To construct pathogenesis as core under new system (TDS)

- ZhouZhongYing ZhouXuePing nanjing university of traditional Chinese medicine

TCM pathogenesis differentiation system the basic framework

With pathological factors for the outline, the subject syndrome, and pathogenesis for entries for the pathogenesis, compound folder pathogenesis of main units, constructing the syndrome differentiation and treatment is new system.

Basic ideas

As the core in pathogenesis syndrome factor

The main content of pathogenesis syndrome factor is pathological factors, pathological factors is the essence of careful card for lesions calculated the core is the machine, it reflects the pathological factors and pathogenesis of transformation and evolution. A single pathogenesis syndrome factor consists of a single evolved pathological factors, wind, cold, heat, dampness, dryness, fire, blood stasis, etc. And clip pathogenesis syndrome factor is a single pathological factors in the primary and disease; Composite pathogenesis syndrome factor often consists of two or more than two pathological factors compound, produce quality, which forms the basis of syndrome diagnostic and treatment of foundation.

With viscera as the connotation

Yin and Yang of the human body along the viscera and generate root of the zang-fu organs function is normal or not, affects the Yin and Yang of the change, human body qi qi Yin and Yang appeared various diseases, all by its zang-fu pathological change. Each viscera body and used also is their Yin and Yang, have different characteristics, so ill caustic properties and related viscera also each have focus. And the nakedness of the Yin and Yang of ups and downs, angry machine in disorder, and lifting will further affect the function of zang-fu organs. Therefore, the core of zang-fu organs and is lesions, careful card for machine must first discernment lesions viscera, derive the ups and downs of the zang-fu organs and Yin and Yang, the rise and fall of angry machine, alternation, discrepancy.

A certificate tainted, disease and syndrome combined

Different illness is likely at some stage, but due to appear approximate evidence the properties and preach change disease, even the difference between law in the same "syndrome" can be different because of the disease have their own characteristics, thus only a certificate tainted with a specific disease, ask machine, can we grasp careful card evolution law of the pathogenesis of disease differentiation and treatment to accurately with targeted. Clinically should first grasp every system disease pathogenesis syndrome factor and secondly according to the characteristics of each system disease pathogenesis syndrome factor grasp specific disease, according to the specific disease for the final stages pathogenesis evolution characteristics determine the syndromes pathogenesis syndrome factor lay the foundation.

Basic steps

In pathogenesis syndrome factor as the core in the syndrome differentiation and treatment under the frame of the new system, the syndrome differentiation and treatment includes the following four basic steps.

Identify pathogenesis syndrome factor

Identify pathogenesis syndrome factor is according to specific disease, visible disorder and related tongue arteries and veins, identify pathological factors and disease bits, ill sex. Specific disease refers to human inner pathological changes of performance outside characteristic symptoms, signs, is the main pathogenesis syndrome factor identification based on which, namely treatise on febrile disease cloud "but see a disease is, don't bore with" meaning. Visible disorder refers to human inner pathological changes may exhibit symptoms, signs, but due to illness and different. Pulse is related to identify the tongue and the pulse disease pathogenesis syndrome factor whether corresponding reference.

For example, by issuing polio-free, wind and specific disease is joint pain wander errant, joint afraid of wind; Cold specific disease is joint cold pain, encounter cold pain increased pain reduction in the heat, and joint afraid of the cold; Wet specific disease is joint pain with and not move, arthralgia YinYuTian aggravating, the body is sour heavy. Visible disorder for wind body muscle pain sour, evil wind, fever; Cold visible disease is binding limbs calmness, joint pain; Wet visible disorder to joint aimless and swollen, inappetence, loose stools. The wind tongue performance for the moss thin white veins, arteries and veins float; Cold expression is qualitative light or reddish, tongue coating thin white, pulse tight or late; Wet oily and tongue coating performance for pulse but slow or fine delay. Clinically already may display and pathogenesis consistent performance and the pulse condition, also can pathogenesis are not consistent pulse condition, so it is also need according to the specific circumstances shekels from disease or shekels pulse from pulse disease.

In the bright post-mortem, on the basis of pathological factors determine the disease bits, ill sex. The attack in body joint disease syndrome, it mainly in liver and kidney disease bits zang-fu spleen (liver advocate muscle, kidney advocate bone, spleen Lord muscles, joints limbs for bone by fascia handover, the beam together). If the disease early mainly in joints, muscle pain, the disease in muscle table meridian, disease long to joint deformation, jiang pain is deep and muscles, mainly kidney disease and; While both muscle gaunt, in disease and spleen. According to the basic theory of TCM, comprehensive specific disease, visible disorder and related tongue pulse can be judged the nakedness of Yin and Yang of ill specimens and priorities are.

According to the pathogenesis syndrome factor combination sure card name

Pathogenesis syndrome factor is the basic unit of the dialectical diagnosis, pathogenesis, pathological factors for the viscera and clip, between the compound, such as kidney empty stomach, stomach, stasis hot photograph of pixu heartbeat, hot and humid yu steaming, cold dampness bi-complex resistance, phlegmy heat implication, phlegmy wet fire interweaves wind resistance, in which are the common for clinical and pathological and clip, cross combinations become compound the name of syndromes.

Disease always is in constant changing, clinical need to pay attention to the dynamic evolution, pathogenesis between around the pathogenesis and clip, composite and transformation and evolution rule for analysis and induction, according to various disease pathogenesis syndrome factor and clarify the different classification, combination characteristic, can directly guide clinical syndrome differentiation and treatment, improve the clinical effect. Such as "stasis hot" is many of a disease differentiation, internal emerged in the course of a composite pathological factors, by blood heat, blood stasis two pathological factors are donated cardial formed knots, consistency, and the clinical manifestations of "stasis hot photograph, and cardiac syndrome" because of disease may manifest as different and different son certificate, such as stroke stasis thermal resistance opening certificate, severe hepatitis yellow card, the stasis heat of arf stasis hot water "syndrome, all sorts of hemorrhagic disease syndrome. Spill blood stasis blood Be like again bi-complex card since the beginning much performance is rheumatism and the wind cold dampness, rheumatic attack resistance (the wind cold dampness bi-complex certificate, rheumatic fever); attack card Between the three and transformation, and clip, performance for cold and dampness bi-complex (cold du syndrome); Disease long still can performance for phlegm and blood stasis qi attack resistance, liver and kidney deficiency (phlegm and blood stasis syndrome, kidney and liver mutual "qi deficiency syndrome, deficiency syndrome).

Establish therapies therapeutic

Clinical attention must be paid to the dynamic changes in the pathogenesis of clarity and pathogenesis syndrome factor, based on the pathogenesis of composite clip, concurrently, establish corresponding combination therapies, accomplish therapeutic method of dialectical accurate, with the card to turn. As for "stasis hot" pathogenesis (stasis heat treatment of cardiac syndrome) in principle is cool blood to remove blood stasis; Due to the different disease pathogenesis, "stasis hot" can have different and clip, combination, appropriate pointed by means of specific therapies, such as stroke stasis thermal resistance opening to cool blood to remove blood stasis, the discharge hot astringing; Heavy of viral hepatitis stasis yellow to cool blood to heat removing detoxification; Diabetes complication for reguar blood stasis qi to clear winding; The stasis systemic lupus erythematosus polio-free resistance to heat to cool blood to remove blood stasis Juan attack.

Choose the application

Namely established clinical therapeutic basis to the application and therapies choose with symptoms of different to add and subtract. Such as stroke stasis thermal resistance to XiJiao obsessed with the card square choose hope, peach stone commonly bearing gas soup, a rhubarb, water ox horn, origin, the nut, borneol, etc. Cerebral hemorrhage patients, many of the levy, c feiwei yam injuries to participate, radix ophiopogonis duhu, altogether, stone; Brain god with coma person, can lose consciousness of god the product compatibility wake, such as calamus, turmeric, etc. Heavy of viral hepatitis yellow card, fang heat and blood stasis XiJiao hope, to choose ChenHao soup, aeromonas commonly have water ox horn, gall, rhubarb, origin, the root, mountain Zhi, Dan skin, anti-freckle etc. Damp and hot accumulate knot, bosom frowsty wan sheng, the new coating yellow greasy, add tuckahoe, pigs), CheQianZi, tiger rod, etc. Rachel, abdominal astringing real warm with pain and stool stem node shall, under general astringing venting, join MangXiao born rhubarb reuse blunt.

Anyhow, around the pathogenesis and clip, between compound and transformation and evolution regularity study to explore the different according to various diseases, clear the TCM pathogenesis syndrome factor classification, combination characteristics, reveals pathogenesis syndrome factor occurrence, evolution, crossover, combination rule, thus TCM pathogenesis extracts new theory, to construct a new system, pathogenesis TDS intractable diseases can improve the clinical ability to achieve the purpose of syndrome differentiation, activation, in order to promote the development of traditional Chinese medicine academic.