现代中医学临床诊疗现状、问题及对策研究
1. 昆明医科大学第一附属医院, 生殖遗传科, 云南昆明 650032
2. 云南出版集团, 云南科技出版社, 云南昆明 650034
| 摘 要： | 中医是一门完整的、系统的诊疗体系，但也需要传承与创新来适应现代社会经济的不断发展，并满足人们对于高质量健康生活的追求。中医诊疗的前提是以阴阳五行、藏象学说等中医经典理论为基石，建立中医临床思维，运用整体观念进行系统全面的辨证论治，以此制定治疗原则与方法。而当前 中医学临床诊疗过程中存在部分重要问题，严重影响了中医学科的发展和人才的培养。理论角度，中医基础知识掌握不够，整体观念思维缺乏或薄弱，不能将中医理论融会贯通，导致理论无法指导临床诊疗；存在分科过细，中医师只懂得某一学科知识，不利于疾病的诊疗。辨证角度，望、闻、问、切病症收集过程过于草率或过度节减，不能综合分析疾病的病因和病机，局限于某一脏腑、某一表象，而不能灵活的将临床症状、体征与中医基础理论相照应，理论与实践脱钩；过分依赖西医辅助检查，忽略了中医诊疗本质。治疗方面，临床疾病治疗普遍依赖汤药方剂，而忽略了中医其他疗法，如砭、针及灸等治疗方式的运用。上述问题严重影响了中医学科的发展。基于此，本文就现代中医发展过程中存在的问题进行分析、归纳及整理，并针对上述问题提出相应的解决方案，以期实现中医要坚持传承与创新相结合的思想，中医诊疗思想的融汇与贯通，充分发挥传统中医的经典理论和方法，同时不断的吸收和借鉴西医的先进方法和技术手段，对患者进行病因和疾病本身的辨证，重视选择合适的疾病治疗方法，在诊疗的同时也注重中医独特治未病思想，兼容并蓄，不断创新和完善，以期为中医学科的发展和人才培养提供一定的参考与借鉴。 |
| 关 键 词： | 中医; 诊疗现状; 辨证论治; 存在问题; 对策; 治未病 |
| DOI： | 10.57237/j.cmrd.2023.01.001 |
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收稿日期: 2022-09-12
接受日期: 2022-10-10
在线出版日期: 2023-02-03
Current Situation, Problems and Countermeasures of Clinical Diagnosis and Treatment of Modern Traditional Chinese Medicine
1. Department of Genetics and Reproduction, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
2. Yunnan Science and Technology Publishing House, Yunnan Publishing Group, Kunming 650034, China
| Abstract: | Traditional Chinese medicine (TCM) was a complete and systematic diagnosis and treatment system, but inheritance and innovation were also needed for TCM for adapting to the continuous development and change of modern society, as well as people's pursuit for high quality healthy life. Yin-yang theory, five elements theory and visceral manifestation theory were the precondition for the diagnosis and treatment of TCM, which were used to perform the systematic and comprehensive syndrome differentiation of disease, thus formulate the treatment principles. However, several severe problems which restricted the application and treatment of disease for TCM. At the theory aspect, the basic knowledge of traditional Chinese medicine was not enough, the overall concept of thinking was lacking or weak, and lacking the mastery of the principal theory of TCM, which limited the diagnosis of disease; the professional division was too meticulous, which caused the doctor of TCM only mastered one subject, which caused the non-precise diagnosis of disease. At the syndrome differentiation aspect, traditional disease information collecting with observation, auscultation and olfaction, inquiry, and pulse feeling and palpation, this process was sloppy or omitted severely, which was also limited to the diagnosis of disease for doctor of TCM with the principal theories; parts of the doctor of TCM performed their diagnosis basing on the checking results of western medicine, but ignored the essence of diagnosis and treatment of TCM. At the aspect of treatment, decoction was commonly used in the treatment of diseases, however, bian, needle, moxibustion and the resting strategy of TCM for treating disease were ignored. The aforementioned factors limited the diagnosis, treatment of TCM, as well as the culture of TCM talents, which restricted the development of TCM. Thus, in this study, we anlyzed the current situation and problems of clinical diagnosis and treatment of TCM, and proposed the appropriate suggestion for the disease diagnose and talent culture of TCM by cooperating the principal theory of TCM. In addition, the usage of syndrome differentiation of disease of TCM with the corporation of checking technology of western medicine for the diagnosis of disease, then chose the suitable treating strategy. This work would provide the referential suggestions for the development of TCM and talent training. |
| Keywords: | TCM; Diagnosis and Treatment Status; Syndrome Differentiation and Treatment; Problems; Countermeasures; Preventive Treatment of Disease |
基金
| 1. | 上海市胚胎源性疾病重点实验室开放课题 (She2020006) |
| 2. | 云南省科技厅面上项目(2019FB096) |
| 3. | 昆明医科大学教改项目 (2019-JY-Y-053) |
| 4. | 云南省卫生健康委员会高层次医学学科带头人 (D-2017007) |
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