辨时论治临证思路探析

以时间为切入点辨析疾病发生的机制、发展的趋势,并在此基础上确立相应的防治方法 ,是天人相应思想的根本要求,也是符合中医思维特点的正确路径。临证过程中可以中医运气学说为理论依据,通过分析胎育出生时间,辨析体质特征及疾病易感性;以患者发病的时间为线索,推演发病之时的运气特征,预测疾病的流行,探求疾病发生的机制;结合"六经病欲解时",通过分析疾病的起、持、甚、愈的病情变化时间,推求疾病的病机,预判间甚之时、死生之期。天地阴阳之机变不可简单拘泥于常数之推演,临证辨时论治还要知常达变,既要用常数之推演寻求病因病机,还要从动态的、整体的综合角度分析天、人、邪气病机变化的特点,必要时"舍时从证"。

Exploration of Clinical Thoughts of Treatment Based on Time Differentiation

With time as the breakthrough point to analyze the mechanism and the development of diseases,and on this basis to establish the methods of treatment,is the fundamental requirement of the thought of correspondence between man and universe,also is the right path of traditional Chinese medicine thinking. In the process of clinical the Yun-qi theory can be used as theoretical basis,through analyze the pregnancy and birth time to explore the physical fitness characteristics and disease susceptibility. With the onset time of the disease as clues,deducing the Yun-qi characteristics of the onset to predict the prevalence and explore the mechanism of diseases. Combining the theory of "the recovery of the channel diseases",through analyze the onset,development,exacerbation,cure time of diseases to ascertain the pathogenesis and predict the law of development of diseases. As the yin-yang variation between heaven and earth cannot be deduced like constant,so in the process of clinical,we should not only explore etiology and pathogenesis by constant deduce,but also analyze the changing characteristics about heaven,human,pathogenic factors,from the comprehensive angle dynamically and integrally,even to "discard time to follow syndrome" when necessary.