曹東義：中醫傳承創新——內核與外圍的辯證思考
在浩瀚的醫學海洋中，中醫以其獨特的理論體系和實踐經驗，屹立不倒，歷久彌新。然而，面對現代醫學的迅猛發展和多元文化的衝擊，中醫如何傳承創新，成爲了一個亟待解決的問題。本文將從中醫的內核與外圍入手，深入探討中醫傳承創新的本質與路徑。
一、內核與外圍：中醫的骨架與血肉
中醫有“理法方藥，完整一套”之說，這恰恰揭示了中醫的內在結構。如果把整個中醫學術體系比作一個實體，那麼其基本理法便是內核，而病證方藥、鍼灸推拿等則是外圍部分。內核，是中醫的骨架，決定着中醫學的基本特徵和生命力；外圍，則是中醫的血肉，豐富着中醫的治療手段和實踐經驗。
在中醫的發展歷程中，原始經驗的積累時期，並沒有完整的理論體系，只是方藥、鍼灸等具體治療措施的簡單創造與彙集。然而，隨着髒象、經絡、氣血、病理等基本醫學理論的形成，中醫便具備了基本內核，如同自然界進化過程中的有機物產生了細胞一樣，這標誌着中醫從經驗醫學向理論醫學的跨越。
二、內核的穩定與外圍的更新
值得注意的是，中醫的內核具有相對的穩定性，而外圍則處於不斷的更新代謝之中。從長沙馬王堆漢墓醫書等早期醫學文獻的出土情況來看，許多古老而寶貴的方藥鍼灸治法等具體經驗已經失傳。然而，這並不影響中醫學的基本性質或特徵，因爲關於臟腑經脈、陰陽氣血、治則治法、藥性和配伍等方面的基本理法卻逐漸豐富完善起來，並得以長久流傳。
這種內核的穩定與外圍的更新，恰如生命過程中的新陳代謝一樣，是中醫保持生命力的關鍵所在。清代開創的活血化瘀法則，之所以能在現代廣泛深入地開展下去，除確有療效之外，更在於其與中醫理法內核關於氣血的學說極爲契合，從而具有了永久的生命力。
三、內核與外圍的緊密結合
中醫的內核與外圍並非孤立存在，而是交錯相連、相互融合的。通過辨別病證、病機，確立治法，使病證與理法內核相連；通過性味歸經學說、組合藥物配伍，使方藥與理法內核融爲一體。這種緊密結合的方式，使得中醫在治療疾病時能夠充分考慮患者的個體差異和病情的特殊性，實現個體化的辨證施治。
正如毛主席在《學習和時局》中所指出的：“對具體問題作具體分析，是馬克思主義最本質的東西，是馬克思主義的活的靈魂。”中醫的辨證施治正是這一思想的生動體現。它不會因客觀世界具有無限精細的可分性而失去其永久的魅力，反而能夠因時、因地、因人制宜，靈活應對各種複雜病情。
四、傳承創新：堅守內核，拓展外圍
面對現代醫學的挑戰和多元文化的衝擊，中醫的傳承創新顯得尤爲重要。然而，傳承並非簡單的複製粘貼，創新也不是無根之木、無源之水。中醫的傳承創新必須堅守內核，拓展外圍。
堅守內核，就是要深入挖掘和整理中醫的基本理法，傳承中醫的精髓和特色。這包括對中醫經典著作的研讀、對中醫理論的闡釋、對中醫臨牀經驗的總結等。只有堅守內核，才能確保中醫的傳承不會走樣、不會變味。
拓展外圍，則是要在堅守內核的基礎上，積極吸收現代醫學和其他學科的優秀成果，豐富中醫的治療手段和實踐經驗。這包括對方藥、鍼灸、推拿等傳統療法的創新和發展，對新型疾病和疑難雜症的研究和探索，以及對中醫國際化、現代化的推動等。
五、結語：中醫的未來在於傳承與創新
中醫作爲中華民族的瑰寶，承載着深厚的文化底蘊和獨特的醫學智慧。然而，中醫的未來並非一片坦途，而是充滿了挑戰和機遇。只有堅守內核、拓展外圍，才能實現中醫的傳承與創新；只有不斷汲取新知識、新技術，才能保持中醫的生命力和活力。
讓我們攜手共進，爲中醫的傳承創新貢獻自己的力量，讓中醫這一古老而神奇的醫學體系在現代社會煥發出更加絢麗的光彩！
參考文獻：2005年12月9日《中國中醫藥報》載《中醫界需要重新認識辨證論治》作者：曹東義
作者簡介：梁世傑 中醫高年資主治醫師，本科學歷，從事中醫臨牀工作24年，積累了較豐富的臨牀經驗。師從首都醫科大學附屬北京中醫院肝病科主任醫師、著名老中醫陳勇，侍診多載，深得器重，盡得真傳！擅用“商湯經方分類療法”、專病專方結合“焦樹德學術思想”“關幼波十綱辨證”學術思想治療疑難雜症爲特色。現任北京樹德堂中醫研究院研究員，北京中醫藥薪火傳承新3+3工程—焦樹德門人（陳勇）傳承工作站研究員，國際易聯易學與養生專委會常務理事，中國中醫藥研究促進會焦樹德學術傳承專業委員會委員，中國藥文化研究會中醫藥慢病防治分會首批癌症領域入庫專家。榮獲2020年中國中醫藥研究促進會仲景醫學分會舉辦的第八屆醫聖仲景南陽論壇“經方名醫”榮譽稱號。2023年首屆京津冀“扁鵲杯”燕趙醫學研究主題徵文優秀獎獲得者。事蹟入選《當代科學家》雜誌、《中華英才》雜誌。
Cao Dongyi: Traditional Chinese Medicine Innovation - Dialectical Thoughts on the Inner and Outside
In the vast ocean of medicine, traditional Chinese medicine, with its unique theoretical system and practical experience, has stood firm and evolved over time. However, in the face of the rapid development of modern medicine and the impact of multiculturalism, how to inherit and innovate traditional Chinese medicine has become an urgent problem to be solved. This article will start from the core and peripheral aspects of traditional Chinese medicine and explore the nature and path of traditional inheritance and innovation.
I. Inner core and peripheral: the skeleton and blood and flesh of Chinese medicine
There is a saying in Chinese medicine that "the traditional remedies are a complete set of remedies," which exactly reveals the inner structure of Chinese medicine. If the entire traditional Chinese medicine academic system is likened to an entity, its basic principles are the inner core, while medical prescriptions, acupuncture, etc. are peripheral parts. The core, which is the skeleton of Chinese medicine, determines the basic features and vitality of Chinese medicine. On the periphery, there is the blood and flesh of traditional Chinese medicine, enriching the therapeutic methods and practical experience of traditional medicine.
In the development of traditional Chinese medicine, the period of accumulation of raw experience, there is no complete theoretical system, but the simple creation and compilation of specific treatment measures such as prescription drugs and acupuncture. However, with the formation of basic medical theories such as sickness, meridians, qi and blood, and pathology, traditional Chinese medicine has a basic core, just as organisms in nature evolved to produce cells, which marks the leap from empirical medicine to theoretical medicine.
II. Internal stabilization and peripheral updates
It is worth noting that the inner core of traditional Chinese medicine is relatively stable, while the periphery is in constant renewal of metabolism. According to the unearthing of early medical documents such as the medical books of Wangdui Han Tomb in Changsha, many ancient and valuable traditional medicines such as acupuncture treatment have been lost. However, this does not affect the basic nature or characteristics of Chinese medicine, because the basic principles concerning the inner and meridians, yin and yang, qi and blood, healing principles, medicine and combinations have gradually been enriched and perfected and have been passed on for a long time.
This stability of the inner core and the renewal of the periphery, just like metabolism in the course of life, is the key to maintaining vitality in TCM. The principle of activating blood and resolving stasis initiated by the Qing Dynasty has been widely and deeply carried out in modern times. It not only has curative effect, but also agrees with the theory of qi and blood in the kernel of TCM.
III. Close integration of the core and periphery
The core and periphery of traditional Chinese medicine do not exist in isolation, but are interconnected and integrated with each other. By identifying the signs and symptoms and establishing a cure, the signs are linked to the core of the theory; Drug compatibility combined with the theory of Nature and Taste Tropism and Channel Tropism can make the formula and medicine be integrated with the essence of principle and law. This closely integrated approach allows traditional Chinese medicine to fully consider the individual differences and specialities of patients when treating diseases, achieving individualized dialectical treatment.
As Chairman Mao pointed out in Study and the Times: "The concrete analysis of specific problems is the essence of Marxism, the living soul of Marxism." The dialectical treatment of Chinese medicine is a vivid expression of this idea. It will not lose its permanent charm because the objective world has unrestricted and finely differentiated qualities, but can respond flexibly to various complex conditions according to time, place and person.
IV. Traditional innovation: stay true to the core, expand the outer reach
In the face of the challenges of modern medicine and the impact of multiculturalism, the inheritance and innovation of traditional Chinese medicine is particularly important. However, inheritance is not simply copying and pasting, and innovation is not rootless wood or sourceless water. The inheritance and innovation of traditional Chinese medicine must adhere to the core and expand the periphery.
To adhere to the core is to dive deep into and adjust the basic principles of Chinese medicine, and to pass on the essence and characteristics of Chinese medicine. This includes the study of classical Chinese medicine books, the interpretation of Chinese medicine theory, and the summary of clinical experience of Chinese medicine. Only by adhering to the core can we ensure that the inheritance of Chinese medicine will not deviate from the same pattern and will not change the taste.
To expand the periphery is to adhere to the core, actively absorb the outstanding results of modern medicine and other disciplines, and enrich the treatment methods and practical experience of traditional Chinese medicine. This includes the innovation and development of traditional therapies such as medicine, acupuncture, and massage, the research and exploration of new diseases and difficult diseases, and the promotion of the internationalization and modernization of traditional Chinese medicine.
V. CONCLUSIONS: The future of Chinese medicine lies in inheritance and innovation
As a treasure of the Chinese nation, traditional Chinese medicine carries a deep cultural heritage and unique medical wisdom. However, the future of traditional Chinese medicine is not a smooth path, but full of challenges and opportunities. Only by adhering to the core and expanding the periphery can we achieve the inheritance and innovation of traditional Chinese medicine. Only by constantly learning new knowledge and new technology can we maintain the vitality and vitality of traditional Chinese medicine.
Let us work together to contribute our strength to the inheritance and innovation of traditional Chinese medicine, so that this ancient and miraculous medical system can shine even brighter in modern society!
References: Chinese TCM Daily, December 9, 2005, published, "The Chinese TCM community needs to re-recognize dialectical treatment." Author: Cao Dongyi
Author Bio: Liang Shijie is a senior medical practitioner in traditional Chinese medicine with an undergraduate degree. He has been engaged in traditional medicine clinical work for 24 years and has accumulated a wealth of clinical experience. Following Chen Yong, chief physician of liver disease at Beijing Traditional Medicine Hospital, affiliated with Capital Medical University, and renowned old Chinese medicine, he has been treated for many years and received great attention. He specializes in the treatment of difficult diseases using "conversational traditional therapy" and special treatments combined with the academic ideas of Jiao Shude and Guan Yubo''s ten-level diagnosis.He is currently a researcher at the Shude Tang TCM Research Institute in Beijing, a fellow at the new 3 + 3 project of traditional Chinese medicine flame inheritance in Beijing - a scholar at the inheritance workstation of Jiao Shude''s protégés (Chen Yong),He is a standing committee member of the International Expert Committee on E-learning and Health Care, a member of the Jiao Shude Academic Heritage Special Committee of the Chinese Association for the Advancement of Chinese Medicine Research, and the first cancer specialist to be included in the chapter of the Chinese Pharmaceutical Culture Research Association. Won the 2020 China Association for the Promotion of Traditional Chinese Medicine Zhongjing Medical Branch held the eighth session of the Medical Saint Zhongjing Nanyang Forum "Classic Prescription Famous Doctor" honorary title. The winner of the first Beijing-Tianjin-Hebei "Pingui Cup" Yanzhao Medical Research Essay Award in 2023. His work was featured in the journal Current Scientist and the journal Chinese Talent.
