摘要：中医承载着千年的智慧与经验，从古老的《黄帝内经》到李时珍的《本草纲目》，一代又一代的医者在这条道路上探索前行，书写着属于自己的传奇。而当我们深入探寻中医的奥秘时，会发现不同年龄阶段的中医，有着截然不同却又紧密相连的诊疗风格，恰似人生在不同阶段展现出的独特魅力。
中医承载着千年的智慧与经验，从古老的《黄帝内经》到李时珍的《本草纲目》，一代又一代的医者在这条道路上探索前行，书写着属于自己的传奇。而当我们深入探寻中医的奥秘时，会发现不同年龄阶段的中医，有着截然不同却又紧密相连的诊疗风格，恰似人生在不同阶段展现出的独特魅力。
三十而立：精准为刃，初露锋芒
三十岁，对于一位中医而言，是踏上征程的起点，是积累与沉淀的关键时期。此时的他们，如同怀揣着珍贵地图的探险家，在中医的浩瀚海洋中，努力寻找着正确的方向。
这个阶段的中医，以“准”字为要诀。他们遍读百家经典著作，从《伤寒杂病论》的辨证论治，到《温热论》的温病辨析，每一部经典都如同一把钥匙，开启着他们对中医理论深入理解的大门。据统计，一位三十岁左右的中医，在初入行时，每年研读的经典书籍平均超过十本，记录的笔记多达数万字。他们深知，只有将经典理论烂熟于心，才能在临床实践中做到辨证求本，遣方用药准确无误。
在临床诊疗中，他们谨小慎微，如同在钢丝上行走的舞者，每一步都小心翼翼。半日读书，半日临症，多临床、多脉诊，是他们提升技能的必经之路。记得有一位三十岁的中医，在面对一位患有顽固性咳嗽的患者时，并没有急于开方用药，而是通过详细的问诊和细致的脉诊，反复斟酌，最终确定是外感风寒，内有痰湿所致。他严格按照药典规定的药物剂量开方，理法方药丝丝入扣。经过一段时间的治疗，患者的咳嗽症状明显减轻。这位中医深知，每一次的诊断和用药，都是一次学习和成长的机会，只有不断总结经验，才能在中医的道路上走得更远。
三十岁的中医，就像一颗刚刚发芽的种子，虽然稚嫩，但却充满了生机和希望。他们在这个阶段，努力吸收着中医知识的养分，为未来的成长打下坚实的基础。
四十不惑：狠招制胜，独辟蹊径
当中医步入四十岁，他们已经积累了相当丰富的临床经验，如同一位身经百战的将军，在战场上能够运筹帷幄，决胜千里。
这个时期的中医，诊疗特点多“狠招”。经过多年的临床实践，他们治疗疾病的面和病案已经达到一定的数量，对中医的基本功和各种诊疗方法有了深入的理解和掌握。他们不再满足于传统的治疗方法，而是努力提升思维认知，熟练运用中医各个门派的诊疗特色，并将其付诸实践。同时，他们多旁及医源，广泛涉猎其他医学领域的知识，为自己的诊疗提供更多的思路和方法。
在医疗的各个维度，包括药方大小、药物剂量大小，他们都能逐渐体会到中医的博大精深。根据患者病情轻重与体质强弱，他们既能十面埋伏，采用多种治疗方法综合施治；又能单刀赴会，精准地找到问题的关键，一击即中。药势能大能小，能急能缓，既能扶正固本，又能力挽狂澜。
有一位四十岁的中医，曾遇到一位患有严重心脏病的患者，病情危急，多家医院都认为治疗难度极大。这位中医经过详细的诊断和分析，大胆地采用了大剂量的中药方剂，同时结合针灸等治疗方法，为患者进行综合治疗。在治疗过程中，他胆大心细，密切关注患者的病情变化，及时调整治疗方案。经过一段时间的努力，患者的病情逐渐好转，最终康复出院。这一案例充分展现了四十岁中医在诊疗中的狠招和出奇制胜的能力。
四十岁的中医，就像一把锋利的宝剑，在中医的战场上披荆斩棘，为患者带来生的希望。他们在这个阶段，不断突破自我，挑战极限，出奇制胜，用独特的诊疗方法书写着属于自己的辉煌。
五十知天命：稳健为基，厚积薄发
五十岁，对于中医来说，是达到了一种境界的标志。此时的他们，已经累积了足够多的医疗经验和理论思维方式，如同一位智者，在中医的道路上从容前行。
这个年龄的中医，诊疗风格以“稳”为主。他们具备丰富的诊疗经验和病例数量，无论是经度和纬度以及六合上下，都没有其不知不明的地方。在诊疗中，他们既要能够力挽狂澜，解决别人不能解决的难题；又要四平八稳，不急不缓，以稳健的方式推进治疗。
据相关数据显示，五十岁左右的中医在治疗急性病和慢性病时，患者的康复率明显高于年轻医生。这是因为他们在长期的临床实践中，积累了丰富的经验，能够根据患者的身体素质强弱，制定出个性化的治疗方案。他们不再用险招狠招出奇制胜，而是多考虑患者的长远利益，稳健推进，扶正祛邪，治病不留邪，久久固本，使之延年益寿。
有一位五十岁的中医，在治疗一位患有慢性肝病的患者时，并没有采用激进的治疗方法，而是通过调理患者的脾胃功能，增强患者的体质，逐步改善患者的肝脏功能。在治疗过程中，他耐心细致，根据患者的病情变化及时调整药方。经过长时间的治疗，患者的病情得到了有效控制，身体也逐渐恢复了健康。这位中医深知，稳健的治疗方式虽然看似缓慢，但却能够从根本上解决问题，为患者带来长期的健康。
五十岁的中医，就像一座巍峨的高山，沉稳而坚定。任凭风吹浪打，汝自岿然不动！定力慧力具足，他们在这个阶段，用自己的经验和智慧，为患者撑起一片健康的天空。
中医之路，犹如一场漫长而精彩的旅程。三十岁的中医，精准为刃，初露锋芒；四十岁的中医，狠招制胜，独辟蹊径；五十岁的中医，稳健为基，厚积薄发。不同年龄阶段的中医，有着不同的诊疗风格，但他们都怀揣着对中医的热爱和对患者的责任，在这条道路上不断前行。他们用自己的智慧和汗水，传承着中医的千年文化，为人类的健康事业做出了巨大的贡献。让我们向这些默默奉献的中医们致敬，期待他们在未来的道路上创造更多的奇迹。
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: 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.
来源：老梁谈养生
