從「動態認知邏輯」的觀點看《金匱要略》「方證論治系統」

Investigation of “Prescriptions Based upon Syndromes Treatment System” from Dynamic Epistemic Logic Perspective

「方證論治系統」是指中醫臨床以尋求「方證相應」為宗旨的診療疾病的系列活動。它可能是中醫診療疾病的最早形式，也可能是一種最簡潔最有效的方法，被譽為中醫學經典的中醫臨床醫學奠基之作——《金匱要略》即是「證—方」的診療模式。時至今日，「證—方」的診療模式仍有效的指導著中醫臨床實踐。動態認知過程是一個多主體的系統，在醫病關係中的主體是：中醫師和病人。最初，中醫師對病人的症狀處於「無知」的狀態；中醫師通過「望、聞、問、切」這樣的行為，從而得知病人症候的各種事實，這是一個資訊積累的過程。這一過程是通過醫病兩個主體之間的互動實現的，這個互動包含了訊息更新情況、步驟的先後、步驟的選擇……等，這為中醫診療方法和過程提供了一個新的視角。

“Dialectic-prescription diagnostic system” is a series of diagnostic processes with seeking “dialectic-prescriptions correspondence” as its primary goal for treatments of diseases. It may be the earliest diagnostic method of diseases as well as the most concise and effective diagnostic method in Chinese medicine. “Synopsis of Golden Chamber”, known as one of the classical foundational texts in Chinese clinical medicine, also uses “dialectic-prescription diagnostic method” clinically. Until today, the “proof-prescription” diagnostic system is still effectively guiding Chinese medical field of practice clinically. Dynamic epistemic process is a multi-agent system. The agents in the system are Traditional Chinese doctor and patients. Traditional Chinese doctor knows nothing about patients’ syndromes. Traditional Chinese doctor can get various facts about patients’ syndromes through inspection, listening and smelling examination, inquiry and palpation. This is a process of accumulating information. It is achieved through the interaction between two agents. The interaction includes information update, the order of the steps, the choice of the steps and etc. This provides a new angel for Traditional Chinese doctor treatment methods and processes.