摘要
《伤寒论》蕴含的外感热病诊疗思维模型以“病脉证并治”为核心逻辑,依托六经辨证整合时空维度,形成三阴三阳病证的动态框架。其疾病模型通过象数思维划分表里层次与传变时序,构建多层级、网络化的“一纲多目”病证体系;诊断模型以“逐级辨病—脉证互参—动态修正”为路径,形成类决策树系统,实现精准病机推演;治疗模型强调基于规则化决策逻辑的祛邪扶正、表里先后及寒热分治原则,最终以高度特异性的“方证对应”强关联规则锚定方药。该模型不仅在外感热病领域具有很强临床适应性,其“病—脉—证—治”的层级逻辑、六经传变的动态决策树特性及方证对应的精准映射规则,更为构建现代中医智能诊疗模型提供了经典原型与可借鉴的思维范式。未来可结合多学科技术手段系统解析模型结构,实现从经验描述向可计算、可量化、可推广的智能模型的转化升级,为智能化中医诊疗体系开辟新路径。
The diagnostic and therapeutic thinking model for exogenous febrile diseases in Treatise on Cold Damage Diseases takes“Syndrome differentiation and treatment based on disease,pulse,and syndrome”as its core logic,and integrates the temporal and spatial dimensions based on the six meridians’differentiation to form a dynamic framework of three Yin and three Yang diseases and syndromes.Its disease model divides the internal and external levels and the transmission and variation sequence through Xiang-number thinking,and constructs a multi-level and networked“one guideline with multiple sub-items”disease and syndrome system.The diagnostic model follows the path of“step-by-step disease differentiation-mutual reference of pulse and syndrome-dynamic correction”,forming a quasi-decision tree system to achieve precise pathogenesis deduction.The therapeutic model emphasizes the principles of eliminating pathogenic factors and strengthening the body’s resistance,sequential treatment of exterior and interior,and separate treatment of cold and heat based on regularized decision-making logic.Ultimately,highly specific“syndrome-prescription correspondence”strong association rules are used to anchor the prescriptions and herbs.This model not only has strong clinical applicability in the field of exogenous febrile diseases,but also in the hierarchical logic of“disease-pulse-syndrome-treatment”,the dynamic decision tree characteristics of the six meridians transmission,and the precise mapping rules of prescriptions and syndromes provide a classic prototype and a referable thinking paradigm for the construction of modern intelligent diagnosis and treatment models of traditional Chinese medicine.In the future,multiple disciplinary technical means can be combined to systematically analyze the model structure,achieving the transformation and upgrading from empirical description to computable,quantifiable and scalable intelligent models,thus opening up new paths for the intelligent medical diagnosis system of traditional Chinese medicine.
作者
杨凤
侯鉴宸
陶晓华
聂莹
高博
毕磊
陈超
贾李蓉
YANG Feng;HOU Jianchen;TAO Xiaohua;NIE Ying;GAO Bo;BI Lei;CHEN Chao;JIA Lirong(Institute of Information on Traditional Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)
出处
《环球中医药》
2025年第12期2526-2532,共7页
Global Traditional Chinese Medicine
基金
中国中医科学院基本科研业务费自主选题项目(ZZ170327)
中央级公益性科研院所基本科研业务费专项资金资助(ZZ17-XRZ-098)
国家重点研发计划(2019YFC1709200)。
关键词
《伤寒论》
外感热病
诊疗思维模型
病脉证并治
智能诊疗
Treatise on Cold Damage Diseases
exogenous febrile diseases
diagnostic and therapeutic thinking model
syndrome differentiation and treatment based on disease,pulse,and syndrome
intelligent diagnosis and treatment
