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1、中西医结合在未来医学中的作用有待思路与方法的突破Growth of the Integration of Traditional Chinese and Western Medicine and Its Effect on Future Medicine Awaiting a Breakthrough in Thinking Route and Working Method,李 恩Li En,Hebei Medical University,前 言(Introduction),1“三个医学”并存共同发展的局面 2基础理论研究促进了中药现代化，同时也丰富了基础 医学相关的学科,In a situ
2、ation of co-existence of Chinese medicine,western medicine and Integration of Traditional and Western Medicine forming a new aspect of three-medicine growing in common.Basis theory study promoted of the modernization the Chinese Herbs,at the same time,enriching the Basis Medicinerelated subjects.,3临
3、床研究中辨证与辨病相结合，宏观辨证与微观辨证显示了中医特色和中西医结合优势。,In clinical study,the effect of syndrome differentiation and differential diagnosis exhibits a special feature in traditional medicine and a superiority of Integration of Traditional and Western Medicine.The practice of macroscopic syndrome differentiation in c
4、ompany with microscopic differential diagnosis improves the quality of both diagnosis and treatment.,4中西医结合进入了高层次研究阶段；全国现有中西医结合硕士点90个，博士学科点31个，博士后流动站6个。中西医结合教育体系正在形成中。,Presently,alongside the growth of the Integration of Traditional and Western Medicine,the research work of which has entered a senio
5、r stage.Now,91 masters study stations concerning the Integration of Traditional and Western Medicine are established.In addition,there are 31 doctors and 6 mobile spots for post doctoral student,showing that a system of the Integration of Traditional and Western Medicine is shaping up and going to d
6、evelop.,5中西医结合有待思路与方法的突破 创新能力三个要素：(1)洞察性：即能通过事物的表面现象把握其内在含义和本 质特性；,A development expected by the Integration of Traditional and Western Medicine awaits a breakthrough of thinking route and working method.The ability of bringing new trailsand novel ideas ought to hold three essential element:(1)Insig
7、ht ability-trying to see things through the appearance to the essence.,(2)敏感性：即能够接受新事物，发现新问题；(3)独创性：即产生新的非凡思想能力，表现为产生新奇、罕见、首创的观念和成就。,(2)Sensibility-an ability apt to accept novel things and ideas and find out new problems.(3)Originality-being able to have a pioneering spirit or a creative initiation
8、 in doing something with astonishing achievement.,一.医学发展的历史与当代医学的特点 The Era reflected by current medicine and its features,二三个医学的内涵与中西医结合“代桥”作用 The connotation of“Three Medicine and the effect of“Generation Bridge of Integration the Chinese Medicine and Western Medicine,西医学：即现代医学。它是自然科学和社会科学两大门类相结合的
9、一门科学。随着近代科学的发展，运用现代的科学理论和技术，研究人体的结构和功能，各种病因的致病作用，病理变化，以及对疾病的诊断、治疗和预防，从而达到增强健康和延缓衰老为目的的 一门科学。,The western medicine namely the modem medicine which integrates two major departments of natural science with social science together.Along with the progress of current science,the modern scientific theories
10、 and techniques are used to study the structures and functions of the human body,etiology,pathology and clinical diagnosis,treatment and prevention,so as to strengthen one s health and to postpone ones aging.,中医学：中医学属于传统医学。传统医学是指：“它是在现代医学传播和发展以前就已存在几百年的有生命力的医疗实践，而且至今还在应用。这些实践由于各国社会传统和文化不同而存在很大差异(WHO
11、第八次工作纲要)。”说明中医是产生在经验医学时代的经验医学，各国传统医学有着各自的理论体系。中医学是世界传统医学中理论最完整、经验最丰富的传统医学，包括汉医、蒙医、维吾尔医、藏医以及其他少数 民族医等。,The Chinese medicine,which belongs to the traditional medicine which demonstrates that before the spread and growth of western medicine,the Chinese medicine had existed and practised clinically for
12、several hundreds years with its great vitality tilt today.There is a significant difference between this two kinds of medical practice owing to the variations of social traditional cultures.Chinese medicine is regarded as an experienced medicine originated from the age of experience medicine The tra
13、ditional medicine in varying countries possess their own theory system,only the Chinese medicine remains the best integraty of its own theory and the richest experience of practice which includes the medicine of Han,medicine of Mongolia and medicine of Urgur etc.,The medicine of the Integration of T
14、raditional and Western Medicine is a subject of medicine in which involves the mode of thinking,objective content and observation process about the evolution and growth.The similarities and differences of both medicine are checked by comparing each other to acquire an outstanding increasing a new sy
15、stem of medical theory.In studying the Integration of Traditional and Western Medicine.,人口谱和疾病谱的变化为中医发展 提供 了历史机遇 The alteration of the population spectrum and the disease spectrum provides a historical opportunity for the growth of Chinese medicine.,代谢性疾病与中医药的整体调节作用 Metabolic disease and integrated
16、regulation of the Traditional Chinese Medicine and herbs,饮食结构变化与环境污染 代谢性疾病 糖尿病、肥胖症、骨质疏松、高脂血症(心脑血管疾病)、肿瘤、精神分裂症、先天畸形,Entity regulation of the Traditional Chinese Medicine and herbs,Therapy:treat patient by syndrome differentiation,Recipe of Chinese medicinal herbs:a principle of Li,Fa,Fang,Yno and rul
17、e of Jun,chen,Zuo,and Shi,Dietary therapy:making the drugs as the food,Acupunctrue qigong taijiquan,第三条给药途径与中医“内病外治”法 The third route of administration and“external treatment for internal disease”,四中西医结合的难点与反思The difficult points and recall in the Integration of Traditional and Western Medicine.,对中医
18、研究提出的新问题 1藏象研究如何从单纯解剖学观点 生理功能体系发展 2证的本质是什么？能否寻找单一指标？,The new problems coming out in studying on the Traditional Chinese Medicine 1.How to transformation of study on Zang and Xiang from simple anatomy to Physical function.2.What is the essence of syndrome in Traditional Chinese Medicine.Are there the
19、 peculiar index for syndrome in Traditional Chinese Medicine,3中医的整体调节用还原论分析方法，怎么反映整体变化4医学模式转变与七情研究怎样客观化、标准化？,3.How to inflect the entity change under the entity regulation of Traditional Chinese Medicine by the analyzed method of reductionism 4.Alternation of medicine model and the objectivation and
20、 standardization of QiQing(七情),5.Whether the ingredient of Chinese Medicinal herbs is not the alternative of the recipe of Chinese medicinal herbs.How to analysis the of the recipe of Chinese medicinal herbs.What is the medium of drugs leading other drugs into the channel and drugs belonging to the
21、channel.Whether the used Chinese medicinal herbs are not the new function.What is the mechanism of diregulation of Chinese medicinal herbs.6.What is the essence of channels and collaterals.,5.中药单体成分能否代表该药？复方如何分析？引经药、归经药作用介质是什么？中药有无“老药新用”？中药双向调节机理是什么？6.经络本质是什么？如何评价“实体”研究？“内病外治”与经络所属脏腑关系。,五中西医结合医学模式与思
22、路方法 Medical Development model of the Integration of Traditional Chinese Medicine(TCM)and Western Medicine(WM),中西医结合医学模式对生物医学模式和恩格尔（GL.Enger）医学模式的评价,说明：(Interpretations),1生物进化和演变，首先受自然环境的影响，适者生存。代谢类型决定物种的生存和进化。因此，研究健康与疾病，要体现“天人合一”的自然观。2人类属于生物属性。由于参加社会的群体交往，产生心理活动，具有社会属性。对健康与疾病的认识必然是身心统一的整体观。,1.First
23、of all,the biological evolution is influenced by the natural environment,leading to the survival of the fittest.The existence and evaluation of the species is determined by different metabolic types.Thus,the concept on nature that nature and man correspond to each other should be incarnated in study
24、ing the health and disease.2.Human species belong to the biological attribution but also possess social property due to the joining in social communication and the producing of psychological activities.The cognition to health and diseases must be in conformity with integrated concept that physical a
25、nd mental activities are united.,3同一种疾病在不同人身上，具有不同的表现，出现了个体差异。在治疗上，中医提出了同病异治和异病同治的个体医学，突出了中医辨证施治的治疗观。4.随着人口谱和疾病谱的转变，自然环境的变化和社会的进步，运用天人合一的自然观，身心统一的整体观和辨证施治的治疗观(三观)，指导医学研究，必将促进医学发展。,3.Individual difference means that different symptoms and signs of the same disease may appear in different human beings
26、.In TCM,that same treatment for different disease and different treatments for one disease,as a kind of individualized medicine is offered giving prominence to the therapeutic concept that treatments are based on syndrome differentiation.4.In pace with the transformation in the pedigree of populatio
27、n and diseases,the change in natural environment and the progress of the society,the development of medicine will undoubtedly be promoted by applying the above three concepts in medical studies.,中西医结合的思路与方法需要解决的五个问题 The thinking route and working method in the Integration of Traditional and Western
28、Medicinefive problems must be solved,1.思维上，形象思维与逻辑思维的统一形象思维与中医自然哲学医学模式的形成逻辑思维与生物医学模式两种思维方式的统一：“从特殊到一般的道路是直觉的，而从一般到特殊的道路则是逻辑性”(爱因斯坦)系统论、控制论、信息论为一切科学提供了新理论和新方法,The integraty of imaging thinking and logic thinkingimaging thinking and forma-tion of natural philosophic medicine in Traditional Chinese Med
29、icine logic thinking and Bio medicine model the integraty of imaging thinking and logic thinking:As stated by Einstein:“The road from particularity to generality is an intuitional sense and road from generality to particularity belongs to logic.the birth of system atology,cybernetics and informatics
30、(three theories)supplie a new theory and method for scientific research work.,2局部和整体的关系 The relationship between a part and a whole,局部组织器官的作用与整体的关系微观分子水平与宏观整体的统一(对抗癌疗效的评价)中药复方研究的指导思想二律背反规律,The relationship between the function of each individual part and the entity The centralization of the macroin-
31、tegraty and the micromolecularity The leading thinking in study of Recipe of Chinese medicinal herbsIt is known that an entirety consists of some part,that is(1+1=2).while sometimes an entirety is larger than a sum of part,that is(1+1=3),3内因与外因的关系人的生存和进化与自然环境和社会环境的关系 The relationship between interna
32、l and external causes:The existence and evolution of mankind is initially influenced by the natural surround and social circumstances.,食物是沟通人体与外界之间的桥梁，饮食在人类进化中起着决定性作用心理因素在致病和治病的作用，研究和发展中医心理学(如五脏与五志),Food is a bridge to link up the human body and the external world.Diet plays a decisive role in mans
33、evolution and growth.Effects of psychological factors on treating disease and resulting in disease.The emotional changes are reflected on the viscera,which is worth studying in current psychology.,4客观指标与病人自觉状况的关系 The relationship of objective index and chief complaint of patient,新的仪器的发明和使用，扩大了对健康和疾病
34、认识的视野医生的经验与病人主诉和体征的作用转变从“治病”到“治病人”的观念,The invention of new apparatus makes mans vision field on health and disease broadened.Physicians effort and the chief complaint and sign of patientTransformation conception of disease is treated by physician to patients are by physicians,5分析与综合的统一 The unity of
35、analysis and synthesis,分析与综合的关系分析是综合的基础，没有分析便没有综合综合分析综合的研究方法,The relationship of of analysis and synthesisanalysis is the basis of synthesis.If there is no analysis，no synthesis is the basis of synthesis.If there is no analysis,no synthesis will be.A unification of analysis and synthesis must be a m
36、ethod of synthesis-analysis-synthesis,小 结(Conclusion),1.中西医结合是两个医学并存的必然产物，代表了未来医学发展的方向 2.科学的发展决定于思路与方法的突破。“提出一个问题比解决一个问题还难”,1.The Integration of Traditional and Western Medicine is the inevitable product of co-existence of Traditional Chinese medicine and Western Medicine.It is the tendency of the f
37、uture medicine development.2.The development of science is restricted by the breakthrough of thinking and working method.Putting forward the question is more difficult than solving it.,3.两个时代、两种模式并存，诊疗观需要更新才能发挥“代桥”作用。4.发挥中西医结合医学模式在未来医学中的作用，中医药学将重现历史辉煌。,3.The conception of diagnosis and treatment nee
38、d to be changed so as to give play to the effect of“generation bridge of the Integration of Traditional Chinese and Western Medicine.4.The integration of the traditional medicine and current medicine has become a tendency of medical growth.A further development of traditional features of Chinese medicine and superiority of Chinese medicine combining with western medicine will accelerate the medical progress in the world,making a new contribution to the prevention and treatment for disease in a new historical period.,谢谢大家!Thank you!,
