Syndrome differentiation
Teacher Xie said: "You still need to learn about dialectical argumentation. ”
Xiao Wang nodded, and took notes more seriously. Mr. Xie said: "In fact, in traditional Chinese medicine, 'syndrome' refers to the comprehensive manifestation of various symptoms that occur in the body at a certain stage in the development of a disease, which can also be understood as a symptom. The syndrome is variable due to the different stages of disease development and the different symptoms that reflect this stage. Since the 'syndrome' is a generalization of the pathological response of the body at a certain stage in the development of the disease, the syndrome reveals the essence of the disease more comprehensively, profoundly and correctly than the symptoms. 'Dialectic' in Chinese medicine refers to the process of authentication and identification. The process of syndrome differentiation is based on the data collected by the four clinics of looking, smelling, asking, and cutting, and through analysis and synthesis, to identify the cause, nature, and location of the disease, as well as the relationship between evil and good, and generalize and judge it as a certain nature of syndrome. ”
Xiao Wang asked again: "What about governance?" ”
Teacher Xie said: "Treatment, also known as treatment, is to determine the corresponding treatment method according to the results of syndrome differentiation. Syndrome differentiation and treatment are two inseparable parts of the process of diagnosis and treatment of diseases.
Syndrome differentiation is the premise and basis for deciding treatment, and treatment is the means and method of treatment. Through the effect of the treatment, the correctness of the dialectic can be tested. ”
Dialectics is in the service of "discourse".
How to "argue"?
Identify the cause:
Teacher Xie took the notebook, nodded with a smile, and motioned for Xiao Wang to sit down. He is well aware of Xiao Wang's intentions and efforts, and has always been full of encouragement and expectation for this young student.
"Etiological differentiation is an important part of TCM diagnosis, which helps us understand the cause of the disease and then guide our treatment." Teacher Xie explained succinctly. Then, he pointed to the contents of Xiao Wang's notebook and continued: "There are many kinds of etiological syndromes, such as the invasion of the six prostitutions, the infection of the furious qi, the internal injury of the seven emotions, the eating disorder, the loss of work and rest, the fall of the golden blade, etc., which may lead to the occurrence of diseases. At the same time, the causes and effects of diseases are usually interrelated, and pathological products in one stage may become new causes in the next stage, such as phlegm turbidity, blood stasis, food accumulation, etc. Improper medical treatment is also a potential cause. ”
Xiao Wang nodded and continued to ask: "So, what is the process of dialectic?" ”
Mr. Xie thought for a while, and then replied: "Identifying the cause is mainly through the four diagnosis methods of looking, smelling, asking, and cutting, understanding the patient's living habits, diet, working environment, emotional state, etc., and analyzing the nature, location, timing and relationship of the cause. First, the patient's medical history should be carefully analyzed, including the cause of the disease, the course of its development, as well as the patient's lifestyle habits and diet. Secondly, observe the patient's symptoms, such as pulse and tongue coating, which are important clues to the cause. These clues are then linked to different causes to deduce the most likely cause. Finally, the syndrome is differentiated according to the etiology and the corresponding treatment plan is formulated. ”
Xiao Wang Shen continued to ask: "So, can you give another example?" ”
Teacher Xie smiled and said, "Taking a cold as an example, the cause of its occurrence may be related to the invasion of external evils such as cold evil, wind evil, and damp evil, or it may also be caused by internal factors such as physical weakness, low immunity, and irregular life. Through syndrome differentiation analysis, different types of syndromes such as wind-cold cold, wind-heat cold, damp evil cold, and qi deficiency cold can be obtained, which provides a basis for the treatment of the cause. ”
Identification of disease location:
Teacher Xie also said: "Xiao Wang, correctly identifying the location of the disease can more accurately determine the cause and nature of the disease, and then guide the formulation of the treatment plan. To master this technique, you need to have an in-depth understanding of the viscera, meridians, six meridians, health qi and blood, and three jiao. First of all, you must understand that the location of the syndrome is crucial for the diagnosis and treatment of the disease. It helps to understand the extent of the spread of the disease and helps you determine the medication to be used. ”
Xiao Wang carefully wrote down this important information. "Teacher Xie, I understand, but I still don't know how to accurately distinguish the disease location."
Teacher Xie smiled, took out an ancient book, and turned a page. "For example, when a cold first appears, it manifests as headache, nasal congestion, cough and other symptoms, which proves that the disease is on the surface, and the treatment should be based on Xinwen Jiebiao; If the condition is aggravated and symptoms such as fever, coughing up yellow phlegm, chest tightness, and shortness of breath appear, it is necessary to consider that the disease has entered the body to dissolve heat, and the treatment should be mainly to clear heat and dissolve phlegm. Therefore, identifying the location of the disease is also a very critical step in TCM diagnosis. ”
Xiao Wang followed Mr. Xie's guidance, and then, Mr. Xie said: "The commonly used methods for syndrome differentiation include viscera syndrome differentiation, six meridian syndrome differentiation, Weiqiying blood pattern differentiation, three-focal pattern differentiation, and meridian pattern differentiation. Among them, viscera syndrome differentiation is mainly used for internal injury and miscellaneous disease differentiation; The pattern differentiation of the six meridians, the pattern differentiation of Weiqiying blood, and the pattern differentiation of the three focal points are mainly used for the differentiation of external susceptible diseases; Meridian pattern differentiation is a supplement and auxiliary to viscera pattern differentiation, which has a wide range of applications, and is especially commonly used in the diagnosis and treatment of acupuncture, massage, bone injury and other specialties. ”
Pathogenesis:
Mr. Xie began to explain: "Pathological syndrome differentiation is a syndrome differentiation method that analyzes, inducts and judges the various symptoms and signs exhibited by patients under the guidance of traditional Chinese medicine theory, so as to determine the current nature of the syndrome of the disease. ”
Xiao Wang nodded, signaling that he was listening carefully. Teacher Xie continued: "Disease discrimination refers to the determination of the virtual and real properties of the disease and the attributes of cold and heat. In the theory of traditional Chinese medicine, it is believed that there is a distinction between yin and yang in the evil qi that causes disease, and there is also a difference between yin and yang in the righteous qi of the human body. Diseases with different attributes invade the human body and compete with the body's righteous qi, resulting in the imbalance of yin and yang, and the appearance of different types of disease syndromes, which are manifested as different cold and heat. ”
Xiao Wang listened with relish, and he quickly recorded these key concepts with a pen. Teacher Xie went on to say: "More specifically, the nature of the disease is divided into general disease and specific disease. General pathologies include cold, heat, deficiency, reality, etc., which belong to abstract disease concepts. The specific pathology is mainly based on the changes of qi, blood, fluid, yin and yang, such as qi deficiency, qi trapping, qi stagnation, qi reversal, blood deficiency, blood stasis, jin deficiency, yin deficiency, yang deficiency, death yin, death yang, etc. ”
Then, he asked, "Mr. Xie, how to distinguish the disease in the specific clinical diagnosis?" ”
Mr. Xie replied with a smile: "Disease differentiation is one of the most important contents in clinical syndrome differentiation. Because the nature of the disease is the current pathological essence of the disease, it is a summary of the overall reaction state of the disease at a certain stage, and it is also a comprehensive understanding of the relationship between evil and good, which has the characteristics of overall and dynamic. Therefore, in the process of pathological syndrome differentiation, it is generally necessary to conduct a comprehensive analysis of systemic symptoms, signs, constitution, environment, etc., in order to accurately distinguish the syndrome. ”
Xiao Wang pondered for a moment and then continued to ask, "So, can you be more specific?" ”
Teacher Xie smiled, pointed to Xiao Wang's notebook and said, "Xiao Wang, remember, for example, Yang wins and heat, that is, Yang evil invades the human body, and 'evil and yang' makes Yang Qi excessive, which leads to fever in the body. Because the characteristic of yang energy is heat, 'if yang wins, it is hot'. The same is true for yin to win and cold, yang deficiency to be cold, and yin deficiency to be hot. ”
Xiao Wang felt a burst of excitement, and he finally began to understand the complexity and importance of pathological syndrome differentiation.
Supplement: Identification of the disease
Mr. Xie added, "Xiao Wang, Chinese medicine is an esoteric knowledge that requires time and patience. I'll add one more one more to identify the disease. Identifying the disease refers to the development trend and prognosis of the disease, and understanding the disease is of great significance for formulating a reasonable treatment plan and predicting the prognosis of the disease. In the theory of traditional Chinese medicine, diseases have their own certain transmission laws, such as the transmission of external diseases is the sun→ yangming→ less yang→ taiyin→ less yin→ yin, and the manifestations and clinical manifestations of different stages are different. Therefore, doctors need to grasp the development trend of the disease through careful observation and analysis, and predict the changes in the disease in advance, so as to adjust the treatment plan in time and accelerate the recovery of the disease. ”