摘要：中医，似一位睿智的老者，以千年传承的智慧，凭借望、闻、问、切，于细微处洞察人体阴阳的失衡；西医，则如一位严谨的学者，凭借先进的仪器与精确的数据，探寻人体内部结构的奥秘。而在这两者之间，患者的报告单，恰似一座无形的桥梁，又似一面锐利的照妖镜，映照出疾病的真面目，
中医，似一位睿智的老者，以千年传承的智慧，凭借望、闻、问、切，于细微处洞察人体阴阳的失衡；西医，则如一位严谨的学者，凭借先进的仪器与精确的数据，探寻人体内部结构的奥秘。而在这两者之间，患者的报告单，恰似一座无形的桥梁，又似一面锐利的照妖镜，映照出疾病的真面目，也检验着医生的医术与医德。
中医，自其诞生之日起，便以症状为切入点，开启对疾病的探索之旅。诸多疾病，皆以症状命名，像头痛、咳嗽、泄泻等，这无不彰显着中医对症状的敏锐捕捉。在中医看来，症状是人体发出的求救信号，是阴阳失调的外在表现。当中医运用辨证论治之法，精准地辨别出病因病机，对症下药，往往能在消除症状的过程中及时取得疗效。这就如同在黑暗中点亮一盏明灯，为患者驱散病痛的阴霾。
然而，我们必须清醒地认识到，并非所有疾病都仅靠症状的消除便可判定治愈。据相关统计数据显示，在众多疾病中，有相当一部分存在器质性病变或血液生化报告异常。这些病变和异常指标，犹如隐藏在身体深处的定时炸弹，随时可能引发更严重的健康危机。此时，患者的报告单便显得尤为重要。它就像是一本详细的健康日记，记录着身体内部的每一次变化。医生慧存这些报告单，每年进行疗效对比，就如同在绘制一幅疾病的演变地图。
以慢性肝炎为例，这种疾病往往伴随着肝脏的器质性病变和血液生化指标的异常。从临床统计来看，经过一个疗程的调理和治疗，仅有约 30%的患者能在短期内使血液生化指标恢复正常，而大部分患者需要经过数个疗程，甚至更长时间的治疗，才能看到明显的改善。这就需要医生定期收集患者的报告单，通过对比不同时期的指标变化，准确判断疗效。若疗效显著，患者的信心会如春日里的花朵般绽放，更加积极地配合治疗；若疗效不佳，医生也能及时反思治疗方案，像一位技艺精湛的工匠，精心雕琢，修正治疗策略，为患者寻找更有效的治疗途径。
除了报告单，医生观察患者舌苔也是诊断的重要环节。舌苔，犹如人体的一面镜子，能反映出体内的气血阴阳变化。此时，医生准备一面小镜子，让患者拿着自个照一照，这一小小的举动，却蕴含着大大的智慧。我称之为准备一面“照妖镜”。当患者亲眼看到自己起初那厚腻、黄浊的舌苔，经过一段时间的治疗后，逐渐变得薄白、润泽，这种直观的对比，就像一场神奇的魔术表演，让患者深刻感受到治疗的效果。
曾经有一位患者，长期被口臭、消化不良所困扰。初诊时，他的舌苔厚腻如积雪，颜色黄浊。医生在诊断后，为他制定了个性化的治疗方案。在治疗过程中，医生每次都会让他拿着镜子观察舌苔的变化。随着治疗的推进，患者惊喜地发现，自己的舌苔一天比一天薄，颜色也逐渐变得正常。这种直观的感受，让他对治疗充满了信心，更加坚定地配合医生的治疗。最终，他的症状完全消失，身体恢复了健康。这一例子充分说明，让患者参与观察舌苔的变化，不仅能增强医患之间的信任，还能激发患者战胜疾病的信心。
再说说摸脉，这可是中医诊断的绝技之一。虽然患者自己不会像医生那样精准地判断脉象的浮沉、迟数、虚实，但对于脉的有力无力，他们还是能够体会出来的。医生可以简单指导患者，让他们自己试一试。这就好比给患者一把打开健康之门的钥匙，让他们在治疗的道路上不再迷茫。当患者感受到自己的脉象从虚弱无力逐渐变得有力有神时，那种对治疗效果的肯定和对医生的信任，会如同潺潺溪流，滋润着医患关系这片土地。
在医学的道路上，患者的报告单、舌苔的观察以及患者的自我感受，都是不可或缺的元素。它们相互交织，构成了一幅完整的健康画卷。医生的职责，便是用心去解读这幅画卷，用智慧和爱心为患者驱散病痛的阴霾。而患者的报告单，就像那面照妖镜，既能照出疾病的本质，也能映照出医生的医术与医德。
让我们珍惜这面照妖镜，在医学的征程中，携手共进，为患者的健康保驾护航。因为，每一个患者的康复，都是对医生最大的褒奖；每一份医患之间的信任，都是对医学事业最美好的诠释。在这条充满挑战与希望的道路上，让我们以患者的报告单为指引，不断探索，不断前行，书写属于医学的辉煌篇章。
作者简介：梁世杰 中医高年资主治医师，本科学历，从事中医临床工作24年，积累了较丰富的临床经验。师从首都医科大学附属北京中医院肝病科主任医师、著名老中医陈勇，侍诊多载，深得器重，尽得真传！擅用“商汤经方分类疗法”、专病专方结合“焦树德学术思想”“关幼波十纲辨证”学术思想治疗疑难杂症为特色。现任北京树德堂中医研究院研究员，北京中医药薪火传承新3+3工程—焦树德门人（陈勇）传承工作站研究员，国际易联易学与养生专委会常务理事，中国中医药研究促进会焦树德学术传承专业委员会委员，中国药文化研究会中医药慢病防治分会首批癌症领域入库专家。荣获2020年中国中医药研究促进会仲景医学分会举办的第八届医圣仲景南阳论坛“经方名医”荣誉称号。2023年首届京津冀“扁鹊杯”燕赵医学研究主题征文优秀奖获得者。事迹入选《当代科学家》杂志、《中华英才》杂志。
Liang Shijie: Patient's Report Card, Doctor's Mirror
Chinese medicine, like a wise old man, with the wisdom inherited over thousands of years, by looking, smelling, asking, and cutting, can discern the imbalance between yin and yang in the human body in the smallest places. Western medicine, for its part, is a serious scholar, using advanced instruments and accurate data to explore the mysteries of the internal structure of the human body. Between the two, the patient's report card is like an invisible bridge, like a sharp mirror that reflects the true nature of the disease and tests the doctor's skill and ethics.
Since its birth, traditional Chinese medicine has used symptoms as an entry point to begin the exploration of diseases. Many diseases are named after symptoms, such as headaches, coughs, and diarrhea, which shows the acute recognition of symptoms in traditional Chinese medicine. In the view of traditional Chinese medicine, symptoms are a signal sent by the body to ask for help and are an external manifestation of yin and yang imbalance. When traditional Chinese medicine applies the method of dialectical healing, accurately identifies the cause and mechanism of the disease, and applies medicine to the specific condition, often achieving therapeutic effect in time in the process of eliminating symptoms. This is like lighting a bright light in the dark to clear the haze of illness for the patient.
However, we must be aware that not all diseases can be judged to be cured by the elimination of symptoms alone. According to relevant statistics, in a large number of diseases, there are organological lesions or biochemical abnormalities in the blood. These pathological changes and abnormal indexes are like time bombs hidden in the body, which may cause more serious health crisis at any time. Patient reports are especially important at this time. It's like a detailed health journal, keeping track of every change inside your body. Doctors keep these reports and compare their effectiveness annually, as if they were mapping the evolution of the disease.
Take chronic hepatitis, for example, which is often accompanied by organological lesions of the liver and abnormalities in the biochemical indicators of the blood. From a clinical point of view, after one course of conditioning and treatment, only about 30% of patients can return blood biochemical indicators to normal in a short period of time, and most patients need several courses or even longer to see significant improvement. This requires doctors to regularly collect patient reports and accurately judge the effectiveness of treatment by comparing the changes in indicators from different periods. If the efficacy of the treatment is significant, the patient's confidence will blossom like a spring flower and cooperate more actively with the treatment; If the treatment is not effective, the doctor can also reflect on the treatment plan in time, like a skilled craftsman, carefully calibrate the treatment strategy, and find a more effective treatment for the patient.
In addition to the report form, the doctor's observation of the patient's tongue and tongue is also an important part of the diagnosis. The tongue and tongue, like a mirror of the human body, can reflect the yin and yang changes in the body. At this moment, the doctor prepared a small mirror and asked the patient to take a picture of himself. This small act, however, contained great wisdom. I call it preparing a "magic mirror." When the patient sees with his own eyes the thick, turbid tongue at first, after a period of treatment, it gradually becomes white and lush. This intuitive contrast is like a magical magic show, allowing the patient to deeply feel the effects of the treatment.
There was once a patient who had been plagued by bad breath and indigestion for a long time. At the first diagnosis, his tongue was thick as snow and yellowish in color. After the diagnosis, the doctor developed a personalized treatment plan for him. During the course of the treatment, the doctor would each time let him hold a mirror to observe changes in the tongue's tongue. As the treatment progressed, the patient was pleasantly surprised to find that his tongue grew thinner every day, and the color gradually became normal. This intuitive feeling has made him feel confident in his treatment and more determined to cooperate with the doctor's treatment. Eventually, his symptoms completely disappeared and his body returned to health. This example fully demonstrates that involving the patient in observing the changes of the tongue can not only enhance the trust between the doctor and the patient, but also inspire the patient's confidence in defeating the disease.
Let's also touch the pulse, which is one of the best techniques in traditional Chinese medicine for diagnosis. Although the patients themselves cannot judge the floating, late, and falseness of the pulse as precisely as the doctor, they can still appreciate the powerlessness of the Pulse. Doctors can simply instruct patients to give them a try for themselves. It's like giving patients a key to open the door to health so they don't get lost on the path to treatment. When a patient feels that his or her pulse has evolved from weakness to strength, that affirmation of the effectiveness of the treatment and trust in the doctor will irrigate the land of the doctor-patient relationship like a brook.
In the path of medicine, the patient's report form, the observation of the tongue and the patient''s self-perception are all indispensable elements. They are intertwined to form a complete picture of health. It is the doctor's duty to interpret this painting with care and to use wisdom and love to clear the shadow of illness for the patient. Patient reports, like the mirror, can reflect both the nature of the disease and the medical skill and ethics of the doctor.
Let us cherish this mirror and work together in the medical journey to safeguard the health of patients. Because every patient's recovery is the greatest reward for the doctor. Every trust between a doctor and a patient is the best expression of the medical profession. On this challenging and hopeful path, let us be guided by patient reports, keep exploring, keep moving forward, and write a brilliant chapter of medicine.
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.
来源：老梁谈养生
