中醫臨床辨證診斷術語之共識
張恒鴻
台灣中醫診斷學會
台灣中醫學界近年來積極發展現代化的學術架構與臨床技能訓練，然而臨床醫師對中醫診斷辨證的定義與解釋卻不盡相同。為使病患獲得明確且系統化的中醫診療服務，整合醫界共識，建立統一的診斷規範，應是台灣中醫界的當務之急。因此，本研究擬透過一系列的溝通研討方式，建構中醫辨證診斷術語之涵義和臨床應用共識。
中醫臨床診斷以辨病與辨證為主，目前辨病結合現代醫學的診斷，更為明確客觀；辨證是以中醫四診症狀的擷取為依據，來進行病機的分析，因此中醫四診決定了辨證的精準度與一致性。近年台灣和大陸學者對證候診斷基準的研究作出了許多貢獻，然而卻一直沒有在廣大的醫療服務線上建立共識，更遑論標準化。臨床上仍舊依賴醫者的學識與經驗，因而在中醫臨床研究上，嚴重影響論文的品質及中醫學術的傳承與發展。
醫者要識病之根源，就必須明白掌握望聞問切的診斷技巧，並將所獲取的症狀進行病機的分析，即所謂的四診合參，則臨床的識病辨證才能萬舉萬當。「明斯診道」，就是要讓讓醫者對辨證能有一致性與客觀性，以提高診斷的精準度，因此應建立中醫診斷辨證作業或其臨床共識，逐步建構中醫臨床的共通語言，進一步使得未來的「量化」與「國際化」工作成為可能，當大量的研究成果都植基於一致化、標準化的操作後，更能有助於趨近實證醫學的境界。
本研究期望透過辨證作業流程，由臨床醫師組成專家小組取得辨證術語之涵義和臨床應用之共識，定期集會研討，舉辦全國性的中醫辨證術語涵義和臨床應用之研討會，以逐步凝聚台灣中醫界之共識。
關鍵字：中醫、術語、診斷、性別議題
The consensus on TCM terminology for clinical pattern diagnosis
Hen-Hong Chang
Formosan Association of Clinical Diagnosis in Traditional Chinese Medicine
Traditional Chinese medicine (TCM) needs accurate pattern diagnosis to provide precise medical services. The consensus for pattern diagnosis is the critical mission for TCM professionals in Taiwan.
TCM diagnosis mainly focus on disease diagnosis and pattern identification. The disease diagnosis in TCM comply with the diagnosis of modern medicine for global understanding. While pattern identification, according to the four examinations, is used to analyze the pathomechanism in TCM. The definition for symptom and sign determine the accuracy and consistency of pattern identification. In recent years, TCM scholars made sound contributions to the benchmark for pattern identification, but there still lack of consensus and golden standard. Pattern identification in TCM depends on the experience and knowledge of experts, and it seriously affects the research and academic development in TCM.
In order to achieve the consensus on the clinical application for pattern diagnosis, a panel for TCM experts will develop the process for the standardization of pattern identification. There will be regular meetings for discussion. A seminar will be held to get the opinions through the participants from all the TCM institutions in Taiwan.
關鍵字：TCM; pattern; diagnosis; the issues of gender
