摘要：在浩瀚的医学领域中，中医以其独特的理论体系和实践经验，屹立千年而不倒。然而，近年来，一种声音悄然兴起，质疑中医过于侧重辨证分型，而忽视了疾病过程状态的全面考量。梁世杰医生，对此持有深刻见解，他呼吁重新审视中医的疾病观念，将病程的动态变化纳入整体治疗思路之中。
在浩瀚的医学领域中，中医以其独特的理论体系和实践经验，屹立千年而不倒。然而，近年来，一种声音悄然兴起，质疑中医过于侧重辨证分型，而忽视了疾病过程状态的全面考量。梁世杰医生，对此持有深刻见解，他呼吁重新审视中医的疾病观念，将病程的动态变化纳入整体治疗思路之中。
“中医之美，在于其整体观与个体化治疗的完美融合。”梁世杰医生的话语掷地有声，直击要害。在他看来，中医不应仅仅局限于对五脏六腑、四肢百骸的静态分析，而应更加关注疾病从起病、进展、可控、病愈到愈后调理的每一个阶段，这些阶段如同生命的乐章，每一个音符都承载着病情的变化与生命的律动。
以感冒为例，常人眼中或许只是鼻塞流涕的小恙，但在中医的视角下，它是一场身体与自然界的抗争，是正气与邪气的较量。起病初期，或许只是风寒束表，轻者一碗姜汤即可驱散寒气；但随着病情进展，若不及时干预，邪气可能深入肺脾，症状加剧，此时需以辛温解表、宣肺止咳之法，方能控制病情；待到病愈之时，还需调养脾胃，固护正气，以防疾病复发。这一过程，无不体现着中医对疾病过程状态的精准把握与动态调整。
然而，现实却并非如此理想。梁世杰医生痛心疾首地指出，当前中医界确实存在一种倾向，即过分强调辨证分型，忽视了疾病过程的连贯性和动态性。这种风气，不仅限制了中医的发展，更让患者难以得到最适宜的治疗。他强调，中医的“整体观念”应当更加全面，不仅要考虑脏腑经络的整体性，更要将疾病的病程变化态势、阶段性连贯特点以及治疗方案的阶段性和整体性关系纳入考量。
仝小林院士的观点与梁世杰医生不谋而合。他指出，中医若只关注当下的“状态”，便如同盲人摸象，难以把握疾病的“动态”和未来发展的“态势”。因此，从中医的思维出发，对疾病进行重新分类、分期、分证，成为指导中医治疗的关键。这不仅是对传统中医理论的继承与发展，更是对现代医学挑战的积极回应。
梁世杰医生进一步阐述，中医现代化并非意味着摒弃传统，而是要在继承的基础上创新。他提倡运用现代科技手段，如大数据分析、人工智能等，辅助中医进行疾病诊断与治疗，使中医的“整体观念”更加精准、高效。同时，加强中医教育与培训，提升医生对疾病过程状态的认知与把握能力，让每一位中医都能成为患者生命中的“调音师”，精准调控，奏响生命的最美乐章。
在这个充满挑战与机遇的时代，梁世杰医生以其深邃的洞察力和坚定的信念，为中医的发展指明了方向。他相信，只要坚持中医的整体观念，注重疾病过程的动态变化，中医定能在现代医学的舞台上绽放更加璀璨的光芒，为人类健康事业贡献更大的力量。
让我们携手并进，在这条古老而又崭新的道路上，共同探索中医的无限可能，让生命之树在中医的智慧滋养下，更加茁壮成长。
作者简介：梁世杰 中医高年资主治医师，本科学历，从事中医临床工作24年，积累了较丰富的临床经验。师从首都医科大学附属北京中医院肝病科主任医师、著名老中医陈勇，侍诊多载，深得器重，尽得真传！擅用“商汤经方分类疗法”、专病专方结合“焦树德学术思想”“关幼波十纲辨证”学术思想治疗疑难杂症为特色。现任北京树德堂中医研究院研究员，北京中医药薪火传承新3+3工程—焦树德门人（陈勇）传承工作站研究员，国际易联易学与养生专委会常务理事，中国中医药研究促进会焦树德学术传承专业委员会委员，中国药文化研究会中医药慢病防治分会首批癌症领域入库专家。荣获2020年中国中医药研究促进会仲景医学分会举办的第八届医圣仲景南阳论坛“经方名医”荣誉称号。2023年首届京津冀“扁鹊杯”燕赵医学研究主题征文优秀奖获得者。事迹入选《当代科学家》杂志、《中华英才》杂志。
Dr. Liang Shijie: Reshaping Traditional Chinese Medicine's view of disease - a holistic grasp of disease progression from diagnosis and classification to disease progression dynamics
In the vast field of medicine, traditional Chinese medicine has stood steadfast for thousands of years with its unique theoretical system and practical experience. In recent years, however, a voice has quietly emerged to argue that traditional Chinese medicine focuses too much on dialectical diagnosis and neglects a comprehensive consideration of the state of the disease process. Dr. Liang Shijie, who has a deep understanding of this, called for a re-examination of the concept of disease in traditional Chinese medicine to incorporate the dynamics of the course of the disease into the overall therapeutic thinking.
"The beauty of traditional Chinese medicine lies in the perfect integration of its holistic view and individualized treatment." Dr. Liang Shijie's words were loud and hit the hardest. In his view, traditional Chinese medicine should not be limited to the static analysis of the various organs, internal organs, and limbs. More attention should be paid to each stage of the disease from onset, progression, control, recovery to post-recovery management. These stages are like the music of life, and each note carries the change of the condition and the movement of life.
Taking the cold as an example, ordinary people may think of it as a minor ailment with runny nose, but in the perspective of traditional Chinese medicine, it is a struggle between the body and nature, a contest between good and evil spirits. In the early stage of the illness, it may be only a cold sickness, and in mild cases a bowl of ginger soup can dissipate the cold. However, as the disease progresses, if there is no timely intervention, the evil spirit may penetrate deep into the lungs and spleen and the symptoms worsen, and at this time, it is necessary to cure the disease by taking a cold soothing pill and suppressing the cough. Until the time of recovery, also need to recuperate the spleen and stomach, solid protection of vital qi, to prevent the recurrence of disease. This process in no way reflects the precise grasp and dynamic adjustment of the disease process state in traditional Chinese medicine.
The reality, however, is not so ideal. Dr. Liang Shijie said with pain that there is a tendency in the current Chinese medicine community to place too much emphasis on dialectical differentiation, neglecting the coherence and dynamics of the disease process. This culture not only limits the development of traditional Chinese medicine, but also makes it difficult for patients to get the most appropriate treatment. He emphasized that the "holistic concept" of traditional Chinese medicine should be more comprehensive, not only considering the holistic nature of the meridians, but also taking into account the pathological changes, the stages coherent features of the disease, and the stages and holistic relationship of the treatment plan.
Academician Tong Xiaoping's views coincide with those of Dr. Liang Shijie. He pointed out that if traditional Chinese medicine focuses only on the present "state," it is like a blind person's image, and it is difficult to grasp the "dynamics" of the disease and the "posture" of future development. Therefore, from the thinking of traditional Chinese medicine, reclassification, phase and certification of the disease has become the key to guiding traditional Chinese medical treatment. This is not only a positive response to the inheritance and development of traditional Chinese medicine theory, but also to the challenges of modern medicine.
Dr. Liang Shijie further elaborated that modernization of traditional Chinese medicine does not mean abandoning tradition, but rather innovating on the basis of inheritance. He advocates the use of modern technological methods, such as big data analysis and artificial intelligence, to assist traditional Chinese medicine in diagnosing and treating diseases, so as to make the "whole concept" of traditional Chinese Medicine more precise and efficient. At the same time, strengthen traditional Chinese medicine education and training, improve the ability of doctors to understand and grasp the state of the disease process, so that every traditional Chinese can become a "tuner" in the life of patients, accurately regulate, and play the most beautiful song of life.
In these times of challenges and opportunities, Dr. Liang Shijie has pointed the way for the development of traditional Chinese medicine with his deep insight and firm conviction. He believes that as long as we adhere to the holistic concept of traditional Chinese medicine and pay attention to the dynamic change of the disease process, traditional Chinese Medicine will shine brighter on the stage of modern medicine and contribute greater strength to the cause of human health.
Let us join hands on this ancient and new path to explore the limitless possibilities of traditional Chinese medicine, so that the tree of life grows even stronger under the wisdom of traditional medicine.
Author Bio: Liang Shijie is a senior medical practitioner in traditional Chinese medicine with an undergraduate degree. He has been engaged in traditional medicine clinical work for 24 years and has accumulated a wealth of clinical experience. Following Chen Yong, chief physician of liver disease at Beijing Traditional Medicine Hospital, affiliated with Capital Medical University, and renowned old Chinese medicine, he has been treated for many years and received great attention. He specializes in the treatment of difficult diseases using "conversational traditional therapy" and special treatments combined with the academic ideas of Jiao Shude and Guan Yubo's ten-level diagnosis.He is currently a researcher at the Shude Tang TCM Research Institute in Beijing, a fellow at the new 3 + 3 project of traditional Chinese medicine flame inheritance in Beijing - a scholar at the inheritance workstation of Jiao Shude's protégés (Chen Yong),He is a standing committee member of the International Expert Committee on E-learning and Health Care, a member of the Jiao Shude Academic Heritage Special Committee of the Chinese Association for the Advancement of Chinese Medicine Research, and the first cancer specialist to be included in the chapter of the Chinese Pharmaceutical Culture Research Association. Won the 2020 China Association for the Promotion of Traditional Chinese Medicine Zhongjing Medical Branch held the eighth session of the Medical Saint Zhongjing Nanyang Forum "Classic Prescription Famous Doctor" honorary title. The winner of the first Beijing-Tianjin-Hebei "Pingui Cup" Yanzhao Medical Research Essay Award in 2023. His work was featured in the journal Current Scientist and the journal Chinese Talent.
来源：老梁谈养生
