Construction and Interpretation of the Four-Dimensional Differentiation and Treatment Model in Traditional Chinese Medicine Clinical Practice
10.13288/j.11-2166/r.2026.13.017
- VernacularTitle:中医临床“四维辨治”模式的构建与阐释
- Author:
Qingguo WANG
1
;
Xueqian WANG
1
;
Fafeng CHENG
1
Author Information
1. Beijing University of Chinese Medicine，Beijing，100029
- Publication Type:Journal Article
- Keywords:
disease;
syndrome;
symptom;
tendency;
traditional Chinese medicine clinical decision making
- From:
Journal of Traditional Chinese Medicine
2026;67(13):1455-1460
- CountryChina
- Language:Chinese
-
Abstract:
It is argued that current clinical practice of traditional Chinese medicine （TCM） is plagued by several drawbacks， including overemphasis on syndrome differentiation while neglecting disease definition， insufficient integration with modern medicine， and inadequate prediction of disease progression. These problems originated from inadequate inheritance of ZHANG Zhongjing's integrated thinking of "disease-syndrome-treatment". By returning to the original logical framework of "differentiating the pulse， symptoms and treatment of specific diseases" from Treatise on Febrile and Miscellaneous Diseases （《伤寒杂病论》）， reaffirming the guiding role of disease in diagnosis and treatment， and incorporating modern objective indicators as well as laws governing disease progression， a four-dimensional diagnosis-treatment model named "disease-syndrome-symptom-disease tendency" is established， which integrated the four-dimensional connotation with a three-step clinical pathway of "observing pulses and manifestations → identifying pathological disorders → administering individualized treatment based on syndromes". Centered on symptoms as the starting point， diseases as the guiding framework， syndromes as the core， and disease tendency as the therapeutic orientation， this model intends to rectify biases in clinical syndrome differentiation， align with contemporary diagnostic and therapeutic criteria， and implement the TCM thinking of "treat disease before it arises"， which provides theoretical support for the transformation of TCM clinical decision-making from empirical pattern toward precision-oriented practice.
