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名字里有什么?台湾的自主神经失衡和医学无法解释的症状。

What is in a name? Autonomic imbalance and medically unexplained symptoms in Taiwan.

机构信息

Institute of Science, Technology and Society, National Yang Ming Chiao Tung University, Taipei, Taiwan.

出版信息

Sociol Health Illn. 2021 May;43(4):881-894. doi: 10.1111/1467-9566.13262. Epub 2021 Mar 13.

Abstract

Medically unexplained symptoms (MUS) are persistent bodily symptoms without known pathology. An unofficial term has recently emerged in Taiwan to accommodate MUS: autonomic imbalance (AI). AI literally refers to disturbances of the autonomic nervous system (ANS) that innervates vital organs. However, AI is variously conceptualised by different parties. This study intends to investigate what is in the name of AI. It draws on available databases and in-depth interviews with AI sufferers and Western and Chinese medicine physicians. Some physicians research ANS functions through heart rate variability measurements. Research findings show that physicians regard AI as a convenient term for clinical communication and a euphemistic substitute for MUS or even psychiatric diagnoses. It is not a 'real thing'. However, AI sufferers treat AI as a bona fide disease, only that it has not been officially classified. AI is therefore an unfaithful translation, or an uncontrolled equivocation, of MUS. The paper concludes by discussing the implications of treating AI as an equivocation. These implications include the limitations of the current diagnostic criteria, the necessity to rethink the dichotomy of mind and body, and the underlying realities exposed or masked by 'diagnosis'.

摘要

未明原因的躯体症状(MUS)是指持续存在的、没有已知病理的躯体症状。台湾地区最近出现了一个非官方术语来涵盖 MUS:自主神经失衡(AI)。AI 字面意思是指支配重要器官的自主神经系统(ANS)的紊乱。然而,不同的人对 AI 的概念理解各不相同。本研究旨在探讨 AI 这个名称所代表的含义。它借鉴了现有的数据库以及对 AI 患者、西方和中医医生的深入访谈。一些医生通过心率变异性测量来研究 ANS 功能。研究结果表明,医生将 AI 视为临床交流的便捷术语,是 MUS 甚至精神科诊断的委婉替代,而不是“真实存在的东西”。然而,AI 患者将 AI 视为一种真实的疾病,只是它尚未被正式分类。因此,AI 是对 MUS 的一种不忠实的翻译,或者说是一种不受控制的模棱两可。本文最后讨论了将 AI 视为模棱两可的含义。这些含义包括当前诊断标准的局限性、需要重新思考身心二分法,以及“诊断”所揭示或掩盖的潜在现实。

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