First, the adaptation time.
The change of climate in four seasons has certain influence on the physiological function and pathological changes of human body. According to the climatic characteristics of different seasons, the principle of medication is "adapting to the time". Generally speaking, in spring and summer, the climate is getting warmer and warmer, the yang is rising, and the human body is relaxed and laxative. Even if you suffer from exogenous cold, you should not use pungent drugs too much to avoid excessive purging of fire and consuming gas and yin. In autumn and winter, the climate changes from cold to cold, with yin flourishing and yang declining, and the human body is restrained by dense yang. At this time, if it is not a heat syndrome, cold medicine should be used with caution to prevent yang injury. Su Wen said: "Use cold to stay away from cold, use cold to stay away from cold, use warm to stay away from warm, and use heat to stay away from heat, and eat in the same way." Summer evil has obvious seasonality, and summer heat is humid, so we should pay attention to relieving summer heat and eliminating dampness when treating diseases in summer; The climate in autumn is dry, and the exogenous autumn dryness should be cool and moist, which is not the same as the exogenous wind temperature in spring and the wind chill in winter. Wind temperature should be pungent and cool to relieve exterior syndrome, and wind-cold should be pungent and warm to relieve exterior syndrome, so the therapeutic drugs must be adapted to the time.
Second, adjust measures to local conditions.
According to the geographical characteristics of different regions, the principle of drug use is "adapting to local conditions". In different areas, due to different topography, climatic conditions and living habits, people's physiological activities and pathological characteristics are also different, so the therapeutic drugs should change according to the local environment and living habits.
For example, the northwest plateau of China has a cold and dry climate with little rain. Its people live in the deep mountains, often in a cold environment, eat more crispy cheese and milk from cattle and sheep, and are physically strong, so external evils are not easy to invade, and its diseases are mostly internal injuries. The southeast coast is swampy, low-lying, warm and rainy. Its people eat fish and love salt, most of them have dark skin, loose texture, many diseases, or are more prone to exogenous diseases. Doctors use different treatment methods to treat the same disease, which can be cured because of different terrain and different treatment methods. For example, exogenous wind-cold syndrome, in the cold region of northwest China, pungent warming is used to relieve exterior symptoms, and hemp and cinnamon are commonly used; In the warm areas of southeast China, antipyretic drugs are used to relieve exterior syndrome, and Fang Jing is often used. This is also due to the different geographical climate, so the treatment must be tailored to local conditions.
Third, it is suitable for the crowd.
According to the age, sex, physique, living habits and other different characteristics of patients, the principle of medication is considered, which is called "different from person to person".
(1) Different ages, different physiological conditions, and different profits and losses of qi and blood should lead to different therapeutic drugs. The old people's vitality declines, their qi and blood are insufficient, and their diseases are deficient, or they are mixed with excess and deficiency. The treatment of deficiency syndrome should be mainly tonic, and the attack of excess evil should be cautious, and the dose should be lighter than that of young adults. Children are full of vitality, but their qi and blood are not full, their viscera are delicate, they are prone to cold and heat, and their condition changes rapidly. Therefore, to treat children's diseases, we should avoid the onslaught, use less tonics and drugs. On febrile diseases. The theory of treating young people differently from old people says: "Older people are most afraid of being exploited. Set up a bracket, with one as ten; With ginseng, ten is not equal to one. Wei Rong's old man is a shriveled man, and his vitality is easily consumed and difficult to recover. Not as lively as a teenager's qi and blood, but once evil spirits are exorcised, healthy qi will be restored. Therefore, the elderly should be careful to have loose bowels, and the young should be careful to make them up, not to misuse them. There are also old thick ones and young thin ones, and they should be from the right, not to say. "
(2) Gender: Men and women are different in gender and each has its own physiological characteristics. Women with menstruation, leucorrhea, pregnancy and childbirth should consider therapeutic drugs. Such as bleeding during pregnancy, slippery, fetal injury or toxic drugs are prohibited or used with caution. After delivery, we should consider deficiency of qi and blood and lochia.
(3) The constitution has the bias of strong and weak cold and heat, and the constitution with yang deficiency or yin deficiency should be used with caution; For the body with yang deficiency or yin deficiency, use drugs that hurt yang by cold with caution. Different constitutions often lead to different therapeutic drugs. In addition, some patients have some chronic diseases or occupational diseases, as well as emotional factors and living habits, which should also be paid attention to when making diagnosis and treatment.
To sum up, when treating a disease, you can't look at the doctor's certificate in isolation, you should look at the whole person and the characteristics of different people; Emphasize the influence of natural environment on human body according to time and place. The principle of treating according to time, place and person fully embodies the overall concept of TCM treatment and the principle and flexibility of syndrome differentiation and treatment in practical application. Only by looking at the problem in an all-round way, analyzing the specific situation, and being good at adapting to the time, place and people can we achieve better treatment results. Treatment based on syndrome differentiation is the basic principle of TCM in understanding and treating diseases, and it is a special research and treatment method of TCM for diseases. Also called syndrome differentiation and treatment. Includes two processes of syndrome differentiation and treatment.
Syndrome differentiation is the process of authentication. Syndrome is a summary of the pathological reaction of the body at a certain stage in the process of disease development, including the location, cause, nature and the relationship between evil and positive, which reflects the essence of the disease at this stage. Therefore, syndrome reveals the essence of disease more comprehensively, profoundly and correctly than syndrome. The so-called syndrome differentiation is to determine the etiology, nature, location and the relationship between evil and positive according to the data collected by four clinics, and to summarize and judge it as a certain type of syndrome.
Treatment, also known as treatment, is to determine the corresponding treatment methods according to the results of syndrome differentiation. In the process of disease diagnosis and treatment, syndrome differentiation and treatment are two interrelated and inseparable parts. Syndrome differentiation is the premise and basis of determining treatment, and treatment is the means and method of treatment. The correctness of syndrome differentiation can be tested by the effect of treatment. Syndrome differentiation and treatment is the process of understanding and solving diseases, the embodiment of combining theory with practice, the concrete application of reasonable methods and prescriptions in clinical practice, and the basic principle guiding the clinical work of traditional Chinese medicine.
Syndrome is a pathological summary of the development of a disease to a certain stage. Because it includes the location, etiology, nature and the relationship between pathogenic factors and positive factors, it reflects the nature of lesions in a certain stage of disease development, so it reveals the essence of disease more comprehensively, profoundly and correctly than symptoms.
"Syndrome Differentiation" is to determine the etiology, nature, location and the relationship between evil and positive of the disease by analyzing and synthesizing the data, symptoms and signs collected by four diagnostic methods (looking, smelling, asking and pulse), and to conclude and judge it as a syndrome. Treatment, also known as "treatment", is to determine the corresponding treatment methods according to the results of syndrome differentiation. Syndrome differentiation is the premise and basis of determining treatment, and treatment is the means and method to treat diseases. Through the effect of syndrome differentiation and treatment, the correctness of syndrome differentiation and treatment can be tested The process of syndrome differentiation and treatment is the process of understanding and solving diseases. Syndrome differentiation and treatment are two interrelated and inseparable aspects in the process of disease diagnosis and treatment. They are the embodiment of the combination of theory and practice, the concrete application of reasonable methods and prescriptions in clinical practice, and the basic principles guiding the clinical practice of traditional Chinese medicine.
The clinical understanding and treatment of diseases in traditional Chinese medicine is based on both disease differentiation and syndrome differentiation, but the main focus is not on the similarities and differences of diseases, but on the differences of syndromes, so as to further understand diseases through syndrome differentiation. For example, a cold is a disease with symptoms such as aversion to cold, fever and head and body pain. However, due to the different pathogenesis and body reactivity, it also shows different syndromes such as wind-cold cold, wind-heat cold and summer-dampness cold. Only by clarifying the syndrome types of cold can we correctly choose different treatment principles and give appropriate treatment by pungent warming, pungent cooling or clearing summer heat and removing dampness. Treatment based on syndrome differentiation is completely different from giving painkillers for headache and antipyretic drugs for fever. It only takes specific measures for symptomatic treatment of a certain symptom, and it is also fundamentally different from simple disease differentiation treatment for all patients with the same disease treated with the same prescription.
Traditional Chinese medicine believes that the same disease can have different syndromes at different stages of development; Different diseases may have the same syndrome types in the development process. Therefore, when treating diseases, we can adopt the principle of "treating different diseases with the same treatment" or "treating different diseases with the same treatment" respectively. "Different treatment for the same disease" refers to different treatment methods for different syndromes at different stages of the same disease. For example, in the early stage of measles, when the rash is not exposed, the treatment method of publishing the rash should be adopted; In the middle stage of measles, lung heat is usually obvious, so the treatment must clear lung heat; However, in the late stage of measles, there is much residual heat, which hurts lung yin and stomach yin. At this time, the treatment should be based on nourishing yin and clearing heat. "Treating different diseases at the same time" means that different diseases have the same syndrome types in the development process, so the same treatment methods can be adopted. For example, arrhythmia and amenorrhea are two completely different diseases, but both of them can have blood stasis syndrome and can be treated with Xuefu Zhuyu Decoction. This principle of solving different contradictions with different methods in the process of disease development is the embodiment of the essence of syndrome differentiation and treatment. Online remote diagnosis only uses one of the four diagnoses, so online Chinese medicine is basically equivalent to the diagnosis method of western medicine, thus losing the characteristics of Chinese medicine.