薛万贵 薛晓霞 李峰利

摘要：整体观念和辨证论治是中医理论体系的核心，也是数千年中医临床实践经验的总结和理论上的升华、中医学术繁荣的重要标志，学术上形成了百花齐放、百家争鸣的松宽学术氛围，有效地促进了中医事业的发展。如汉代医圣张仲景将汉代以前中医临床经验和理论总结归纳为六经辨证;明清时期的温病学大家叶天士创立卫气营血辨证;温病学大家吴鞠通创立三焦辨证;后世医学家在此基础上还创立八纲辨证、脏腑辨证、气血精液辨证等等，但众多的辨证方法也容易使中医临床工作者在学习和选用辨证方法上产生困惑。现将常用的辨证方法之内在关系和辨证要点综合归纳、重新分类、执简驭繁，便于后学者学习和临床应用。

关键词：中医辨证;六经辨证;卫气营血辨证;三焦辨证

Abstract：The overall concept and syndrome differentiation are the core of the theoretical system of traditional Chinese medicine. They are also the summary of the clinical practice experience of Chinese medicine for thousands of years and the important symbol of the sublimation of Chinese medicine and the prosperity of Chinese medicine. Academically， it has formed a Song-Kuan academic atmosphere with a hundred flowers and a hundred schools of thought， effectively promoting The development of the Chinese medicine industry. For example， the Chinese medical doctor Zhang Zhongjing summarized the clinical experience and theoretical summary of traditional Chinese medicine before the Han Dynasty into six syndromes; in the Ming and Qing Dynasties， Wen Tianxue， Ye Tianshi， founded the Weiqiying Blood Syndrome; Wen Xuexue， Wu Yitong， founded the Sanjiao syndrome; later medical scientists On this basis， eight classes of syndrome differentiation， viscera syndrome differentiation， qi and blood semen syndrome differentiation， etc.， are also created， but many dialectical methods are also easy to make Chinese medicine clinicians confused in learning and using dialectical methods. Now the intrinsic relationship and dialectical points of the commonly used dialectical methods are comprehensively summarized， reclassified， and simplified， which is convenient for later scholars to learn and clinical application.

Key words：TCM syndrome differentiation;Six syndrome differentiation;Weiqiying blood syndrome differentiation;Sanjiao syndrome differentiation

中醫辨证方法有六经辨证、卫气营血辨证、三焦辨证、八纲辨证、脏腑辨证、气血精液辨证等，各法自成一派，各自传承。各辨证方法间产生差异的主因在于采用了不同的辨证要点，形成了相异的辩证体系。继而造成临床工作者在使用、理解上的困惑。本文从各辨证方法的辨证要点和内在关系入手，总结出综合辩证方法，并结合实践案例加以分析，以期为中医临床辩证提供方法论及具体实例层面的参考。

1各辨证方法的辨证要点

1.1六经辨证中的三阳病判断 可从热型上分辨，表证必有恶寒，恶寒是诊断表证的必备标准[1] 。……