国医大师周仲瑛复合病机论的整体观内涵探微

补娟娟，刘颖，江珊，周崇怡，叶放南京中医药大学，国医大师周仲瑛传承工作室，江苏 南京 210023摘要：通过从周仲瑛教授复合病机论的提出、表现形式、复合病机动态转化、临床运用等方面进一步研究和梳理复合病机论，探究其整体观内涵。认为复合病机论深谙整体观之旨，复合病机论立于气一元的整体观思想；以多病位复合、多病机要素复合的表现形式体现对疾病的整体认知；通过认知疾病的动态演变规律，全面动态地呈现疾病发展过程、预测疾病转归；复合病机论指导下采用复法制方对疑难杂症进行整体把控，实现整体观的灵活运用。复合病机论将整体观贯穿于疾病辨治诊疗全过程，对辨治临床疑难杂症意义重大。关键词：复合病机；整体观；病机转化；辨证论治；周仲瑛；名医经验

中图分类号：R249 文献标识码：A 文章编号：1005-5304(2024)05-0162-05 DOI：10.19879/j.cnki.1005-5304.202306259 开放科学（资源服务）标识码（OSID）： Analysis on the Connotation of the Holistic View of Compound Pathogenesis by National TCM Master Zhou Zhongying

BU Juanjuan, LIU Ying, JIANG Shan, ZHOU Chongyi, YE Fang

Nanjing University of Chinese Medicine, Traditional Chinese Medicine Master Zhou Zhongying Inheritance Studio,

Nanjing 210023, China

Abstract: This article further researched and combed of the compound pathogenesis from professor Zhou Zhongying through proposal, expression form, dynamic transformation and clinical application, explored the connotation of its holistic view. It is believed that the theory of compound pathogenesis deeply understands the essence of the holistic view, and is based on the holistic view of the unity of qi; it reflected the overall understanding of the disease in the form of multiple disease sites and multiple pathogenic factors; by understanding the dynamic evolution laws of diseases, comprehensively and dynamically presenting the disease development process and predicting disease outcomes; guided by the theory of complex pathogenesis, the use of complex methods to comprehensively control difficult and complicated diseases has achieved flexible application of a holistic approach. The theory of compound pathogenesis runs through the entire process of disease diagnosis and treatment with a holistic perspective, which is of great significance for the diagnosis and treatment of clinically difficult and complex diseases.

Keywords: compound pathogenesis; holistic view; pathogenesis transformation; syndrome differentiation and treatment; Zhou Zhongying; experiense of famous doctors

整体观是中医学理论体系的主要特点之一[1]。后世医家一般认为整体观包括人体自身为一整体、人与自然为一整体及人体脏腑、经络等组织之间相互联系形成一个整体这3个层面[2]。体现了医家初步将整体观运用于人体生理病理的解读，但如何将整体观思维有效运用于临床辨证与论治之理法方药过程中，值得基金项目： 中国中医科学院科技创新工程项目（CI2022E028XB）；江苏省（社会发展）重点研发计划（BE2019723）通讯作者：叶放，E-mail：yefang973@163.com

深入探讨。

首届国医大师周仲瑛教授，从事中医临床、教学、科研70余年，素来重视病机理论，指出病机是指疾病的病理因素、病性、病位及病程中变化的要理。周老构建的病机辨证体系基于整体观思想，提出病机十三条，认为“审证求机，活化辨证”是提高临床疗效的锁钥，突出强调多种急难病症的共性病机特征为复合病机，并针对复合病机特点提出了多法复合、复法制

方的治疗策略[3]。本文通过研究和梳理复合病机论进一

步探究其整体观内涵。