中医杂志2026，Vol.67Issue(10)：1033-1037,5.DOI:10.13288/j.11-2166/r.2026.10.001
解释学视域下中医辨证论治"证-治-效"内在逻辑探讨
On the Internal Logic of"Syndrome-Treatment-Effect"in Traditional Chinese Medicine Syndrome Differen-tiation and Treatment from the Perspective of Hermeneutics
摘要
Abstract
The concept of syndrome differentiation and treatment is often misunderstood as"arbitrary empiri-cism"or dismissed as unjustifiable when judged by a single external indicator.To address it,this paper draws on hermeneutics,especially the idea that"tradition,understanding,and practice"are mutually generative,to elucidate the object levels,inferential pathways,and efficacy-based validation and correction mechanisms underlying this approach in the clinical process.It is argued that"syndrome"is not a substitute for a disease label or an isolated indicator,but rather a structured configuration of manifestations and an evolving trajectory of illness situated in a specific clinical context.The correlation of all four examinations and physician-patient dialogue form a reasoned chain for the selection of diagnoses,through which discrete signs and symptoms are organized into a syndrome judgment that can be articulated and debated.Therapeutic principles and prescriptions externalize clinical understanding and,through feedback from therapeutic effects,reflexively prompt re-differentiation,thereby forming a cyclical,self-corrective dynamic loop of"syndrome,treatment and effect".Accordingly,syndrome differentiation and treatment should not be regarded as a contingent accumulation of experience,but as a form of clinical rationality under multiple constraints,including clas-sical methods,communal training,and clinical verification.关键词
解释学/辨证论治/证候结构/四诊合参/疗效反馈Key words
hermeneutics/syndrome differentiation and treatment/syndrome structure/correlation of all four exami-nations/therapeutic feedback引用本文复制引用
韩梓逸,张其成..解释学视域下中医辨证论治"证-治-效"内在逻辑探讨[J].中医杂志,2026,67(10):1033-1037,5.基金项目
国家社会科学基金重大项目(16ZDA234) （16ZDA234）
北京中医药大学横向课题:中医文化促进中医药老字号品牌塑造与传播研究项目(BUCM-2025-JS-FW-160) （BUCM-2025-JS-FW-160）
中国人民大学横向课题:医易会通与中医理论自主知识体系研究项目(2026K20041) （2026K20041）
