Treating "syndrome" as merely at the level of the concept of pathogenesis, we actually understand the syndrome as the pathogenesis corresponding to a specific prescription. With this understanding, no matter what research method we take, the final result seems to be distilled and expressed as a concept of pathogenesis. This method of research is still deeply rooted in the traditional theoretical framework of traditional Chinese medicine, which relies on pathogenesis for deductive reasoning, but often does not realize that in many cases, such reasoning has gone beyond the original scope of practical experience, and its empirical basis appears to be unstable.
For example, we have seen a discussion of formulas such as Guizhi Dahuang Soup, Zhuye Soup, and Maziren Pills. These formulas are undoubtedly good prescriptions that have been proven by generations and have significant curative effects. Zhang Zhongjing's description of the indications of these prescriptions is mainly based on his plain clinical records. However, later generations of physicians gave these manifestations the concept of pathogenesis, and used the theory of traditional Chinese medicine to deduce the pathogenesis of prescriptions. Today's scholars continue to explore in depth along this line of research.
However, we can't help but ask, if there is no rich practical experience (i.e., clinical phenomena) as a basis, then what is the value of the concept of pathogenesis? Do we have a good reason to reason and deduce further on this basis? This is indeed a question worth pondering. If we rely too much on theoretical deduction and ignore the verification of clinical practice, will our research still maintain its authenticity and validity? This requires us to re-examine our research methods and rethink the relationship between theory and practice.
In recent years, the development of forensic research has shown an exciting trend. People began to use the methods of modern science to conduct in-depth research on the corresponding problems of evidence from multiple perspectives. Novel research methods such as statistics, data mining, rough set theory, and systems biology have been introduced into the field of forensic research, injecting new vitality into this ancient and complex topic.
Through the application of these methods, we become more objective and accurate in our formulation of the issue of evidence. Compared with the purely theoretical reasoning of the past, the introduction of modern scientific methods has enabled us to reveal the intrinsic connections between the evidence in a deeper way. These new methods not only help us collect and analyze large amounts of data, but also uncover the patterns and information hidden behind the data.
However, despite the remarkable results achieved by the authors, they all seem to prefer to revert the results to the formulation of the pathogenesis, without further exploring the links between the phenomena. This may be due to the fact that pathogenesis is at the heart of TCM theory, or it may be because existing research methods are not yet sufficient to reveal deeper connections between phenomena.
In the future, with the continuous progress of science and technology and the continuous innovation of methods, we have reason to believe that the research of evidence will make more in-depth progress. At that time, we will not only be able to more accurately describe the relationship between the evidence, but also reveal more of the mystery behind the phenomenon. This will provide a more solid scientific foundation for the development and practical application of TCM theory.
He Xinhui et al. conducted an in-depth study on the law of the syndrome and treatment of Wuling Sanfang. They extensively collected 11 monographs on ancient and modern medical cases and 3,633 cases of Wulingsan in more than 40 modern journals, and used a log-linear regression model and trend x2 test for analysis. The study found that the main symptoms of Wuling San syndrome included poor urination, vomiting, edema, diarrhea, pale tongue, pale or thin white tongue, and heavy or slippery pulse. The basic pathogenesis lies in the loss of trifocal gasification and the internal arrest of water and gas, and the poor spleen movement is the key to the disease.
Li and Tang Guoxiang, who are also committed to the study of Wuling San's formula, also made similar explorations. They collected ancient and modern TCM medical books and the examination cases of Wuling San prescription in Chinese medicine journals since the 50s, and used factor models to conduct in-depth research on the formula. Their conclusions were similar to those of He Xinhui et al., and they also confirmed that the main clinical manifestations of Wuling Sanfang syndrome included unfavorable urination, pale tongue, thin white moss or white greasy, etc. In addition, they also clarified the syndrome, pathogenesis, and diseases involved in the Wuling San syndrome, including spleen deficiency and dampness or cold and dampness trapped in the spleen, and poor urine and poor urination caused by spleen loss; Spleen deficiency and dampness, water stagnation in the abdomen; diarrhoea in the dampness; The external sense is not solved, gasification does not work, water inversion caused by water dampness and storage, and water storage certificate; as well as phlegm, dampness, vomiting, dizziness, etc.
Although these authors have adopted modern scientific research methods to summarize the pathogenesis characteristics of the scattered formulas, they do not seem to have reached a deeper understanding of the clinical phenomena. They still rely on traditional concepts of pathogenesis to summarize and try to grasp the changing clinical phenomena. However, the results of such studies are still difficult to grasp clinically, because clinical phenomena are often more complex and variable than simple pathogenesis concepts. Therefore, future research needs to dig deeper into clinical phenomena to more accurately understand and grasp the syndrome and treatment rules of Wuling San formula.
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