病证结合及其临床科研设计思路的理论思考

病证结合是中医理论和临床研究的切入点。病、证均有广义和狭义概念,相互关系因纵横联系既单一又复杂。临床诊疗应根据病、证、症的主次、轻重、缓急,以病为主,病证结合;或以证为主,证病结合;或以症为主,症病或症证结合。临床疗效评价或中医证候研究,依据目标适应证选择病证结合、证病结合、症病(或证)结合模式,科研设计、分析总结应注意因广义或狭义病证关系所致多种混杂因素的均衡,分析总结应注意排除上述混杂因素导致的各种偏倚。分析症、证、病及其各种观察指标的相关性,有助于探讨药物或治疗方法的临床特点,阐明中医证候与西医检测指标的内在联系。

Theoretical Thinking on Syndrome and Disease Combination and its Clinical Research

Syndrome and disease combination is the essential point of traditional Chinese medicine (TCM) and clinical research.Disease and syndrome can all be interpreted from a broad and narrow sense.The relationship of them is both simple and complex.In clinical treatment,the primary and secondary symptom,syndrome and disease should be firstly differentiated,as well as their developing stage,then treat in successive orders.When doing clinical evaluation or TCM syndrome score,the combination of disease and symptom,symptom and syndrome,or disease and syndrome should be chosen.Besides,during scientific research,the balance among various factors induced by broad and narrow sense of disease and syndromes should be paid with special attention,and extract any bias.Analyzing the disease,syndrome,symptoms and their indexes can help in discussing the clinical characteristics of medication and treatment and the inner relationship between TCM syndrome and western examination.