Specimen priority in traditional Chinese medicine: conceptual analysis and clinical application

Traditional Chinese Medicine"Specimen priority"It is one of the core principles of treatment, emphasizing the need to distinguish between primary and secondary conflicts and priorities in disease treatment. "Standard" refers to symptomatic symptoms, "original" refers to the underlying cause, and "urgent" determines the priority of treatment. This article will start from four parts: concept definition, syndrome differentiation methods, classic cases and modern applications, and systematically explain how this theory guides clinical practice.

1. Theoretical basis of specimen priority

"Huangdi Neijing" first proposed"Treat the symptoms if it's urgent, treat the root cause if it's slow"Principle, as recorded in "Suwen·Biography of Specimen and Diseases": "If you are sick first and then reverse, treat the root cause; if you are first reverse and then sick, treat the symptoms." When patients experience emergencies such as heavy bleeding or high fever (standard), they need to stop bleeding and reduce fever first; after the condition stabilizes, they can then adjust the imbalance of qi and blood (this). Zhang Zhongjing of the Eastern Han Dynasty further refined it in "Treatise on Febrile Diseases" and put forward the syndrome differentiation idea that "when external symptoms are urgent, the external symptoms should be treated, and when internal symptoms are urgent, the internal symptoms should be attacked".

2. Three-level logic of clinical syndrome differentiation

1.specimen identification: For example, if cough is accompanied by lung qi deficiency, cough is the symptom and qi deficiency is the root cause.
2.Priority classification: According to the standards of "Jingyue Encyclopedia", symptoms are divided into three categories: critical (requires intervention within 24 hours), urgent (treated within 3 days), and mild (can be treated for a long time).
3.Dynamic adjustment: Li Shizhen's "Compendium of Materia Medica" of the Ming Dynasty records that when treating malaria, Changshan should be used to cut off the malaria during the attack period (standard), and ginseng should be used to replenish vitality during the intermittent period (this).

3. Classic cases and modern transformation

Taking chronic gastritis as an example, when acute stomach pain occurs, use Yuanhu Painkilling Tablets (standard), and after relief, use Xiangsha Yangwei Pills (standard) to regulate the spleen and stomach. Modern Chinese patent medicines such as:

4. Overall thinking and precautions

It should be noted that the symptoms are not absolute. For example, "Medical Enlightenment" points out that "the intermediate ones work together, and the worst ones work alone." Mild diseases can treat both the symptoms and the root causes. Modern research has confirmed (China Academy of Chinese Medical Sciences 2020 report) that in the treatment of hypertension, Western medicine to control blood pressure (standard) and Chinese medicine to regulate the liver and kidneys (main) can reduce the incidence of complications by 27%. However, it is necessary to avoid exaggerating the efficacy, and all medications should be used as directed by your doctor.

Quote sources:
1. "The Yellow Emperor's Internal Classic" Suwen Chapter (Warring States to Han Dynasty)
2. Zhang Zhongjing's "Treatise on Febrile and Miscellaneous Diseases" (Eastern Han Dynasty)
3. Li Shizhen's "Compendium of Materia Medica" (Wanli Period of Ming Dynasty)
4. China Academy of Chinese Medical Sciences "Evidence-based Research on Traditional Chinese Medicine in the Treatment of Hypertension" (2020)