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[中医病名将何去何从?]

[Where will Chinese medicine disease names go?].

作者信息

Su Zhan-Qing

机构信息

Department of Traditional Chinese Medicine, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, China.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2013 Jun;33(6):726-30.

Abstract

The statistical survey of "Clinical Articles", one column of Journal of Traditional Chinese Medicine (24 volumes in total) showed that, of the 151 academic exploration on diseases, Western disease (WM) names were used in 145 articles, constituting 96.03% of the entire column. Obviously, Chinese medicine (CM) disease names were not basically used by CM physicians. Taking Chinese Internal Medicine (2nd edition), a national textbook for students in CM universities, as an example, we could find that the use of disease names was in a chaos logically, disease, syndrome, and symptom were not used clearly. In the general knowledge part, when mentioning a disease, the book sometimes used "disease", sometimes "disease-syndrome". In the classified parts, some diseases were simply named as "A or B syndrome", and when talking about a specific disease, it referred to the symptom-based disease as a kind of "disease-syndrome". Throughout the whole book, the disease names named after symptoms or heavily colored by symptoms amounted to 31, accounting for 59.6% of the listed 52 common diseases. In clinical practices, using CM disease names ran the risk of making wrong diagnosis or failing to diagnose patients in time, and therefore, leading to improper treatment or loss of treatment time. For critical diseases, these names can't reveal the serious situations and help to get rid of possible dangers. For chronic diseases, using these names can't lead to early recognition and prevention of diseases. Considering that CM disease names can't go with clinical practices, and lag behind the development of integrative medicine, the author suggested that we should borrow as many WM disease names as possible in CM, because when compared with CM, WM has a much clearer and more objective knowledge of the location, cause, mechanisms, diagnosis, treatment, and prevention of diseases. The classification and naming of diseases in WM is the result of negotiation of WHO and its member countries (including China), and therefore, more generally accepted. How to do that? We should start from the present clinical practice, refer to the tradition, face the future, and work hard. Borrowing WM disease names is of great significance. It will help to bring the theory of Zang-Fu organs back to its origin, clinically help to deepen the combination of disease and syndrome, disease and formula, promote the objectification and micronization of syndrome differentiation in CM, and possibly bring about new theories of CM which will in return promote clinical development. CM will be able to occupy an important position in the field of world medicine and make its own contributions to the health of the global population.

摘要

对《中医杂志》(共24卷)“临床报道”栏目进行统计调查发现,在151篇疾病学术探讨文章中,有145篇使用了西医病名,占该栏目的96.03%。显然,中医医生基本未使用中医病名。以中医院校学生全国统编教材《中医内科学》(第2版)为例,可发现病名使用逻辑混乱,病、证、症未明确区分。在总论部分,提及疾病时,该书有时用“病”,有时用“病证”。在各论部分,有些疾病简单命名为“A或B证”,在论述某一具体疾病时,又将以症状命名的疾病称为“病证”。全书以症状命名或以症状色彩浓重的病名达31个,占所列出52种常见疾病的59.6%。在临床实践中,使用中医病名存在误诊或不能及时诊断患者的风险,进而导致治疗不当或延误治疗时机。对于危重病,这些病名无法揭示严重病情并帮助消除可能的危险。对于慢性病,使用这些病名无法实现疾病的早期识别与预防。鉴于中医病名与临床实践脱节,且滞后于中西医结合的发展,作者建议中医应尽可能多地借用西医病名,因为与中医相比,西医对疾病的部位、病因、机制、诊断、治疗及预防有更清晰、客观的认识。西医的疾病分类与命名是世界卫生组织及其成员国(包括中国)协商的结果,因而更具普遍接受性。如何做到这一点呢?我们应从当前临床实践出发,借鉴传统,面向未来,并努力为之。借用西医病名意义重大。它将有助于使脏腑学说回归本源,临床上有助于深化病与证、病与方的结合,促进中医辨证的客观化与微观化,可能催生中医新理论,进而推动临床发展。中医将能够在世界医学领域占据重要地位,为全球民众的健康做出自身贡献。

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