解释学视域下中医辨证论治“证-治-效”内在逻辑探讨

韩梓逸; 张其成

doi:10.13288/j.11-2166/r.2026.10.001

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解释学视域下中医辨证论治“证-治-效”内在逻辑探讨

学术探讨 | 更新时间：2026-05-19

- 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 Differentiation and Treatment from the Perspective of Hermeneutics
- 中医杂志 2026年67卷第10期页码：1033-1037
- 作者机构：
  
  北京中医药大学国学院，北京市朝阳区北三环东路11号，100029
- 作者简介：
  
  zhangqicheng96@163.com
- 基金信息：
  
  国家社会科学基金重大项目(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);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)
- DOI：10.13288/j.11-2166/r.2026.10.001
  中图分类号：
- 收稿：2026-01-18，
  
  修回：2026-03-17，
  
  录用：2026-03-04，
  
  纸质出版：2026-05-17
- 稿件说明：
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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.

HAN Ziyi,ZHANG Qicheng.On the Internal Logic of "Syndrome-Treatment-Effect" in Traditional Chinese Medicine Syndrome Differentiation and Treatment from the Perspective of Hermeneutics[J].Journal of Traditional Chinese Medicine,2026,67(10):1033-1037.
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. DOI： 10.13288/j.11-2166/r.2026.10.001.

HAN Ziyi,ZHANG Qicheng.On the Internal Logic of "Syndrome-Treatment-Effect" in Traditional Chinese Medicine Syndrome Differentiation and Treatment from the Perspective of Hermeneutics[J].Journal of Traditional Chinese Medicine,2026,67(10):1033-1037. DOI： 10.13288/j.11-2166/r.2026.10.001.

摘要

针对辨证论治常被误读为“经验任意”或被外在单一指标否定其可证性的问题，借助解释学关于“传统-理解-实践”相互生成的思想，梳理辨证论治在临床流程中所依据的对象层级、推理进路与效验校正方式。认为“证”并非病名或单一指标的替代，而是患者在特定情境下的证候结构与病势过程；四诊合参与医患问答构成互证取舍的理由链条，使离散征象得以被组织为可讨论的证候判断；治法方药将理解外化并在疗效反馈中返观再辨证，从而形成“证-治-效”往复参证的自我校正环。由此，辨证论治并非任意经验堆积，而是一种在经典成法、共同体训练与临床效验多重约束下运行的临床理性。

Abstract

The concept of syndrome differentiation and treatment is often misunderstood as "arbitrary empiricism" 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 classical methods， communal training， and clinical verification.

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references

宋逸杰，马素亚，戴亚盛，等 . 人工智能辅助中医辨证的关键问题与技术挑战［J］. 中国工程科学， 2024 ， 26 （ 2 ）： 234 - 244 .

陈格 . 《存在与时间》中的诠释学循环［J］. 哲学进展， 2025 ， 14 （ 5 ）： 87 - 93 .

黄楚枫 . 狄尔泰精神科学方法论探析［J］. 哲学进展， 2025 ， 14 （ 6 ）： 37 - 42 .

吴亚琳 . 商谈伦理学视角下对儒家角色伦理学的解读：以哈贝马斯伦理学思想为棱镜［J］. 社会科学前沿， 2025 ， 14 （ 6 ）： 235 - 242 .

PERTIERRA I X L . On Gadamerian hermeneutics： fusions of horizons， dialogue， and evolution（s） within culture as dynamic system of meaning ［J］. Eidos ， 2020 ， 4 （ 4 ）： 45 - 62 .

BOUZIANE L . A hermeneutical reading of postcolonial literature： fusion of horizons in E.M. Forster's A Passage to India and Tayeb Salih's Season of Migration to the North ［J］. Int Human Sci Rev ， 2019 ， 1 （ 1 ）： 29 - 37 .

AUSTGARD K . Doing it the Gadamerian way-using philosophical hermeneutics as a methodological approach in nursing science ［J］. Scand J Caring Sci ， 2012 ， 26 （ 4 ）： 829 - 834 .

KOSKINEN C ， NYSTRÖM L . Hermeneutic application research-finding a common understanding and consensus on care and caring ［J］. Scand J Caring Sci ， 2017 ， 31 （ 1 ）： 175 - 182 .

MAXWELL C ， RAMSAYER B ， HANLON C ， et al . Exami-ning researchers' pre-understandings as a part of the reflexive journey in hermeneutic research ［J］. Int J Qual Methods ， 2020 ， 19 ： 1609406920985718 . doi： 10.1177/1609406920985718 http://dx.doi.org/10.1177/1609406920985718 .

KIM J H . Teacher action research as Bildung： an application of Gadamer's philosophical hermeneutics to teacher professional development ［J］. J Curric Stud ， 2013 ， 45 （ 3 ）： 379 - 393 .

LEIVISKÄ A . The relevance of Hans-Georg Gadamer's concept of tradition to the philosophy of education ［J］. Educ Theory ， 2015 ， 65 （ 5 ）： 581 - 600 .

张其成 . 中华文明精神标识的内核与图式［J］. 人民论坛·学术前沿， 2025 （ 17 ）： 33 - 45 .

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