 　　中图分类号：R22 文献标识码：A 文章编号：1673-7717（2011）04-0878-03 　　Five types of misusing on “Pattern identification and treatment”（2【sup】nd【/sup】 part） 　　LI Yu-ming 　　（Dongzhimen Hospital, The 1【sup】st【/sup】 Clinical School Affiliated to Beijing University of Chinese Medicine，Beijing 100700，China） 　　Abstract:Since the phrase “Pattern identification and treatment raised, because of no accurate and unity on its concept, it causes several misuses, which could mainly divide into 5 categories. The latter three categories are: Thirdly, about the Prescription corresponding to Pattern which skip the pathogensis part, in fact is equal to symptomatic treatment, result in Chinese Medicine theory retrogressionfourthly, Prescription corresponding to Disease of treatment according to different types, or even a tendency on Specific disease treat by special prescription or medicine, it made the diagnosis and treatment in CM become simplified, neglected the time state of diseaseFifthly, research on the nature of Pattern, in fact the research object is not pattern, but is the substance of CM pathogensis research, since microscopic research is not Pattern identification, integration of macroscopic and microscopic Pattern identification is impossible to realize conceptually. 　　Key words:Pattern；Zheng；Patter identificationSydrome differentiationPatter identification and treatmentTreatment according to syndrome differentiation；Misuse 　　收稿日期：2010-11-13 　　作者简介：李宇铭（1981－），男，香港人，香港注册中医，博士研究生，研究方向：仲景学说理论、经典方药量效关系规律研究。 　　3 方证相对论──见证就治 　　3.1 问题的形成 　　“方证相对论”是指临床中用中医的某一个方剂，对应某一“症候群”来进行治疗的做法【sup】［1］【/sup】。这种方法主要特点在于，就像西医的“综合症”、“症候群”一样，认为那些一系列的临床表现，目前找不到特异性的原因，或者认为背后的原因不重要，也可以做出相应的“对症治疗”。 　　3.2 误用的矛盾 　　这种想法最初原自日本吉益东洞对《伤寒论》的误解，认为“