Abstract： Treatment based on syndrome differentiation is one of the core theories of Chinese medicine. Syndrome， pathogenesis and prescription are basic elements in the process of diagnosis and treatment by Chinese medicine， whose relationship covers the principle of syndrome- based prescription，pathogenesis- based medicine and matched dosage and effect，and reflects the real process of clinical diagnosis and treatment. The authors further deepened the mode of thinking of syndrome differentiation in Chinese medicine by discussing the principle of syndrome- based prescription， pathogenesisbased medicine and matched dosage and effect.