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基于病证结合的核心方剂-证候研究思路

[Research ideas of core formulas-syndromes based on disease-syndrome-treatment combination].

作者信息

Yu Yue, Jin Zi-Xuan, Luo Fu-Kun, Liu Wei, Wang Peng-Qian, Xiong Xing-Jiang

机构信息

Guang'anmen Hospital, China Academy of Chinese Medical Sciences Beijing 100053, China.

Beijing Hospital of Traditional Chinese Medicine, Capital Medical University Beijing 100010, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2023 May;48(10):2625-2629. doi: 10.19540/j.cnki.cjcmm.20230203.502.

Abstract

The relationship between disease and syndrome is a research focus in integrated traditional Chinese and western medicine. Depending on the focus, the disease-syndrome combination for treatment is manifested as the different treatment methods for the same disease and the same treatment method for different diseases based on the syndrome, and different treatment methods for the same syndrome and the same treatment method for different syndromes based on the disease. The mainstream model is the combination of di-sease identification in modern medicine with syndrome identification and core pathogenesis in traditional Chinese medicine. However, current research on the combination of disease and syndrome and core pathogenesis tends to focus on the heterogeneity between disease and syndrome and the separation of syndrome and treatment. Therefore, the study proposed the research idea and model of core formulas-syndromes(CFS). According to the theory of formula-syndrome correspondence, the research idea of CFS deepens the research on core pathogenesis, which aims to summarize the core formulas and syndromes for diseases. The research fields include diagnostic criteria for the indications of formulas, distribution patterns of formulas and syndromes for diseases, the evolution of medicinal-syndrome based on formulas-syndromes, formula combination law based on formulas-syndromes, and the dynamic evolution of formulas-syndromes. Through the summary of ancient classics, clinical experience, and medical records, and with the methods of expert consultation, factor analysis, and clustering analysis, research on the diagnostic criteria for the indications of formulas aims to explore the diagnosis information such as the diseases, symptoms, signs, and pathophysiology. The research on the distribution patterns of formulas and syndromes for diseases tends to summarize the specific types of formulas and syndromes for the diseases through literature research and clinical cross-sectional studies based on the establishment of diagnostic criteria for the indications of formulas. The research on the evolution of medicinal-syndrome aims to clarify the medicinal-syndrome law through literature and clinical research. The formula combination law refers to the fact that the core prescriptions for a disease often appear in combination with other prescriptions on a regular basis. The dynamic evolution of formulas-syndromes refers to the continuous transformation and change of formulas and syndromes in the process of disease development with changes in time and space. The CFS is conducive to the unification of disease, syndrome and treatment and to the deepening of the research model of disease and syndrome integration.

摘要

病与证的关系是中西医结合研究的重点。基于不同侧重点,病证结合论治表现为同病异治、异病同治以及同证异治、异证同治。主流模式是现代医学辨病与中医辨证及核心病机相结合。然而,目前关于病证结合及核心病机的研究多聚焦于病与证的异质性及证与治的分离。因此,本研究提出了核心方剂 - 证候(CFS)的研究思路与模式。依据方证相应理论,CFS的研究思路深化了对核心病机的研究,旨在总结疾病的核心方剂与证候。研究领域包括方剂适应证诊断标准、疾病方剂与证候分布规律、基于方证的药证演变、基于方证的方剂配伍规律以及方证的动态演变。通过对古代经典、临床经验及医案的总结,运用专家咨询、因子分析和聚类分析等方法,方剂适应证诊断标准研究旨在探寻疾病、症状、体征及病理生理学等诊断信息。疾病方剂与证候分布规律研究倾向于在确立方剂适应证诊断标准的基础上,通过文献研究和临床横断面研究总结疾病的具体方剂与证候类型。药证演变研究旨在通过文献及临床研究阐明药证规律。方剂配伍规律是指某疾病的核心处方常与其他处方有规律地联合出现。方证的动态演变是指在疾病发展过程中,随着时间和空间的变化,方剂与证候不断转化和改变。CFS有助于实现病、证、治的统一,深化病证结合的研究模式。

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