1.中国中医科学院广安门医院,北京市西城区北线阁5号,100053
2.北京中医药大学
2.陕西中医药大学第二附属医院
3.广西中医药大学
4.首都医科大学附属宣武医院
tongxiaolin@vip.163.com
收稿:2023-01-14,
修回:2023-07-20,
纸质出版:2023-11-17
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张莉莉,薛崇祥,周凌等.由靶及态之现代中西医结合医学模式探析[J].中医杂志,2023,64(22):2269-2274.
ZHANG Lili,XUE Chongxiang,ZHOU Ling,et al.Exploration of Modern Integrated Chinese and Western Medicine Model:from Target to State[J].Journal of Traditional Chinese Medicine,2023,64(22):2269-2274.
张莉莉,薛崇祥,周凌等.由靶及态之现代中西医结合医学模式探析[J].中医杂志,2023,64(22):2269-2274. DOI: 10.13288/j.11-2166/r.2023.22.001.
ZHANG Lili,XUE Chongxiang,ZHOU Ling,et al.Exploration of Modern Integrated Chinese and Western Medicine Model:from Target to State[J].Journal of Traditional Chinese Medicine,2023,64(22):2269-2274. DOI: 10.13288/j.11-2166/r.2023.22.001.
如何找到中西医结合的突破方向,从交叉到融合再到创新,打开中西医结合新局面,是目前中西医结合遇到的困惑。中医之进步在于借助现代诊疗设备扩大四诊的范围,发展“微观”辨证,西医之进步在于放眼“宏观”,发展系统医学、整合医学,两者相向而行。“态靶辨治”将可能成为构建现代中西医结合诊疗体系的重要途径,“由靶及态”思维模式是在“态靶辨治”理论体系基础上的进一步细化和发展,可为现阶段中西医结合医学模式提供较明确的解决思路,为未来中西医结合指明重要发展方向。从战略高度和临床诊疗实践出发,将“由靶及态”思维模式融入现代中西医结合诊疗模式中,即“以西为本,中为西用,以中为本,西为中用”。一方面,加强西医学对中医传统理论和整体观等方面的借鉴,提倡中医传统理论指导下的更高层次的中西医结合教育;另一方面,在临床实践时运用“由靶及态”思维模式指导确立诊疗策略和临床选药,从而循序渐进地打靶、调态,为现代中西医结合临床工作提供切实可行的方法。中西医学体系学习互鉴,有机结合,发挥各自优势,形成内在规律,真正取得中西医结合医学模式的突破和创新。
It is the current confusion encountered by integrated Chinese and Western medicine that how to find the breakthrough direction of integrating Chinese and Western medicine, from crossover to integration to innovation, and open up a new horizon of integrated Chinese and Western medicine. The progress of Chinese medicine lay in expanding the scope of diagnosis and treatment with the help of modern diagnostic and therapeutic equipments and developing “micro” identification, while the progress of Western medicine lay in looking at “macro” and developing systemic medicine and integrated medicine, both of which are in the direction of each other. The “state-target identification and treatment” may become an important way to build a modern diagnosis and treatment system of integrated Chinese and Western medicine, and the thinking mode of “from target to state” is a further refinement and development on the basis of the theoretical system of “state-target identification and treatment”, which provided a clearer solution for the current stage of the integrated Chinese and Western medicine model, and pointed out the important development direction for the future integrated Chinese and Western medicine. From the perspective of strategic level and diagnosis and treatment practice, it integrated the “target-state” thinking mode into the modern diagnosis and treatment model of the integrated Chinese and Western medicine, i.e., “Western medicine as the basis and treating with Chinese medicine; Chinese medicine as the basis and treating with Western medicine”. On the one hand, Western medicine should strengthen the reference to the traditional theories and holism of Chinese medicine, and advocate a higher level of education on the integrated Chinese and Western medicine under the guidance of the traditional theories of Chinese medicine. On the other hand, the “from target to state” mode of thinking should be applied to guide the establishment of diagnostic and treatment strategies and clinical selection of medicines in clinical practice, so as to locate the target and adjust the body state in a gradual and orderly manner, and to provide practical methods for the modern clinical work of the integrated Chinese and Western medicines. Chinese and Western medicine systems can learn from each other, combine organically, give full play to their respective strengths, and form an internal law, so as to make breakthroughs and innovations in the integrated Chinese and Western medicine model.
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