Analysis of Diagnostic Methods, Etiology and Pathogenesis of Traditional Chinese Medicine

Huang Qikun, Wu Jinni ^*

Cuixi Academy of Biotechnology, Zhuji, 311800

*Corresponding author, 2314548193@qq.com

Abstract The diagnostic methods and pathogenesis theory of traditional Chinese medicine are one of the core contents of traditional Chinese medicine. Through the comprehensive application of the four diagnostic methods, pulse diagnosis, tongue diagnosis, etc., doctors can obtain more comprehensive and accurate diagnostic information, thus formulating more scientific and personalized treatment plans. The theory of etiology and pathogenesis provides doctors with a basic theory for treating diseases, enabling them to better understand the essence and development laws of diseases, and formulate corresponding treatment plans. Although the diagnostic methods and pathogenesis theories of traditional Chinese medicine play an important role in clinical practice, they still need to be better adapted to the needs of modern medicine through long-term practice and continuous improvement. This review aims to explore the diagnostic methods and pathogenesis theories of traditional Chinese medicine, provide reference and reference for the development of traditional Chinese medicine, and contribute to the promotion of traditional Chinese medicine and the inheritance of Chinese culture.

Keywords Diagnostic method; Causationism; Five elements' motion and six kinds of natural factors; Future development

Traditional Chinese medicine, as a treasure of traditional medicine, has a long history and profound traditional background. It has a long history and can be traced back to ancient times. After thousands of years of development and evolution, it has formed a unique theoretical system and treatment methods. Traditional Chinese medicine, with its unique inspection methods and dialectical treatment theory, has provided valuable experience and wisdom for the health of the Chinese people for thousands of years.

中医药作为中国传统医学的瑰宝，拥有悠久的历史和深厚的传统背景。其源远流长，可追溯至上古时代，历经千百年的发展与演变，形成了独特的理论体系和治疗方法。中医药以其独特的观察方法和辨证施治理论，为千百年来的中国人民健康提供了宝贵的经验和智慧。

The diagnostic methods of traditional Chinese medicine are mainly based on the four diagnostic methods, namely inspection, listening and smelling examination, inquiry, palpation. The four diagnostic methods are the foundation of traditional Chinese medicine diagnosis. By observing the patient's external manifestations and internal changes, combined with information such as medical history, symptoms, and signs, the nature and severity of the disease can be determined. The theory of etiology and pathogenesis in traditional Chinese medicine emphasizes the fundamental causes and pathogenesis of diseases, believing that the occurrence and development of diseases are a combination of multiple factors, such as changes in the internal and external environment of the human body, emotional factors, and improper diet. With the rapid development and technological progress of modern medicine, the position and value of traditional Chinese medicine in the field of modern medicine are increasingly valued.

中医药的诊断方法以四诊法为主要手段，即望诊、闻诊、问诊、切诊。四诊法是中医药诊断的基础，通过观察病人的外部表现和内在变化，结合病史、症状和体征等信息，以此来判断疾病的性质和严重程度。中医药的病因病机理论则强调疾病的根本原因和发病机制，认为疾病的发生和发展是由多种因素综合作用而成的，如人体内外环境的变化、情志因素、饮食不当等。随着现代医学的快速发展和科技进步，中医药在现代医学领域中的地位和价值日益受到重视。

However, the diagnostic methods and pathogenesis theories of traditional Chinese medicine also have certain limitations and shortcomings. On the one hand, the diagnostic methods and pathogenesis theories of traditional Chinese medicine require long-term practice and continuous improvement in order to better adapt to the needs of modern medicine. On the other hand, the diagnostic methods and pathogenesis theories of traditional Chinese medicine also need to be better integrated with modern medical theories in order to better serve human health. Therefore, this review will provide a detailed introduction to the diagnostic methods of traditional Chinese medicine, including the four diagnostic methods (inspection, listening and smelling examination, inquiry, palpation), pulse diagnosis, tongue diagnosis, face diagnosis, etc., exploring their principles and applications, elucidating the unique features of traditional Chinese medicine diagnostic methods, and conducting a detailed exploration of the etiology and pathogenesis theory of traditional Chinese medicine, revealing the fundamental causes of traditional Chinese medicine treatment, and providing scientific basis for the clinical practice of traditional Chinese medicine. Deeply explore the diagnostic methods and pathogenesis theories of traditional Chinese medicine, provide new ideas and methods for the application of traditional Chinese medicine in modern medicine, and further expand the role and value of traditional Chinese medicine in human health. This will help promote the integration of traditional Chinese medicine and modern medicine, making greater contributions to human health and well-being.

然而，中医药的诊断方法和病因病机理论也存在一定的局限性和不足。一方面，中医药的诊断方法和病因病机理论需要经过长期的实践和不断的改进才能更好地适应现代医疗的需求。另一方面，中医药的诊断方法和病因病机理论也需要更好地与现代医学理论相结合，以便更好地为人类健康服务。因此，本综述将详细介绍中医药的诊断方法，包括四诊法(望、闻、问、切)、脉诊、舌诊、面诊等，探讨其原理和应用，阐明中医药诊断方法的独特之处，并对中医药病因病机理论进行详细的探讨，揭示中医药治疗的根本原因，为中医药的临床实践提供科学依据。深入探析中医药的诊断方法和病因病机理论，为中医药在现代医学中的应用提供新的思路和方法，进一步拓展中医药在人类健康事业中的作用和价值。这将有助于促进中医药与现代医学相互融合，为人类的健康福祉做出更大的贡献。

1 Diagnostic Methods of Traditional Chinese Medicine

1.1 The principle and application of the four diagnostic methods

The four diagnosis method is the basic diagnostic method of traditional Chinese medicine, which is an important means for herbalist doctor to judge the condition and differentiate symptoms, including inspection, listening and smelling examination, inquiry, palpation (Figure 1), to identify the mechanism, location, nature, severity, and prognosis of the disease.

1中医药诊断方法

1.1四诊法的原理和运用

四诊法是中医药的基本诊断方法，是中医医生用来判断病情和辨证的重要手段，包括望诊、闻诊、问诊、切诊四个方面(图1)，来辨别疾病发生的机理、部位、性质、轻重以及预后情况等。

图 1 四诊法 Figure 1 Four diagnostic methods

Inspection is the process of obtaining diagnostic information by observing the patient's appearance and physical condition. Herbalist doctor will carefully observe the changes in the patient's facial color, tongue coating, tongue texture, and eyes. For example, a pale complexion may indicate insufficiency of qi and blood, and a rosy tongue may indicate fever, etc. Through inspection, herbalist doctor can preliminarily determine the condition and distinguish the types of diseases and syndromes. listening and smelling examination is the process of obtaining diagnostic information by listening to the patient's voice, breathing, coughing, and other sounds. For example, whether a patient's cough sounds include phlegm or wheezing can reflect different changes in the condition. By smelling and diagnosing, herbalist doctor can understand the patient's qi and blood status and changes in visceral function. Consultation is the process of conducting detailed conversations with patients to understand their condition and symptoms. herbalist doctor will inquire about patients' medical history, symptoms, pain, dietary habits, and other information. Through consultation, herbalist doctor can obtain more detailed information on the condition, help with syndrome differentiation and determine treatment plans. Palpation is the process of obtaining diagnostic information by palpating the patient's pulse. herbalist doctor will carefully touch the patient's pulse to understand changes in pulse frequency, rhythm, strength, and texture. Based on different changes in pulse, herbalist doctor can determine the patient's visceral function, qi and blood status, as well as the severity of the condition (Kang et al., 2015; Li et al., 2022).

望诊是通过观察患者的外表特征和身体状态来获得诊断信息。中医医生会仔细观察患者的面色、舌苔、舌质、目睛等方面的变化。例如，苍白的面色可能暗示气血不足，红润的舌质可能表示热症等。通过望诊，中医医生可以初步判断病情，辨别病证的类型。闻诊是通过听取患者的声音、呼吸、咳嗽等声音来获得诊断信息。例如，患者的咳嗽声音是否有痰鸣、气喘等，都能反映出病情的不同变化。通过闻诊，中医医生可以了解患者的气血状况和脏腑功能的变化。问诊是通过与患者进行详细的交谈来了解病情和症状。中医医生会询问患者的病史、症状、疼痛情况、饮食习惯等方面的信息。通过问诊，中医医生可以获取更详细的病情资料，帮助辨证和确定治疗方案。切诊是通过触诊患者的脉搏来获得诊断信息。中医医生会仔细触摸患者的脉搏，了解脉搏的频率、节律、力度和质地等变化。根据脉搏的不同变化，中医医生可以判断患者的脏腑功能和气血状况，以及病情的轻重缓急(Kang et al., 2015; Li et al., 2022)。

The four diagnostic methods are complementary in traditional Chinese medicine diagnosis. By comprehensively analyzing the information of the four diagnostic methods, herbalist doctor can comprehensively understand the patient's condition and make accurate diagnosis and treatment decisions. The four diagnosis method is a unique diagnostic method in traditional Chinese medicine, with rich clinical experience and a unique theoretical system. It is one of the important skills of herbalist doctor. In the practice of traditional Chinese medicine, the application of the four diagnostic methods is indispensable, which helps to improve the diagnostic level and treatment effectiveness of herbalist doctor.

四诊法在中医诊断中是相辅相成的，通过综合分析四诊的信息，中医医生可以全面了解患者的病情，做出准确的辨证和治疗决策。四诊法是中医独有的诊断方法，具有丰富的临床经验和独特的理论体系，是中医医生的重要技能之一。在中医药的实践中，四诊法的应用是不可或缺的，有助于提高中医医生的诊断水平和治疗效果。

1.2 The role of pulse diagnosis and tongue diagnosis in traditional Chinese medicine diagnosis

Pulse diagnosis and tongue diagnosis are two important diagnostic methods in traditional Chinese medicine, and they play an extremely important role in clinical practice of traditional Chinese medicine. Pulse diagnosis is the process of touching a patient's pulse to understand changes in pulse conditions, in order to reflect the function of the patient's internal organs, qi and blood status, and changes in the patient's condition; Tongue diagnosis, on the other hand, involves observing the patient's tongue coating and texture to understand their physical condition, visceral condition, and disease manifestations. These two diagnostic methods are unique techniques of traditional Chinese medicine, with a long history and rich clinical experience, and are one of the important basis for traditional Chinese medicine diagnosis (Wang et al., 2014).

1.2脉诊与舌诊在中医诊断中的作用

脉诊与舌诊是中医诊断中两种重要的诊断方法，它们在中医临床实践中发挥着极为重要的作用。脉诊是通过触摸患者的脉搏，了解脉象的变化，以反映患者体内脏腑功能、气血状况和病情变化；而舌诊则是通过观察患者的舌苔和舌质，来了解患者体质、脏腑状况和疾病表现。这两种诊断方法都是中医独有的技术，具有悠久的历史和丰富的临床经验，是中医诊断的重要依据之一(Wang et al., 2014)。

Pulse diagnosis is one of the important methods for syndrome differentiation in traditional Chinese medicine. According to the different changes in pulse, herbalist doctor can determine the patient's visceral function and qi and blood status, and then make a decision on syndrome differentiation and treatment (Figure 2). For example, a weak pulse may indicate qi deficiency, and a slippery pulse may indicate dampness and heat. Pulse diagnosis can help herbalist doctor understand the severity of a patient's condition. The changes in pulse speed, strength, and weakness can reflect the acute or chronic degree of the disease, which helps herbalist doctor formulate corresponding treatment plans. Pulse diagnosis can be used to observe the therapeutic effect. During the treatment process, herbalist doctor can understand whether the treatment is effective by palpating changes in pulse, which helps to adjust the treatment plan in a timely manner. Pulse diagnosis can be used to observe the therapeutic effect. During the treatment process, herbalist doctor can understand whether the treatment is effective by palpating changes in pulse, which helps to adjust the treatment plan in a timely manner.

脉诊是中医辨证的重要方法之一。根据脉搏的不同变化，中医医生可以判断患者的脏腑功能和气血状况，进而作出辨证施治的决策(图2)。例如，脉搏细弱可能暗示气虚，脉搏滑数可能暗示湿热等。脉诊可以帮助中医医生了解患者病情的轻重缓急。脉搏的快慢、强弱、有无力等变化，可以反映疾病的急性或慢性程度，有助于中医医生制定相应的治疗方案。脉诊可以用于观察治疗效果。在治疗过程中，中医医生可以通过触诊脉搏的变化，了解治疗是否有效，有助于及时调整治疗方案。脉诊可以用于观察治疗效果。在治疗过程中，中医医生可以通过触诊脉搏的变化，了解治疗是否有效，有助于及时调整治疗方案。

图 2 脉诊 Figure 2 Pulse diagnosis

Tongue diagnosis is one of the important basis for traditional Chinese medicine syndrome differentiation. The color, thickness, dampness, and dryness of the tongue coating, as well as the changes in the shape and color of the tongue material, can reflect the patient's condition and constitution, which is helpful for herbalist doctor in dialectical treatment. Tongue diagnosis can help herbalist doctor understand the severity of a patient's condition. The thickness and color of the tongue coating, as well as the degree of dryness of the tongue, can reflect the acute or chronic severity of the disease. Tongue diagnosis can be used to observe the therapeutic effect. During the treatment process, herbalist doctor can observe the changes in tongue coating and tongue substance to understand whether the treatment is effective, which helps to adjust the treatment plan in a timely manner. Tongue diagnosis can also be used to remind patients to pay attention to their own health status. Traditional Chinese medicine believes that changes in tongue coating and tongue texture are closely related to the health status of the body. Patients can understand their own health status and take timely measures by observing their own tongue coating and tongue texture.

舌诊是中医辨证的重要依据之一。舌苔的颜色、厚薄、湿燥等特征，舌质的形态、颜色等变化，都可以反映患者的病情和体质，有助于中医医生进行辨证施治。舌诊可以帮助中医医生了解患者病情的轻重缓急。舌苔的厚薄、颜色，舌质的湿燥程度等变化，可以反映疾病的急性或慢性程度。舌诊可用于观察治疗效果。在治疗过程中，中医医生可以通过观察舌苔和舌质的变化，了解治疗是否有效，有助于及时调整治疗方案。舌诊也可以用于提醒患者注意自身健康状况。中医认为舌苔和舌质的变化与体内的健康状况密切相关，患者可以通过观察自己的舌苔和舌质，了解自身的健康状况并及时采取措施。

Pulse examination and tongue examination are two indispensable and important methods in traditional Chinese medicine diagnosis. They complement and confirm each other, helping herbalist doctor comprehensively understand the patient's condition and constitution, and thus carry out accurate diagnosis and treatment. The application of pulse and tongue diagnosis can help improve the diagnostic level of herbalist doctor and ensure that patients receive better treatment outcomes. Meanwhile, with the progress of modern technology, the application of pulse and tongue diagnosis is constantly innovating and developing, providing new possibilities for the modernization of traditional Chinese medicine (Zhang et al., 2021).

脉诊与舌诊是中医诊断中不可或缺的两种重要方法，它们相辅相成，互相印证，帮助中医医生全面了解患者的病情和体质，从而进行准确的辨证施治。脉诊和舌诊的应用可以帮助提高中医医生的诊断水平，确保患者得到更好的治疗效果。同时，随着现代科技的进步，脉诊和舌诊的应用也在不断创新和发展，为中医药的现代化发展提供了新的可能性(张钰莹等, 2021)。

1.3 The skills and applications of traditional Chinese medicine face diagnosis and symptom diagnosis

Traditional Chinese-medical face diagnosis and symptom diagnosis is one of the important methods in traditional Chinese medicine diagnosis, which obtains diagnostic information by carefully observing the patient's facial features and physical symptoms.

1.3中医面诊与症状诊断的技巧与应用

中医面诊与症状诊断是中医诊断中重要的方法之一，它是通过仔细观察患者的面部特征和身体症状，来获取诊断信息。

During face diagnosis, herbalist doctor carefully observe the patient's complexion, including whether it is rosy, pale, or yellowish red. Changes in complexion can reflect the state of qi, blood, and visceral function. Observing the patient's eyes, including their brightness, expression, and whether the lacrimal sac is swollen, can reflect the patient's mental state and liver and kidney function. Observe the patient's lip color, including whether it is rosy, pale, or dark purple. Changes in lip color can reflect qi, blood, and heart and lung function. Observing the patient's nasal shape, including whether the nasal tip is red and swollen, and whether the nasal wings are open, changes in nasal shape can reflect lung function and fluid metabolism. Observing the color and shape of the patient's earlobe can reflect renal function and blood circulation.

在面诊中，中医医生会仔细观察患者的面色，包括面色是否红润、苍白、黄赤等，面色变化可以反映气血和脏腑功能的状态。观察患者的眼睛，包括眼睛的亮度、神采、泪囊是否浮肿等，这些可以反映患者的精神状态和肝肾功能。观察患者的唇色，包括唇色是否红润、苍白、紫暗等，唇色变化可以反映气血和心肺功能。观察患者的鼻形，包括鼻尖是否红肿、鼻翼是否张开等，鼻形变化可以反映肺功能和水液代谢。观察患者的耳垂颜色和形态，耳垂颜色变化可以反映肾功能和血液循环。

In symptom diagnosis, herbalist doctor will carefully inquire about the patient's symptoms, including the main complaint, medical history, pain location, nature, and degree, in order to comprehensively understand the condition. Through detailed inquiries, herbalist doctor will identify the causes, including the impact of factors such as diet, emotions, and environment on the condition. herbalist doctor will analyze the relationship between symptoms and determine the pathogenesis, including the invasion of pathogenic factors and dysfunction of visceral functions. Based on the characteristics of symptoms, herbalist doctor will determine the nature of the disease, including cold, heat, deficiency, and excess, providing a basis for treatment.

在症状诊断中，中医医生会仔细询问患者的症状，包括主诉、病史、疼痛部位、性质和程度等，以全面了解病情。通过详细询问，中医医生会辨别病因，包括饮食、情志、环境等因素对病情的影响。中医医生会分析症状之间的关系，判断病机，包括病邪的入侵、脏腑功能的失调等。根据症状特点，中医医生会判断疾病的性质，包括寒、热、虚、实等，为治疗提供依据。

Through face diagnosis and symptom diagnosis, herbalist doctor can perform syndrome differentiation and treatment, that is, based on the patient's facial features and symptoms, determine the pathogenesis of the disease, and then choose corresponding treatment methods. Traditional Chinese medicine face diagnosis and symptom diagnosis can also be used for disease prevention. By observing facial features and symptoms, herbalist doctor can identify patients' physical weaknesses and potential health problems in advance, and take timely preventive measures. During the treatment process, herbalist doctor can observe the changes in facial features and symptoms of patients, judge the effectiveness of treatment, and adjust the treatment plan in a timely manner.

通过面诊和症状诊断，中医医生可以进行辨证施治，即根据患者的面部特征和症状，判断疾病的病机，然后选用相应的治疗方法。中医面诊和症状诊断也可以用于疾病的预防。通过观察面部特征和症状，中医医生可以提前发现患者的体质弱点和潜在的健康问题，及时采取预防措施。在治疗过程中，中医医生可以通过观察患者的面部特征和症状的变化，判断治疗的效果，及时调整治疗方案。

Traditional Chinese medicine face diagnosis and symptom diagnosis are important methods of traditional Chinese medicine diagnosis. They comprehensively utilize various information to help herbalist doctor comprehensively understand the patient's condition and physique, so as to carry out accurate diagnosis and treatment, improve treatment effectiveness and efficacy observation. At the same time, face and symptom diagnosis also provide important basis for disease prevention, which helps to improve the health level and quality of life of patients.

中医面诊和症状诊断是中医诊断的重要方法，它综合运用多方面的信息，有助于中医医生全面了解患者的病情和体质，从而进行准确的辨证施治，提高治疗效果和疗效观察。同时，面诊和症状诊断也为疾病预防提供了重要的依据，有助于提高患者的健康水平和生活质量。

2 The Theory of Etiology and Pathogenesis of Traditional Chinese Medicine

2.1 The basic concept and classification of traditional Chinese medicine etiology

Traditional Chinese medicine etiology is an important component of traditional Chinese medicine, which studies the causes and laws of disease formation and development. The basic concept of traditional Chinese medicine etiology is "causality", which believes that diseases are the result of the interaction between internal and external factors. In traditional Chinese medicine etiology, etiology is mainly divided into two categories: external causes and internal causes.

2中医药的病因病机理论

2.1中医病因学的基本理念和分类

中医病因学是中医学的重要组成部分，它研究疾病形成的原因和发展的规律。中医病因学的基本理念是“因果论”，认为疾病是由于内外因素的相互作用而产生的结果。在中医病因学中，病因主要分为外因和内因两大类。

The external causes can be divided into evil invasion and traumatic injury. Exogenous diseases are caused by external pathogens invading the human body. External pathogens can be the six qi types of wind, cold, heat, dampness, dryness, and fire, which invade the human body under specific seasonal and environmental conditions, causing corresponding diseases. Trauma is caused by accidents or external forces that damage the structure of human tissues, leading to diseases. The internal causes can be divided into emotional disorders, improper diet, improper exercise, and congenital endowments. Emotions are the internal emotions and psychological states of the human body, and excessive emotional disorders such as worry, sadness, anger, and fear may lead to dysfunction of the internal organs, leading to diseases. Poor dietary habits, such as overeating and eating spicy and greasy foods, can damage the spleen and stomach, leading to digestive dysfunction. Excessive fatigue or lack of appropriate physical exercise can lead to dysfunction of the organs and poor circulation of qi and blood, leading to diseases. Congenital endowment refers to the genetic factors that affect the human body during fetal development, which have a certain impact on an individual's physical constitution and susceptibility to diseases. The comprehensive etiology can be divided into yang deficiency with cold coagulation, yin deficiency with excessive fire, and accumulation of dampness and heat. Yang deficiency and cold coagulation refer to the prolonged illness caused by insufficient Yang Qi and the invasion of cold pathogens, resulting in the weakness of Yang Qi. Yin deficiency and excessive fire refer to the symptoms caused by insufficient yin fluid and inflammation of fire evil, leading to yin deficiency and excessive fire. The accumulation of dampness and heat refers to the interaction between dampness and heat evil, which blocks the meridians and leads to complex conditions.

外因病因可分为邪气入侵和创伤损伤。外感疾病是由外邪侵袭人体而引起的。外邪可以是风、寒、暑、湿、燥、火等六气，它们在特定的时令和环境条件下侵入人体，引起相应的病症。外伤则是由于意外事故或外力的作用，导致人体组织结构的损伤，从而引发疾病。内因病因可分为情志失调、饮食不节、运动不当和先天禀赋。情志是人体内在的情绪和心理状态，过度的忧思、悲伤、愤怒、恐惧等情志失调可能导致脏腑功能失调，从而引起疾病。不良的饮食习惯，如暴饮暴食、过食辛辣油腻食物等，会损伤脾胃，导致消化功能失调。过度劳累或缺乏适当的体育锻炼，都可能导致脏腑功能失调和气血运行不畅，引发疾病。先天禀赋是指人体在胎儿发育阶段受到的遗传因素影响，对个体的体质和易患疾病有一定影响。综合因素病因可分为阳虚寒凝、阴虚火旺和湿热蕴结。阳虚寒凝是指由于阳气不足，寒邪内侵，导致阳气无力而使病势迁延。阴虚火旺是指由于阴液不足，火邪上炎，导致阴虚火旺而出现症状。湿热蕴结是指湿气和热邪相互作用，阻滞经络，导致病情复杂。

The classification of traditional Chinese medicine etiology is an important component of the theoretical system of traditional Chinese medicine, which is the foundation of diagnosis and treatment in traditional Chinese medicine. In clinical practice, herbalist doctor will comprehensively consider various factors such as the patient's external environment, physical condition, emotional state, dietary habits, etc., analyze the causes of the disease, in order to develop a reasonable treatment plan. At the same time, the concept of traditional Chinese medicine etiology also emphasizes the prevention and treatment of diseases, encouraging people to adjust their lifestyles and prevent the occurrence of diseases (Tang et al., 2008). The theory of etiology and pathogenesis in traditional Chinese medicine is a comprehensive, systematic, and dynamic theoretical system that provides strong theoretical basis for the diagnosis and treatment of traditional Chinese medicine. In practice, doctors need to develop personalized treatment plans based on the specific situation of patients, combined with the theory of etiology and pathogenesis, in order to maximize the treatment effect.

中医病因学的分类是中医学理论体系的重要组成部分，它是中医诊断和治疗的基础。在临床实践中，中医医生会综合考虑患者的外部环境、体质状况、情志状态、饮食习惯等多方面因素，分析疾病产生的原因，以便制定合理的治疗方案。同时，中医病因学的理念也强调疾病的防治，鼓励人们调整生活方式，预防疾病的发生(Tang et al., 2008)。中医学病因病机理论是一种全面、系统、动态的理论体系，它为中医学的诊断和治疗提供了有力的理论依据。在实践中，医生需要根据病人的具体情况，结合病因病机理论，制定个性化的治疗方案，以达到治疗效果的最大化。

2.2 The concept and main content of traditional Chinese medicine pathogenesis

Traditional Chinese medicine pathogenesis is one of the important disciplines in traditional Chinese medicine, which studies the occurrence, development, and pathological changes of diseases, mainly including etiology, pathogenesis, syndrome differentiation, and pathology (Tian et al., 2023). Traditional Chinese medicine pathogenesis is an important component of traditional Chinese medicine, which studies the occurrence, development, and pathological changes of diseases, providing an important theoretical basis for the differentiation, treatment, and treatment of traditional Chinese medicine. The study of traditional Chinese medicine pathogenesis not only helps to improve the diagnostic level and treatment effect of herbalist doctor, but also provides scientific basis and guidance for people's health.

2.2中医病机学的概念和主要内容

中医病机学是中医学中的重要学科之一，它是研究疾病的发生发展规律和病理变化的学科，主要包括病因学、病机学、辨证学和病理学(Tian et al., 2023)。中医病机学是中医学的重要组成部分，它研究疾病的发生发展规律和病理变化，为中医辨证施治和治疗提供重要的理论基础。中医病机学的研究不仅有助于提高中医医生的诊断水平和治疗效果，还为人们的健康提供了科学依据和指导。

Traditional Chinese medicine pathogenesis studies the causes of diseases, including internal and external factors. Internal factors mainly refer to internal factors in the human body, such as emotional disorders, improper diet, weak physique, etc., while external factors mainly refer to external factors such as the invasion of the six qi factors such as wind, cold, heat, dampness, dryness, and fire. Etiological research provides an important basis for the differentiation and treatment of traditional Chinese medicine. Pathogenesis is the study of the laws and mechanisms of disease occurrence and development, including the development process, course changes, pathological changes, etc. Traditional Chinese medicine believes that diseases are caused by dysfunction of the internal organs, poor circulation of qi and blood, resulting in an imbalance of yin and yang, forming the pathogenesis and ultimately leading to diseases. Syndrome differentiation is the core content of traditional Chinese medicine pathogenesis, which is the foundation of diagnosis and treatment in traditional Chinese medicine. Traditional Chinese medicine syndrome differentiation is the analysis of the etiology and pathogenesis of a disease based on the patient's symptoms and constitution, in order to determine a treatment plan. Traditional Chinese medicine syndrome differentiation can be divided into various types, such as the ‘Ba Gang’ Syndrome (eight-principle pattern identification), ‘Zang Fu’ Syndrome (viscera syndrome differentiation), ‘Qi Xue Jin Ye’ Syndrome (differentiation of qi, blood, and body fluid), etc. Each type has corresponding diagnostic criteria and treatment principles. Traditional Chinese medicine pathology studies the pathological changes and mechanisms of diseases. Traditional Chinese medicine pathology believes that the occurrence of diseases is due to dysfunction of the organs, leading to obstacles in the movement of qi, blood, and body fluids, resulting in pathological changes. The study of pathology helps to gain a deeper understanding of the essence and pathogenesis of diseases, providing scientific basis for traditional Chinese medicine treatment.

中医病机学研究疾病的病因，包括内因和外因。内因主要指人体内部的因素，如情志失调、饮食不节、体质弱等，而外因主要指外界的因素，如风、寒、暑、湿、燥、火等六气的侵袭。病因学研究为中医辨证施治提供了重要的依据。病机学是研究疾病发生发展的规律和机制，包括疾病的发展过程、病程变化、病理变化等。中医认为，疾病是由于脏腑功能失调，气血运行不畅，导致阴阳失衡，形成病机，从而引发疾病。辨证学是中医病机学的核心内容，它是中医诊断和治疗的基础。中医辨证是根据患者的症状和体质，分析疾病的病因病机，从而确定治疗方案。中医辨证可以分为八纲辨证、脏腑辨证、气血津液辨证等多种类型，每种类型都有相应的诊断标准和治疗原则。中医病理学研究疾病的病理变化和病理机制。中医病理学认为，疾病的发生是由于脏腑功能失调，导致气血津液的运行障碍，从而形成病理变化。病理学的研究有助于深入了解疾病的本质和病机，为中医治疗提供科学依据。

2.3 The relationship between five elements and six weathers and the etiology and pathogenesis of traditional Chinese medicine

Five elements and six weathers are important theories in traditional Chinese medicine etiology, closely related to the etiology and pathogenesis of traditional Chinese medicine. Five elements refer to the laws of the movement of the five elements of ‘Mu, Huo, Tu, Jin, Shui’ while six weatherss refers to the six climate changes of wind, cold, heat, humidity, dryness, and fire. Five elements, six weathers are closely related to the etiology and pathogenesis of traditional Chinese medicine, and together they constitute the theoretical system of traditional Chinese medicine etiology. In clinical practice, herbalist doctor will conduct comprehensive analysis and judgment based on the changes in five elements and six weathers, combined with the specific symptoms and constitution of patients, in order to develop a reasonable treatment plan based on syndrome differentiation, improve treatment effectiveness, and prevent the occurrence of diseases. At the same time, people can also take corresponding preventive and health care measures based on the changes in five elements and six weathers, promoting health and longevity.

2.3五运六气与中医病因病机的关系

五运六气是中医病因学中的重要理论，与中医病因病机密切相关。五运指的是金、木、水、火、土五行运行的规律，六气指的是风、寒、暑、湿、燥、火六种气候变化。五运六气与中医病因病机密切相关，它们共同构成了中医病因学的理论体系。中医医生在临床实践中，会根据五运六气的变化，结合患者的具体症状和体质，进行综合分析和判断，以便制定合理的辨证施治方案，提高治疗效果和预防疾病的发生。同时，人们也可以根据五运六气的变化，进行相应的预防保健，促进健康和长寿。

Five elements and six weathers are natural climate change patterns that directly affect the physiological and pathological changes of the human body. The theory of etiology and pathogenesis in traditional Chinese medicine believes that the invasion of external pathogens is one of the main causes of diseases. The changes in five elements and six weatherss can affect the body's resistance and adaptability. When the body has poor adaptation or decreased resistance, it is easy to be attacked by external pathogens, leading to diseases. According to the changes in five elements and six weathers, herbalist doctor will differentiate and treat patients based on their specific symptoms and constitution. For example, in summer, due to the influence of heat, fever is prone to occur, and treatment should be carried out to clear heat and detoxify; In winter, due to the influence of cold, it is easy for cold pathogens to invade, and treatment should be carried out by warming the interior and dispersing the cold. The changes in the five elements and six weatherss also remind people to adjust their lifestyle and carry out corresponding preventive health care. For example, in spring, it is easy to be attacked by wind evil, so clothing can be added appropriately to avoid catching a cold (Figure 3); In autumn, it is easy to be affected by dryness. You can drink plenty of water to keep your skin moist.

五运六气是自然界的气候变化规律，直接影响着人体的生理和病理变化。中医病因病机理论认为，外邪入侵是引起疾病的主要原因之一。五运六气的变化可以影响人体的抵抗力和适应能力，当人体适应不良或抵抗力下降时，容易受到外邪的侵袭，从而引发疾病。根据五运六气的变化，中医医生会根据患者的具体症状和体质，辨证施治。例如，在夏季由于暑热的影响，容易出现热病，治疗时要清热解毒；而在冬季由于寒冷的影响，容易出现寒邪内侵，治疗时要温里散寒。五运六气的变化也提醒人们应该调整生活方式，进行相应的预防保健。例如，在春季容易受到风邪的侵袭，可以适当增加衣物，避免感冒(图3)；在秋季容易受到干燥的影响，可以多喝水，保持皮肤湿润。

图 3 感冒 Figure 3 Cold

3 Future Development and Challenges of Traditional Chinese Medicine

3.1 The development and evolution of traditional Chinese medicine diagnosis method theory

The development of traditional Chinese medicine diagnostic methods has undergone a long historical evolution and accumulation. From the initial observation and understanding of nature, to the theoretical establishment of classical medicine, to the formation of the medical school and the accumulation of medical experience, it continuously enriches and develops. These traditional diagnostic methods still have important value and applications in modern medicine, serving people's health (Li et al., 2021).

3中医药的未来发展与挑战

3.1中医药诊断方法理论的发展演变

中医诊断方法的发展经历了漫长的历史演变和积累。从最初的自然观察和认识，到经典医学阶段的理论建立，再到医家学派的形成和医学经验的积累，不断丰富和发展。这些传统诊断方法在现代医学中仍具有重要的价值和应用，为人们的健康服务(李金霞等, 2021)。

The early diagnostic methods of traditional Chinese medicine were mainly based on people's observation and understanding of the natural environment and human physiology. Ancient physicians identified the causes and mechanisms of diseases based on changes in weather conditions, natural phenomena, and patient symptoms. With the gradual formation of traditional Chinese medicine theory, a series of important medical classics have emerged, such as Huánɡdì Nèijīnɡ (Inner Canon of Huangdi), Nán Jīnɡ (Classic on Medical Problems), etc. These classics provide an important theoretical foundation for the development of traditional Chinese medicine diagnostic methods, systematically elaborating on the theory and practice of diagnostics. At different periods in Chinese history, a group of famous traditional Chinese medicine practitioners emerged, such as Zhang Zhongjing, Wang Shuhe, etc. They summarized their experience in clinical practice and formed different schools of thought and diagnostic methods. For example, Zhang Zhongjing's syndrome differentiation and treatment method has become one of the important methods for traditional Chinese medicine diagnosis and treatment. With the development of traditional Chinese medicine and the accumulation of clinical practice, the diagnostic methods of traditional Chinese medicine have been continuously enriched and developed. Doctors from various regions have summarized and innovated, forming many distinctive local diagnostic methods. Since modern times, traditional Chinese medicine has gradually integrated with modern medicine, and some modern scientific technologies have been applied to traditional Chinese medicine diagnosis, such as medical imaging and laboratory examinations. Meanwhile, some traditional diagnostic methods of traditional Chinese medicine have been re evaluated and applied, providing new ideas and methods for the development of modern medicine.

早期的中医诊断方法主要是基于人们对自然环境和人体生理的观察和认识。古代医家根据天候变化、自然现象和患者的症状表现，辨识疾病的原因和病机。随着中医学理论的逐步形成，一系列重要的医学经典出现，如《黄帝内经》、《难经》等。这些经典为中医诊断方法的发展提供了重要的理论基础，系统地阐述了诊断学的理论和实践。在中国历史的不同时期，出现了一批著名的中医医家，如张仲景、王叔和等，他们在临床实践中总结经验，形成了不同的学派和诊断方法。例如，张仲景的辨证施治法成为中医诊断和治疗的重要方法之一。随着历代医家的发展和临床实践的积累，中医诊断方法不断丰富和发展。各地医家纷纷总结和创新，形成了许多特色鲜明的地方性诊断方法。近现代以来，中医学逐渐与现代医学融合，一些现代科学技术应用于中医诊断，如医学影像学、实验室检查等。同时，一些传统的中医诊断方法得到了重新评估和应用，为现代医学的发展提供了新的思路和方法。

3.2 The application of modern technology in traditional Chinese medicine diagnosis

The application of modern technology in traditional Chinese medicine diagnosis has brought many new technologies and methods to medical diagnosis, further improving the accuracy and scientificity of diagnosis. Medical imaging techniques such as X-ray and computed tomography can be used to observe and detect the structure and function of internal organs in the human body, which plays an important role in the diagnosis of tumors, visceral organ diseases, and other aspects in traditional Chinese medicine (Figure 4). Modern laboratory examination technology can analyze biochemical indicators through samples such as blood and urine, helping herbalist doctor understand the patient's constitution and condition, and assisting traditional Chinese medicine in syndrome differentiation and treatment. Bioinformatics technology can study biomolecules such as genes and proteins, providing new ideas and methods for traditional Chinese medicine syndrome differentiation and personalized treatment. Modern technology has developed many specialized instruments and equipment for traditional Chinese medicine, such as electronic pulse diagnostic instruments, tongue diagnostic analyzers, etc., which can assist herbalist doctor in diagnosis and inspection. Artificial intelligence technology is gradually being applied in traditional Chinese medicine diagnosis, which can help herbalist doctor make diagnosis and treatment decisions through big data analysis and machine learning algorithms.

3.2现代科技在中医诊断中的应用

现代科技在中医诊断中的应用为医学诊断带来了许多新的技术和方法，进一步提高了诊断的准确性和科学性。包括X射线、计算机断层扫描等医学影像学技术可以用于观察和检测人体内部器官的结构和功能，对于中医诊断肿瘤、内脏脏器病变等方面有重要作用(图4)。现代实验室检查技术可以通过血液、尿液等样本分析生化指标，帮助中医医生了解患者的体质和病情，辅助中医辨证论治。生物信息学技术可以对基因、蛋白质等生物分子进行研究，为中医辨证和个体化治疗提供了新的思路和方法。现代科技为中医研发了许多专门的仪器设备，如电子脉搏诊断仪、舌诊分析仪等，可以辅助中医医生进行诊断和观察。人工智能技术在中医诊断中逐渐得到应用，可以通过大数据分析和机器学习算法，帮助中医医生进行诊断和治疗决策。

图 4 计算机断层扫描 Figure 4 Computed tomography

Although modern technology has brought many conveniences and advances to the diagnosis of traditional Chinese medicine, traditional diagnostic methods of traditional Chinese medicine are still the cornerstone of traditional Chinese medicine. herbalist doctor should continue to inherit and develop traditional diagnostic methods while applying modern technology, combining modern technology with traditional medicine, and providing patients with more comprehensive, scientific, and personalized diagnosis and treatment services (Chen et al., 2018).

虽然现代科技为中医诊断带来了许多便利和进步，但传统的中医诊断方法依然是中医学的基石。中医医生在应用现代科技的同时，也要继续传承和发展传统的中医诊断方法，将现代科技与传统医学相结合，为患者提供更加全面、科学和个性化的诊疗服务(Chen et al., 2018)。

3.3 The development prospects of traditional Chinese medicine research

With the support of contemporary science and technology, traditional Chinese medicine research has shown broad prospects and potential. As people's understanding of traditional Chinese medicine gradually deepens, its unique treatment concepts and methods are receiving increasing attention both domestically and internationally. The organization and inheritance of traditional Chinese medicine knowledge is an important direction in traditional Chinese medicine research. We need to strengthen the organization and research of traditional Chinese medicine classics, formulas, and the experience of famous doctors, and inherit these valuable traditional knowledge to provide useful reference for future generations.

3.3中医药研究的发展前景

中医药研究在当代科学技术的支持下，展现出广阔的前景和潜力。随着人们对中医药的认知逐渐深入，其独特的治疗理念和方法越来越受到国内外的关注。对传统中医药知识的整理和传承是中医药研究的重要方向。我们要加强对中医经典、方剂和名医经验的整理和研究，将这些宝贵的传统知识传承下去，为后人提供有益借鉴。

The application of modern technology in traditional Chinese medicine research will promote the development of traditional Chinese medicine. For example, the application of technologies such as genomics, bioinformatics, and artificial intelligence can help reveal the molecular mechanisms and pathways of traditional Chinese medicine treatment, providing new ideas and methods for the research of traditional Chinese medicine. The clinical research of traditional Chinese medicine will be more in-depth and comprehensive, and the efficacy and safety of traditional Chinese medicine will be verified through large-scale clinical trials and randomized controlled studies, providing scientific basis for its application in modern medicine (Xu et al., 2009; Ma et al., 2019). The integration of traditional Chinese and Western medicine is one of the important directions for future research on traditional Chinese medicine. Traditional Chinese medicine, as a treasure of traditional Chinese medicine, will be combined with modern Western medicine to form a more comprehensive and diverse medical model, providing more comprehensive protection for people's health. The international influence of traditional Chinese medicine is gradually increasing, and more countries and regions will be interested in traditional Chinese medicine. International cooperation and exchange will promote the development of traditional Chinese medicine and promote its dissemination and application internationally.

现代科技在中医药研究中的应用将会推动中医药的发展。例如，基因组学、生物信息学、人工智能等技术的应用可以帮助揭示中医药治疗的分子机制和作用途径，为中医药的研究提供新的思路和方法。中医药的临床研究将更加深入和全面，通过大规模的临床试验和随机对照研究，验证中医药的疗效和安全性，为其在现代医学中的应用提供科学依据(Xu et al., 2009; Ma et al., 2019)。中西医结合是未来中医药研究的重要方向之一。中医药作为中国传统医学的瑰宝，将与现代西医学相结合，形成更加综合、多元的医疗模式，为人们的健康提供更全面的保障。中医药在国际上的影响力逐渐增强，将有更多的国家和地区对中医药感兴趣。国际合作与交流将推动中医药的发展，促进中医药在国际上的传播和应用。

The prospect of traditional Chinese medicine research is very broad, and it will continue to lead the development of the medical field in the future. By inheriting and developing traditional knowledge, applying modern technology, deepening clinical research, integrating traditional Chinese and Western medicine, and international cooperation, traditional Chinese medicine will make greater contributions to the cause of human health.

中医药研究的前景非常广阔，未来将继续引领医学领域的发展。通过传承和发展传统知识、应用现代科技、深化临床研究、中西医结合和国际合作，中医药将为人类健康事业做出更大的贡献。

4 Summary and Outlook

Traditional Chinese medicine has a rich and diverse diagnostic methods, including the four diagnostic methods of looking, smelling, asking, and cutting, as well as pulse, tongue, and face examinations. These methods complement each other and together constitute a comprehensive and unique diagnostic system of traditional Chinese medicine. By observing the external manifestations of patients, listening to their complaints, inquiring about medical history, and palpating pulse signals, herbalist doctor can identify the pathogenesis and etiology of diseases, providing a basis for formulating effective treatment plans. Traditional Chinese medicine emphasizes the fundamental causes of treating diseases, and its theories of etiology and pathogenesis include five elements and six weatherss, yin-yang and five elements. These theories construct the unique disease concept and treatment concept of traditional Chinese medicine. By identifying the causes and mechanisms of diseases, herbalist doctor can develop personalized treatment plans tailored to individual differences, promoting patients' recovery.

4总结与展望

中医药拥有丰富多样的诊断方法，其中包括望、闻、问、切四诊法和脉诊、舌诊、面诊等，这些方法相辅相成，共同构成了中医药全面、独特的诊断体系。通过观察患者外在表现、听闻患者的主诉、询问病史和切诊脉象，中医医生能够辨别疾病的病机和病因，为制定有效的治疗方案提供依据。中医药强调治疗疾病的根本原因，其病因病机理论包括五运六气、阴阳五行等，这些理论构建了中医药独特的疾病观念和治疗理念。通过辨别疾病的病因和病机，中医医生能够针对个体差异制定个性化的治疗方案，促使患者恢复健康。

Traditional Chinese medicine, as a treasure of traditional Chinese medicine, has important modern medical significance and value. Traditional Chinese medicine emphasizes individual differences, and each patient is considered a unique individual, so the treatment plan is personalized. This concept of individualized treatment is increasingly valued in modern medicine and is in line with the trend of modern medical development. Traditional Chinese medicine emphasizes the holistic nature of treatment, treating diseases as a whole disorder rather than a single local problem. In modern medicine, the concept of comprehensive treatment is also widely applied, recognizing the importance of multidisciplinary collaboration for disease treatment. Traditional Chinese medicine emphasizes "preventive treatment of disease" and focuses on preventing the occurrence of diseases. In modern medicine, preventive medicine is becoming increasingly important, and disease prevention has become an important component of health management. Traditional Chinese medicine has accumulated rich experience in treating complex chronic diseases, stubborn diseases, and these diseases still pose challenges in modern medicine. Therefore, the research and application of traditional Chinese medicine will provide new ideas and methods for treating these diseases.

中医药作为中国传统医学的瑰宝，具有重要的现代医学意义和价值。中医药强调个体差异，每个患者都被视为独特的个体，因此治疗方案是个性化的。这种个体化治疗的理念在现代医学中日益受到重视，符合现代医学发展的趋势。中医药注重治疗的整体性，将疾病视为整体的紊乱，而不是单一的局部问题。在现代医学中，综合治疗的思想也被广泛应用，认识到多学科协作对于疾病治疗的重要性。中医药强调“治未病”，注重预防疾病的发生。在现代医学中，预防医学的地位越来越重要，预防疾病成为了健康管理的重要组成部分。中医药在治疗复杂慢性疾病、疑难杂症等方面积累了丰富的经验，这些疾病在现代医学中仍然是挑战。因此，中医药的研究和应用将为治疗这些疾病提供新的思路和方法。

The diagnostic methods and pathogenesis theory of traditional Chinese medicine provide a solid theoretical foundation for the development of traditional Chinese medicine. Its personalized treatment, comprehensive treatment, and emphasis on prevention and treatment of complex diseases have important significance and value in modern medicine. In order to better develop traditional Chinese medicine, we should continue to strengthen the research and inheritance of traditional Chinese medicine, promote the integration of traditional Chinese medicine and modern medicine, and make greater contributions to the cause of human health.

中医药的诊断方法和病因病机理论为中医药的发展提供了坚实的理论基础。其个体化治疗、综合治疗、强调预防和治疗复杂疾病等特点在现代医学中具有重要的意义和价值。为了更好地发展中医药，我们应当继续加强中医药的研究和传承，促进中医药与现代医学相互融合，为人类健康事业作出更大的贡献。

Authors’ contributions

HQK was responsible for the relevant literature and material researching, organizing, and the writing for the first draft of this review; WJN participated in discussions and paper revisions; WJN was the person in charge of this review, guiding the writing and revision of the paper. Both authors read and approved the final manuscript.

作者贡献

黄琪琨负责本综述初稿的相关文献资料查阅、整理和撰写；吴金妮参与讨论和论文的修改；吴金妮是本综述的负责人，指导论文写作与修改。两位作者都阅读并同意最终的文本。

Acknowledgments

Thanks to Ms. Jin L.F. and Ms. Xuan J. for their guidance and encouragement in every step from the topic selection and initial draft of the paper to the completion of multiple revisions. They will carefully and seriously point out the shortcomings in the paper and patiently answer my confusion. Thank you again to Ms. Jin L.F. and Ms. Xuan J. for their tolerance and support, which allowed me to successfully complete my paper.

致谢

感谢金玲飞女士和宣佳女士，从论文的选题、初稿到多次修改后的完成，每一步都离不开他们的指导鼓励。他们会仔细认真地指出论文中的不足之处，耐心解答我的困惑。再次感谢金玲飞女士和宣佳女士的包容与支持，让我顺利完成论文。

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