梁世傑：“準”“狠”“穩”歲月沉澱下的診療三重境
中醫承載着千年的智慧與經驗，從古老的《黃帝內經》到李時珍的《本草綱目》，一代又一代的醫者在這條道路上探索前行，書寫着屬於自己的傳奇。而當我們深入探尋中醫的奧祕時，會發現不同年齡階段的中醫，有着截然不同卻又緊密相連的診療風格，恰似人生在不同階段展現出的獨特魅力。
三十而立：精準爲刃，初露鋒芒
三十歲，對於一位中醫而言，是踏上征程的起點，是積累與沉澱的關鍵時期。此時的他們，如同懷揣着珍貴地圖的探險家，在中醫的浩瀚海洋中，努力尋找着正確的方向。
這個階段的中醫，以“準”字爲要訣。他們遍讀百家經典著作，從《傷寒雜病論》的辨證論治，到《溫熱論》的溫病辨析，每一部經典都如同一把鑰匙，開啓着他們對中醫理論深入理解的大門。據統計，一位三十歲左右的中醫，在初入行時，每年研讀的經典書籍平均超過十本，記錄的筆記多達數萬字。他們深知，只有將經典理論爛熟於心，才能在臨牀實踐中做到辨證求本，遣方用藥準確無誤。
在臨牀診療中，他們謹小慎微，如同在鋼絲上行走的舞者，每一步都小心翼翼。半日讀書，半日臨症，多臨牀、多脈診，是他們提升技能的必經之路。記得有一位三十歲的中醫，在面對一位患有頑固性咳嗽的患者時，並沒有急於開方用藥，而是通過詳細的問診和細緻的脈診，反覆斟酌，最終確定是外感風寒，內有痰溼所致。他嚴格按照藥典規定的藥物劑量開方，理法方藥絲絲入扣。經過一段時間的治療，患者的咳嗽症狀明顯減輕。這位中醫深知，每一次的診斷和用藥，都是一次學習和成長的機會，只有不斷總結經驗，才能在中醫的道路上走得更遠。
三十歲的中醫，就像一顆剛剛發芽的種子，雖然稚嫩，但卻充滿了生機和希望。他們在這個階段，努力吸收着中醫知識的養分，爲未來的成長打下堅實的基礎。
四十不惑：狠招制勝，獨闢蹊徑
當中醫步入四十歲，他們已經積累了相當豐富的臨牀經驗，如同一位身經百戰的將軍，在戰場上能夠運籌帷幄，決勝千里。
這個時期的中醫，診療特點多“狠招”。經過多年的臨牀實踐，他們治療疾病的面和病案已經達到一定的數量，對中醫的基本功和各種診療方法有了深入的理解和掌握。他們不再滿足於傳統的治療方法，而是努力提升思維認知，熟練運用中醫各個門派的診療特色，並將其付諸實踐。同時，他們多旁及醫源，廣泛涉獵其他醫學領域的知識，爲自己的診療提供更多的思路和方法。
在醫療的各個維度，包括藥方大小、藥物劑量大小，他們都能逐漸體會到中醫的博大精深。根據患者病情輕重與體質強弱，他們既能十面埋伏，採用多種治療方法綜合施治；又能單刀赴會，精準地找到問題的關鍵，一擊即中。藥勢能大能小，能急能緩，既能扶正固本，又能力挽狂瀾。
有一位四十歲的中醫，曾遇到一位患有嚴重心臟病的患者，病情危急，多家醫院都認爲治療難度極大。這位中醫經過詳細的診斷和分析，大膽地採用了大劑量的中藥方劑，同時結合鍼灸等治療方法，爲患者進行綜合治療。在治療過程中，他膽大心細，密切關注患者的病情變化，及時調整治療方案。經過一段時間的努力，患者的病情逐漸好轉，最終康復出院。這一案例充分展現了四十歲中醫在診療中的狠招和出奇制勝的能力。
四十歲的中醫，就像一把鋒利的寶劍，在中醫的戰場上披荊斬棘，爲患者帶來生的希望。他們在這個階段，不斷突破自我，挑戰極限，出奇制勝，用獨特的診療方法書寫着屬於自己的輝煌。
五十知天命：穩健爲基，厚積薄發
五十歲，對於中醫來說，是達到了一種境界的標誌。此時的他們，已經累積了足夠多的醫療經驗和理論思維方式，如同一位智者，在中醫的道路上從容前行。
這個年齡的中醫，診療風格以“穩”爲主。他們具備豐富的診療經驗和病例數量，無論是經度和緯度以及六合上下，都沒有其不知不明的地方。在診療中，他們既要能夠力挽狂瀾，解決別人不能解決的難題；又要四平八穩，不急不緩，以穩健的方式推進治療。
據相關數據顯示，五十歲左右的中醫在治療急性病和慢性病時，患者的康復率明顯高於年輕醫生。這是因爲他們在長期的臨牀實踐中，積累了豐富的經驗，能夠根據患者的身體素質強弱，制定出個性化的治療方案。他們不再用險招狠招出奇制勝，而是多考慮患者的長遠利益，穩健推進，扶正祛邪，治病不留邪，久久固本，使之延年益壽。
有一位五十歲的中醫，在治療一位患有慢性肝病的患者時，並沒有採用激進的治療方法，而是通過調理患者的脾胃功能，增強患者的體質，逐步改善患者的肝臟功能。在治療過程中，他耐心細緻，根據患者的病情變化及時調整藥方。經過長時間的治療，患者的病情得到了有效控制，身體也逐漸恢復了健康。這位中醫深知，穩健的治療方式雖然看似緩慢，但卻能夠從根本上解決問題，爲患者帶來長期的健康。
五十歲的中醫，就像一座巍峨的高山，沉穩而堅定。任憑風吹浪打，汝自巋然不動！定力慧力具足，他們在這個階段，用自己的經驗和智慧，爲患者撐起一片健康的天空。
中醫之路，猶如一場漫長而精彩的旅程。三十歲的中醫，精準爲刃，初露鋒芒；四十歲的中醫，狠招制勝，獨闢蹊徑；五十歲的中醫，穩健爲基，厚積薄發。不同年齡階段的中醫，有着不同的診療風格，但他們都懷揣着對中醫的熱愛和對患者的責任，在這條道路上不斷前行。他們用自己的智慧和汗水，傳承着中醫的千年文化，爲人類的健康事業做出了巨大的貢獻。讓我們向這些默默奉獻的中醫們致敬，期待他們在未來的道路上創造更多的奇蹟。
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。
Liang Shijie: Diagnosis and treatment triple situation under the years of precision, rigor and stability
Traditional Chinese medicine carries thousands of years of wisdom and experience. From the ancient Huangdi Inner Book to Li Shizhen''s Materia Medica, generations of healers have explored this path and written their own legends. When we delve into the mysteries of traditional Chinese medicine, we find that traditional Chinese people of different ages have very different but closely related styles of healing, just like the unique charms of different stages of life.
Standing at thirty: precision is the blade, and sharpness first reveals.
Thirty years of age, for a Chinese medicine practitioner, is the beginning of a journey, and is a crucial period of accumulation and settling. At this time, they were like explorers with precious maps, trying to find the right direction in the vast ocean of Chinese medicine.
In this stage of Chinese medicine, the word "quasi" is the key word. They read hundreds of classical works, from the dialectical treatment of typhoid to the treatment of fever, each classic was like a key that opened the door to their in-depth understanding of traditional Chinese medicine. According to statistics, a traditional Chinese medicine practitioner around the age of 30 years old, when he first began his practice, he studied more than ten classic books each year, and recorded tens of thousands of words of notes. They know that only by knowing the classical theory well in heart, can they identify the evidence and find the prescription correctly in clinical practice and administer medication accurately.
In clinical treatment, they are cautious, like dancers walking on a wire, taking care every step of the way. Half the day of reading a book, half the day of attending a medical emergency, and multi-clinical and multiple consultations are the necessary ways for them to improve their skills. I remember a thirty-year-old Chinese medicine practitioner who, in the face of a patient with a persistent cough, did not rush to prescribe a medication, but through detailed consultation and meticulous pulse examination, repeated deliberations, and finally determined that it was due to external cold and internal sputum. He prescribed the medicine strictly in accordance with the dosages specified in the pharmacopoeia and kept the prescription drugs in check. After a period of treatment, the patient''s cough symptoms were significantly reduced. The Chinese medicine practitioner knows that every diagnosis and medication is an opportunity to learn and grow, and only by constantly learning from experience can we go further in the path of Chinese medicine.
A thirty-year-old Chinese medicine is like a seed that has just sprouted, although young, but full of life and hope. At this stage, they strive to absorb the nutrients of traditional Chinese medicine knowledge to lay a solid foundation for future growth.
Forty years without a doubt: Winning with a ruthless strategy and a unique approach
When traditional Chinese medicine reached the age of forty, they had accumulated considerable clinical experience, like a general who had been through a hundred wars, and could maneuver and win thousands of times on the battlefield.
During this period of Chinese medicine, the characteristics of diagnosis and treatment were many "brutal techniques." After years of clinical practice, they have reached a certain number of cases and treatments for diseases, and have gained an in-depth understanding and mastery of the basic techniques of traditional Chinese medicine and various methods of diagnosis and treatment. They are no longer satisfied with traditional treatment methods, but strive to improve their thinking and understanding, and are skilled in applying the healing features of various schools of traditional Chinese medicine and putting them into practice. At the same time, they have a wide range of medical sources and extensive knowledge of other medical fields, providing more ideas and methods for their own diagnosis and treatment.
In all dimensions of medical treatment, including the size of the prescription and the size of drug dosage, they can gradually realize the profound depth of traditional Chinese medicine. Depending on the severity of the patient''s condition and physical strength, they can ambush all aspects of treatment and apply a variety of treatment methods. He can also go to the meeting single-handedly, find the key to the problem precisely, and hit it right. The medicine has great potential energy, can be urgent and slow, both strengthening and consolidating body resistance, and can turn the tide.
A forty-year-old Chinese medicine practitioner had encountered a patient with severe heart disease who was in a critical condition, and several hospitals considered it extremely difficult to treat. After detailed diagnosis and analysis, the Chinese medicine practitioner boldly adopted large doses of Chinese herbal remedies, while combining treatment methods such as acupuncture to provide comprehensive treatment for the patient. During the treatment process, he is courageous and careful, closely monitors the changes of the patient''s condition, and promptly adjusts the treatment plan. After a period of effort, the patient''s condition gradually improved and eventually recovered and was discharged from hospital. This case fully demonstrates the ferocity and ability of 40-year-old traditional Chinese medicine in diagnosis and treatment.
Forty-year-old Chinese medicine, like a sharp sword, has cut through thorns and brambles in the battlefield of Chinese medicine, bringing hope for life to patients. At this stage, they continue to break through themselves, challenge the limits, surprise attack, with a unique diagnosis and treatment approach to write their own glory.
Fifty years of knowing your destiny: Strength is the foundation, thick accumulation and thin hair.
Fifty years old, for Chinese medicine, is a sign of reaching a realm. At this time, they have accumulated enough medical experience and theoretical thinking to move forward in the path of traditional Chinese medicine like a wise man.
TCM practitioners of this age have a "steady" style of diagnosis and treatment. They have a wealth of diagnostic and therapeutic experience and a number of cases, and there is no unknown place, whether at latitude and longitude or up and down Phoenix. In diagnosis and treatment, they must be able to overcome the chaos and solve problems that others cannot solve; Again, we must be stable, not in a hurry, and proceed with treatment in a prudent manner.
According to relevant data, when treating acute and chronic diseases, the rehabilitation rate of patients in traditional Chinese medicine in their 50s is significantly higher than that of young doctors. This is because they have gained a lot of experience in long-term clinical practice and are able to develop a personalized treatment plan based on the strength of the patient''s physical condition. Instead of using dangerous tactics to win spectacularly, they think more about the long-term interests of the patient, advance steadily, correct the evil, cure the illness without leaving the evil behind, and solidify the root cause for a long time, so as to prolong the life of the patient.
A 50-year-old Chinese medicine practitioner, when treating a patient with chronic liver disease, did not use aggressive treatment methods, but instead improved the patient''s liver function by regulating the spleen and stomach function, enhancing the patient''''s physical condition, and gradually improving the patient''s hepatitis function. During the treatment process, he is patient and meticulous, and adjusts the prescription in time according to the changes in the patient''s condition. After a long period of treatment, the patient''s condition was effectively controlled, and the body gradually returned to health. This traditional Chinese medicine knows that a robust treatment, although seemingly slow, can solve the root cause of the problem and bring long-term health to the patient.
A fifty-year-old Chinese medicine is like a huge mountain, steady and determined. Let the wind blow and the waves blow, and you will not move! They are well positioned, and at this stage, they use their experience and wisdom to create a healthy sky for patients.
The road to Chinese medicine is like a long and wonderful journey. Thirty-year-old Chinese medicine, with precision as a cutting edge, has shown a new edge. A forty-year-old Chinese medicine practitioner has a hard game to win and has a unique approach. The fifty-year-old Chinese medicine practitioner has a steady foundation and thin hair. TCM practitioners of different ages have different styles of diagnosis and treatment, but they all have a love for TCM and a responsibility to their patients and continue to move forward on this path. With their wisdom and sweat, they have inherited the millennia-old culture of traditional Chinese medicine and made tremendous contributions to the cause of human health. Let us pay tribute to these silent dedicated Chinese medicine practitioners and look forward to them creating more miracles on the road ahead.
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.
