Basic guidance of traditional Chinese medicine: syndrome differentiation and treatment of theoretical system of traditional Chinese medicine

There are three methods to diagnose and treat diseases in TCM, namely, syndrome differentiation, syndrome differentiation and symptomatic treatment. Among the three, Chinese medicine pays special attention to syndrome differentiation, which is unique to Chinese medicine but not to western medicine. Symptomatic treatment is as the saying goes, treating headache, treating foot pain, stopping bleeding and so on. Syndrome differentiation and treatment is based on the diagnosis of what disease and what medicine to use. Syndrome differentiation and treatment is the essence of traditional Chinese medicine. Here, we must first understand the difference between disease, syndrome and syndrome.

After understanding the meaning of syndrome, it is easy to understand syndrome differentiation. The so-called syndrome differentiation is to analyze and synthesize the data, symptoms and signs collected by the four diagnostic methods (looking, smelling, asking and pulse), identify the cause, nature, location and the relationship between evil and positive, and judge it as a certain syndrome. For example, the aversion to cold and headache in the Shanghai Stock Exchange stems from consultation; Nasal congestion and cough come from smelling diagnosis; Thick yellow phlegm, turbid runny nose, red tongue tip and thin yellow fur; Fever and pulse floating number originated from pulse diagnosis. Comprehensive analysis shows that the cause is exogenous wind and heat; The nature of the disease is heat syndrome; The disease is located in the lung system; The relationship between evil and positive is empirical. Generally, it is judged as wind-heat invading lung syndrome.

Treatment is to determine the corresponding treatment method according to the results of syndrome differentiation. Syndrome differentiation and treatment are two different stages. The former is the premise and foundation of the latter, and the latter is the purpose of the former.

Because syndromes are staged and dynamic, the same disease will naturally have different pathological changes, that is, different syndromes, and different treatments will be carried out according to the principle of syndrome differentiation and treatment. This situation is called "different treatments for the same disease"; That is, the same disease, due to different stages of disease, different treatment methods. For example, the early, middle and late stages of the same measles have different treatment methods because of their different syndromes. It is advisable to wear hair in the early stage; In the medium term, it is advisable to clear heat and detoxify; It is advisable to nourish yin in the later stage. Because patients' body reactivity is different, and syndromes are comprehensive manifestations of internal and external factors, even if the same disease is at the same stage, different individuals will have different syndromes due to different body reactivity (internal factors), so the treatment methods are different. For example, infected with the same cold virus, in different individuals, there will be wind-cold or wind-heat exterior syndrome; The prescriptions used are Mahuang Decoction, Guizhi Decoction and Yinqiao Powder. Therefore, treating a disease with one prescription from beginning to end does not meet the requirements of syndrome differentiation and treatment.

On the contrary, different diseases sometimes have the same pathogenesis changes, that is, the same syndromes. According to the principle of syndrome differentiation and treatment, the same treatment method can be adopted. This situation is called "treating different diseases at the same time". For example, proctoptosis and uterine prolapse are two different diseases, but Chinese medicine believes that both of them are caused by stagnation of middle qi, and the pathogenesis and syndrome of the two diseases are the same, so the treatment is to replenish middle qi and promote Yang Qi.

To sum up, syndrome differentiation methods (or schemes) mainly include eight categories, etiology, viscera, six meridians, qi and blood, meridians and triple energizer, which are often combined together, and the combination of multiple syndrome differentiation methods can meet the needs of syndrome differentiation. After the certificate is confirmed, it is prescription medication. Because doctors have different experiences and habits, even if the syndrome differentiation is the same, the prescriptions and medicines prescribed are different. I was alone at first. Later, after repeated use by many patients, some prescriptions were considered to be particularly effective for a certain disease, and such prescriptions became classic prescriptions and empirical prescriptions. The syndromes corresponding to these prescriptions become the syndromes of prescriptions. In addition to the unique connotation of prescriptions, the prescriptions here also have the connotation of the above eight categories of syndrome differentiation, viscera syndrome differentiation or etiology syndrome differentiation.

Syndrome differentiation and treatment embodies the characteristics of overall hierarchy, individuality (patient as the main body) and flexibility. Because it is one-on-one treatment for individuals, it is more practical. However, each disease has its own special contradictions and its own special laws of development and change. Traditional Chinese medicine has long attached importance to the observation and research of "syndrome" and neglected the observation and research of diseases to some extent, so there is relatively little understanding of the particularity of diseases and targeted therapeutic drugs, which is the place where syndrome differentiation and treatment need to be improved. The predecessors also noticed this problem. For example, Xu Ling said in the preface to "Lan Tai Gui": "There must be a main prescription for diseases and a main medicine for diseases." However, due to the long-term neglect of the observation and research of the disease, so far, there are not many accumulated data in this area. Today we have a clear understanding of many diseases, so how to find out the law of disease-syndrome-prescription is the direction of our efforts.

Understand the concept of syndrome by studying the characteristics of syndrome differentiation and treatment; Understand the actual content of syndrome differentiation and treatment; By comparing with symptomatic treatment and disease differentiation treatment, we can deepen our understanding of syndrome differentiation and treatment. On this basis, we fully understand the truth of "different treatments for the same disease and the same treatment for different diseases" through examples.