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Part Two: SPECIFIC AND PROFOUND TCM

第二部分: 中医的独特性与深刻意义

http://www.100md.com   2006-2-7
     TCM, one of China's splendid cultural heritages, is the science dealing with human physiology, pathology, diagnosis, treatment and prevention of diseases. TCM summed up the experience of the Chinese people in their long struggle against diseases and, under the influence of ancient naive materialism and dialectics, evolved into a unique, integral system of medical theory through long clinical practice. During several thousand years it has made great contributions to the promotion of health, the proliferation and prosperity of the Chinese nation, and the enrichment and development of world medicine as well. The formation of the theoretical system of TCM was greatly influenced by ancient Chinese materialism and dialectics. The theoretical system takes the physiology and pathology of zang-fu organs and meridians as its basis, and TDS as its diagnostic and therapeutic features.

    中医是中国辉煌的传统文化之一,它是一门涉及人体生理、病理、诊断、治疗和疾病预防的科学。它是在古代朴素的唯物主义和辨证法的影响下对中国人民长期与疾病斗争经验的总结, 并在长期的临床实践中演化成了一套独特完整的医学理论。在过去的几千年里,中医为中华人民健康水平的提高、民族的繁荣昌盛及世界医学的丰富及发展做出了巨大的贡献。中医理论系统的形成受到古代中国的唯物主义和辩证法的极大影响。这套理论系统以脏腑经络的生理病理为基础,以辨证论治为其诊断特色。

    TCM has its own specific understanding both in the physiological functions and pathological changes of the human body and in the diagnosis and treatment of disease. TCM regards the human body itself as an organic whole interconnected by zang-fu organs, meridians and collaterals.And TCM also holds that the human body is closely related to the outside world. In regard to the onset and development of a disease, TCM attaches great importance to the endogenous pathogenic factors, namely the seven emotion, but it by no means excludes the exogenous pathogenic factors, namely the six pathogens. In diagnosis, TCM takes the four diagnostic methods ( inspection, auscultation ant olfaction,inquiry, pulse-taking and palpation as its principal tcchniques, eight principal syndromes as its general guideline, and differentiation of syndrome according to the zang-fu theory, differentiation of syndromes according to the six-meridian theory, and differentiation of syndromes according to the theory of wei, qi, ying and xue as its basic theories of the differentiation of syndromes. It also stresses the prevention and preventive treatment of disease, and puts forward such therapeutic principles as "treatment aiding at the root cause of disease". "strengthening vital qi and dispelling pathogens, regulating yin and yang and treating diseases in accordance with three conditions" (i. e. the climatic and seasonal conditiont, geographic localities and the patient's constitution).

    中医在对人体的生理功能、病理改变和诊治疾病方面有其独特的见解。它把人体看作一个以脏腑和经络相互联系的有机整体并认为人体与其外界环境也是息息相关的。中医高度重视内因即所谓的“七情”在疾病的发生和发展过程中所起的作用,但也决不排除外因的作用即所谓的“六淫”。在诊断方面,中医以四诊(望、闻、问、切)为技术原则、八纲辨证为指导总纲并把脏腑辨证、六经辨证、卫气营血辨证作为其辨证论治的基础。它强调“未病先防”、“治病求本”、“扶正祛邪”、“调整阴阳”和“三因制宜”(因时、因地、因人制宜)的重要性。

    These characteristicts, however, can be generalized as the holistic concept and treatment by differentiation of syndromes (TDS)

    然而,对以上的中医特点可以用“整体观念”和“辨证论治”加以概括。

    l. The Holistic Concept 1.整体观念

    By "the holistic concept" is meant a general idea of, on the one hand, the unity) and integrity within the human body and, on the other, its close relationship with the outer world. The human body is composed of various organs and tissues, each having its own distinct function, which is a component part of the life activities of the whole body. And in TCM the human body is regarded as an organic whole in which its constituent parts are inseparable in structure, interrelated and interdependent in physiology, and mutually influential in pathology. Meanwhile, man lives in nature, and nature provides the conditions indispensible to man's survival. So it follows that the human body is bound to be affected directly or indirectly by the changes of nature, to which the human body, in turn, makes corresponding responses. TCM says: "Physicians have to know the law of nature and geographical conditions when diagnosing and treating diseases." That's why TCM not only stresses the unity of the human body itself but also attaches great importance to the interrelationship between the body and nature in diagnosing and treating diseases.

    整体观念的总思想是一方面认为人体是一个统一的整体,另一方面认为人体与其外界环境密切相关。人体由不同的脏腑组织组成,每个脏腑组织都有其独特的功能并都是整个人体进行生命活动的组成部分。中医把人体看作一个有机人体认为人体的各部分在生理上相互联系和相互独立,在病理上相互影响。同时,因为人类生活在自然中,自然提供给人类赖以生存的环境,所以人体就会直接或间接的受到自然环境变化的影响并产生相应的反应。中医认为医生在诊治疾病时应该熟悉自然规律和地理环境。这便是中医为何在诊治疾病时既强调人体为一整体也重视人体与自然环境相互作用的关系。

    2. Treatment by Differentiation of Syndromes 2.辨证论治

    TCM, on the other hand, is characterized by TDS. Differentiation means comprehensive analysis, while syndrome refere to symptoms and signs. So differentiation of syndromes implies that the patient's symptoms and signs collected by the four diagnostic methods are analyzed and summarized so as to identify the etiology, nature and location of a disease, and the relation between vital qi and pathogens, thereby determining what syndrome the disease belongs to. By treatment is meant selecting the corresponding therapy according to the outcome of differentiating syndromes. Taken as a whole, TDS means diagnosis and treatment based on overall analysis of symptoms and signs.

    中医的另一特色是辨证论治。“辨证”即综合分析相关的症状,因此辨证意味着将四诊收集到的症状加以分析和总结确定疾病的病理、病性、病位和邪正关系,从而确定疾病的证型。“论治”指的是根据辨证的结果选择相应的治疗。总的来说,辨证论治即在对症状的全面分析基础上进行诊治。

    As concerns the relationship between "disease" and "treatment", TCM takes two different clinical ways on the basis of TDS. One is "treating the same disease with different therapies", by which is meant that the same disease may manifest itself in different syndromes at different stages or under different conditions. Therefore, the therapies of the same diease should be adopted towards different therapies according to the patient's constitution, the geographical environment, the climatic and seasonal changes. Take flu for example, it may be caused by wind-cold,wind-heat, summer-heat and dampness or other pathogens. So is advisable to adopt dispersing wind-cold, eliminating wind-heat, clearing away summer-heat and dampness respectively. The other is called "treating different diseases with the same therapy", by which is meant that different diseases manifesting themselves in the same syndrome may be treated with the same therapy. For example prolapse of the rectum due to protracted diarrhea and hysteroptosis are two different diseases. However, if they are both marked by themselves in the same syndrome of qi of sinking of the middle energizer, they can be treated in the same therapy by lifting qi of the middie energizer. From the above it becomes obvious that TCM does not focus its attention on similarities or dissimilarities between diseases but on the differences between the syndromes. Generally speaking, the same syndromes are treated with basically same therapies, while different syndromes with different ones.

    关于疾病和治疗的关系,中医在辨证论治的基础上存在两种治疗途径。一种是“同病异治”,即同一疾病在不同环境、不同阶段下会显示出不同的证候,因此,对同一疾病应根据患者的体质、地理环境的不同和天气季节的变化采取不同的治疗措施。例如流感可以由风寒、风热、暑湿之邪造成,所以治疗应相应的采取祛风散寒、疏散风热和清暑化湿的方法。另一种是“异病同治”,即不同的疾病出现相同的证候可以采取相同的治疗。例如泻泄引起的脱肛和子宫下垂是两种不同的疾病,然而,如果它们都是以中焦之气下陷引起相同的证候为特征的话就可以采取相同的治疗——升提中焦之气。从以上,显而易见,中医并不是注重疾病之间的相似和不相似,而是重视证候的相同与否。总而言之,相同的证候采取相同的治疗方法,不同的证候采取不同的治疗方法。

    To sum up, the principle that different contradictions in essence are handled by different methods in the course of development of a disease is the core of TDS.

    总之,原则是在疾病的发展过程中不同的本质矛盾应采取不同的方法,这就是辨证论治的核心。

 
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