“西学中”学习路径：中医思维、实践流程与标准化探索

Learning path of “Western medicine practitioners learning TCM”: TCM thinking, practical procedures, and standardization exploration

摘要

中医学体系宏大而深邃，初学者常感艰难。现代中医教育常从阴阳五行、脏腑经络等抽象理论入手，虽有助于知识体系建构，却容易让初学者望而生畏。中医之学，并非先有概念而后解释生命与疾病，而是在长期观察自然、人体与疾病变化的过程中，逐渐形成取象比类、由象达理的认识方式。基于此，文章对仝小林院士在中山大学附属第三医院“西学中培训班”第一课“轻轻松松学中医”内容进行整理，提出“从观象到抽象、从思维到实践”的中医学学习路径：以“象思维”为入门之钥，从自然之理体悟中医之理；以“形神一体”深化生命整体观；通过“态靶辨治”实现中医辨证与现代医学指标的衔接；掌握“方药量效”精髓以提升疗效；并将“药食同源”的中医智慧融入日常生活。

Abstract

Traditional Chinese medicine (TCM) is a vast and profound system of knowledge, and beginners often find it difficult to approach. Modern TCM education frequently begins with abstract theories such as yin-yang, the five phases, zang-fu organs, and meridians. Although this helps construct a systematic framework of knowledge, it can also make TCM appear daunting to newcomers. TCM did not originate from abstract concepts imposed upon life and disease; rather, it gradually developed through long-term observation of nature, the human body, and patterns of disease, forming a mode of thinking that proceeds from observing images and phenomena to grasping underlying principles. Based on this understanding, this article summarizes the first lesson about “learning TCM with ease” delivered by Academician Tong Xiaolin at the “TCM training course for Western medicine practitioners” at the Third Affiliated Hospital of Sun Yat-sen University. It proposes a TCM learning pathway that moves “from observation to abstraction, and from thinking to practice”. This pathway takes “image-based thinking” as the key entry point, enabling learners to understand TCM principles through the observation of natural laws; deepens the holistic view of life through the concept of “unity of form and spirit”; bridges TCM pattern differentiation with modern medical indicators through the “state-target differentiation and treatment” approach; enhances clinical efficacy by mastering the essence of “dose-effect relationships in formulas and medicinals”; and integrates the wisdom of “medicine and food sharing the same origin” into everyday life.

关键词

象思维 / 态靶辨治 / 方药量效 / 药食同源 / 中医学习

Key words

Xiang-thinking / State-target differentiation and treatment / Dosage-effect relationship / Homology of medicine and food / TCM learning

参考文献

[1] 仝小林， 郑玉娇， 刘文科， 等 . 浅谈现代中医思维模式及其临床应用[J]. 中医杂志， 2017， 58（13）： 1104-1107. DOI: 10.13288/j.11-2166/r.2017.13.007.

[2] Tong X L, Zheng Y J, Liu W K, et al. Modern Chinese medicine thinking model and the clinical application[J]. J Tradit Chin Med, 2017, 58(13): 1104-1107. DOI: 10.13288/j.11-2166/r.2017.13.007.

[3] Liu D, Zhao L, Wang Y, et al. Berberine: a rising star in the management of type 2 diabetes: novel insights into its anti-inflammatory, metabolic, and epigenetic mechanisms[J]. Pharmaceuticals, 2025, 18(12): 1890. DOI: 10.3390/ph18121890.

[4] 姜青松， 王庆其. 三才思想与《黄帝内经》的三因制宜[J]. 中华中医药学刊， 2015， 33（9）： 2065-2067. DOI: 10.13193/j.issn.1673-7717.2015.09.004.

[5] Jiang Q S, Wang Q Q. Sancai thought and adjusting measures to difference of huangdi’s internal classic[J]. Chin Arch Tradit Chin Med, 2015, 33(9): 2065-2067. DOI: 10.13193/j.issn.1673-7717.2015.09.004.

[6] 张莉莉， 薛崇祥， 周凌， 等 . 由靶及态之现代中西医结合医学模式探析[J]. 中医杂志， 2023， 64（22）： 2269-2274. DOI: 10.13288/j.11-2166/r.2023.22.001.

[7] Zhang L L, Xue C X, Zhou L, et al. Exploration of modern integrated Chinese and western medicine model: from target to state[J]. J Tradit Chin Med, 2023, 64(22): 2269-2274. DOI: 10.13288/j.11-2166/r.2023.22.001.

[8] 贾锐馨， 彭定国， 李国永， 等 . 仝小林治疗糖尿病经验[J]. 中医杂志， 2010， 51（S2）： 141-142. DOI: 10.13288/j.11-2166/r.2010.s2.041.

[9] Jia R X, Peng D G, Li G Y, et al. Tong Xiaolin’s experience in treating diabetes[J]. J Tradit Chin Med, 2010, 51(S2): 141-142. DOI: 10.13288/j.11-2166/r.2010.s2.041.

[10] 仝小林. 态靶辨治——构建中西医融合医学创新之路[C]//世界针灸学会联合会，中国中医科学院. 世界针灸学会联合会第十届会员大会暨2022世界针灸学术大会论文集. 中国中医科学院广安门医院， 2022： 309-314. DOI: 10.26914/c.cnkihy.2022.093850.

[11] Tong X L. Target-state differentiation and treatment: constructing an innovative path for integrating Chinese and western medicine[C]//World Federation of Acupuncture-Moxibustion Societies, China Academy of Chinese Medical Sciences. Proceedings of the 10th general assembly of the World Federation of Acupuncture-Moxibustion Societies and the 2022 world acupuncture academic conference, 2022. Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 2022: 309-314. DOI: 10.26914/c.cnkihy.2022.093850.

[12] Lian F, Ni Q, Shen Y, et al. International traditional Chinese medicine guideline for diagnostic and treatment principles of diabetes[J]. Ann Palliat Med, 2020, 9(4): 2237-2250. DOI: 10.21037/apm-19-271.

[13] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南（2020年版）[J]. 国际内分泌代谢杂志， 2021， 41（5）： 482-548. DOI: 10.3760/cma.j.cn121383-20210825-08063.

[14] Chinese Diabetes Society. Guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition)[J]. Int J Endocrinol Metab, 2021, 41(5): 482-548. DOI: 10.3760/cma.j.cn121383-20210825-08063.

[15] 郑玉娇， 张莉莉， 丁齐又， 等 . 神曲、半夏曲、红曲治疗高脂血症经验：仝小林三味小方撷萃[J]. 吉林中医药， 2020， 40（8）： 998-1000. DOI: 10.13463/j.cnki.jlzyy.2020.08.006.

[16] Zheng Y J, Zhang L L, Ding Q Y, et al. Experience in the treatment of hyperlipemia with massa medicata fermentata, rhizoma pinelliae fermentata and fermentum rubrum: three prescription by professor TONG Xiaolin[J]. Jilin J Chin Med, 2020, 40(8): 998-1000. DOI: 10.13463/j.cnki.jlzyy.2020.08.006.

[17] 王春梅， 车金营， 崔凯， 等 . 五味子酯甲通过TLR4/NF-κB通路对肝纤维化的保护作用研究[J]. 北华大学学报（自然科学版）， 2022， 23（6）： 757-762. DOI: 10.11713/j.issn.1009-4822.2022.06.011.

[18] Wang C M, Che J Y, Cui K, et al. Protective effect of schisantherin a on liver fibrosis through TLR4/NF-κB pathway[J]. J Beihua Univ (Nat Sci), 2022, 23(6): 757-762. DOI: 10.11713/j.issn.1009-4822.2022.06.011.

[19] 仝小林. 关于“重构现代中医本草体系”的设想及建议[J]. 吉林中医药， 2023， 43（ 1）： 1-4. DOI: 10.13463/j.cnki.jlzyy.2023.01.001.

[20] Tong X L. Ideas and suggestions on “reconstructing the modern TCM materia medica system”[J]. Jilin J Chin Med, 2023, 43(1): 1-4. DOI: 10.13463/j.cnki.jlzyy.2023.01.001.

[21] 谢鹏飞， 张莉莉， 赵林华， 等 . 基于态靶辨治理论探讨糖尿病及其并发症的诊疗策略[J]. 吉林中医药， 2025， 45（9）： 1021-1025. DOI: 10.13463/j.cnki.jlzyy.2025.09.007.

[22] Xie P F, Zhang L L, Zhao L H, et al. Diagnosis and treatment strategies for diabetes and its complications based on the theory of state-target differentiation and treatment[J]. Jilin J Chin Med, 2025, 45(9): 1021-1025. DOI: 10.13463/j.cnki.jlzyy.2025.09.007.

[23] 杨泽， 苟筱雯， 赵林华， 等 . 态靶辨证在痰瘀互阻心绞痛中的运用：瓜蒌薤白半夏汤加降香、三七、蜈蚣粉[J]. 辽宁中医杂志， 2021， 48（7）： 1-3. DOI: 10.13192/j.issn.1000-1719.2021.07.001.

[24] Yang Z, Gou X W, Zhao L H, et al. Application of ‘state-target’ strategy for the angina pectoris of coronary heart disease with the “obstruction of phlegm and blood stasis syndrome”: Gualou-Xiebai-Banxia Decoction with dalbergiae odoriferae odoriferae lignum, notoginseng radix et rhi[J]. Liaoning J Tradit Chin Med, 2021, 48(7): 1-3. DOI: 10.13192/j.issn.1000-1719.2021.07.001.

[25] 郝瑞， 高泽正， 杨映映， 等 . 仝小林院士“心系”疾病辨治要诀[J]. 长春中医药大学学报， 2022， 38（3）： 237-240. DOI: 10.13463/j.cnki.cczyy.2022.03.001.

[26] Hao R, Gao Z Z, Yang Y Y, et al. Academician Tong Xiaolin’s key to the differentiation and treatment of heart system diseases[J]. J Changchun Univ Chin Med, 2022, 38(3): 237-240. DOI: 10.13463/j.cnki.cczyy.2022.03.001.

[27] 陈璐， 丁强， 吴莉琴， 等 . 仝小林辨治慢性阻塞性肺疾病[J]. 长春中医药大学学报， 2025， 41（7）： 709-712. DOI: 10.13463/j.cnki.cczyy.2025.07.001.

[28] Chen L, Ding Q, Wu L Q, et al. Teaching ward round transcript on state-target treatment based on syndrome differentiation of chronic obstructive pulmonary disease case by Academician Tong Xiaolin[J]. J Changchun Univ Chin Med, 2025, 41(7): 709-712. DOI: 10.13463/j.cnki.cczyy.2025.07.001.

[29] 仝小林， 郭敬， 赵林华. 中医方药量效关系研究进展：“973”计划“以量-效关系为主的经典名方相关基础研究”项目研究进展[J]. 中国基础科学， 2014， 16（6）： 10-13. DOI: 10.3969/j.issn.1009-2412.2014.06.002.

[30] Tong X L, Guo J, Zhao L H. Recent progress in the dose-effect relationship study of the traditional Chinese medicine[J]. China Basic Sci, 2014, 16(6): 10-13. DOI: 10.3969/j.issn.1009-2412.2014.06.002.

[31] Zou X, Chang K, Fan G, et al. Effectiveness and safety of Sanhan Huashi granules versus nirmatrelvir-ritonavir in adult patients with COVID-19: a randomized, open-label, multicenter trial[J]. Sci Bull, 2024, 69(12): 1954-1963. DOI: 10.1016/j.scib.2024.04.040.

[32] 金素凡， 蒋建微， 金彦， 等 . 跨文化视域下中医药文化传播策略探析[J]. 中国社会医学杂志， 2023， 40（5）： 507-510. DOI: 10.3969/j.issn.1673-5625.2023.05.001.

[33] Jin S F, Jiang J W, Jin Y, et al. The communication strategies of traditional Chinese medicine culture from a cross-cultural perspective[J]. Chin J Soc Med, 2023, 40(5): 507-510. DOI: 10.3969/j.issn.1673-5625.2023.05.001.

[34] 曹东义. 新中国中医药曲折发展史：回眸70年，展望新时代[J]. 疑难病杂志， 2019， 18（8）： 757-759. DOI: 10.3969/j.issn.1671-6450.2019.08.001.

[35] Cao D Y. The tortuous development history of traditional Chinese medicine in new China: looking back 70 years and looking forward to a new era[J]. Chin J Difficult Complicat Cases, 2019, 18(8): 757-759. DOI: 10.3969/j.issn.1671-6450.2019.08.001.

基金资助

中国中医科学院研究生教育教学改革研究重点项目(JG24-01)