中西医结合在未来医学中作用有待思路与方法突破课件.ppt

1、中西医结合在未来医学中的作用中西医结合在未来医学中的作用有待思路与方法的突破有待思路与方法的突破Growth of the Integration of Traditional Chinese Growth of the Integration of Traditional Chinese and Western Medicine and Its Effect on Future and Western Medicine and Its Effect on Future Medicine Awaiting a Breakthrough in Thinking Medicine Awaiting

2、 a Breakthrough in Thinking Route and Working MethodRoute and Working Method 李李 恩恩Li En,Hebei Medical UniversityLi En,Hebei Medical University 前前 言言(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 situation of co-existence of Chinese medicine,western medicine and Integration of T

3、raditional 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 d

4、ifferentiation 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 company with microscopic differential diagnosis improves the quality of both diagn

5、osis 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 senior stage.Now,91 m a s t e r s s t u d y s t a t i o n s concerning the Integration o

6、f 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 develop.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

7、 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)Insight ability-trying to see things through the appearance to the essenc

8、e.(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 in doing something with astonishing achievement.一一.医学发展的历史与当代医学的特点医学发

9、展的历史与当代医学的特点 The Era reflected by current medicine and its features当代医学的特点：两个时代、两种医学模式并存当代医学的特点：两个时代、两种医学模式并存 The features of current medicine:two ages and two medical models 实验医学时代 整体医学时代 age of experimental medicine age of integrated medicine 生物医学模式 生物-心理-社会医学模式 model of biomedicine model of bio-p

10、sycho-socia-medieine 出现了：交融与冲突 minglement or conflict二三个医学的内涵与中西医结合二三个医学的内涵与中西医结合“代桥代桥”作用作用 The connotation of“Three Medicine and the effect of “Generation Bridge of Integration the Chinese Medicine and Western Medicine西医、中医和中西医结合的含义西医、中医和中西医结合的含义 The conception of western medicine,Chinese medicine

11、and the integrated Chinese medicine with 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 The western medicine namely the modem medicine namely the modem medicine which integrates two which

12、integrates two major departments of major departments of natural science with natural science with social science together.social science together.Along with the progress Along with the progress of current science,the of current science,the m o d e r n s c i e n t i f i c m o d e r n s c i e n t i f

13、 i c theories and techniques theories and techniques are used to study the are used to study the structures and functions structures and functions o f t h e h u m a n o f t h e h u m a n body,etiology,pathology body,etiology,pathology and clinical diagnosis,and clinical diagnosis,treatment and preve

14、ntion,treatment and prevention,so as to strengthen one so as to strengthen one s health and to postpone s health and to postpone ones aging.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

15、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 several hundreds years with its great vitality tilt today.T

16、here 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 traditional medicine in varying countries possess their own th

17、eory 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 Traditional and Western Medicine is a subject of medicine in

18、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 system of medical theory.In studying the Integration of Tradit

19、ional and Western Medicine.三个医学的形成和发展比较三个医学的形成和发展比较“三个医学”形成和发展的比较“三个医学”形成和发展的比较 中医学 西医学 中西医结合医学产生时代 经验医学时代 实验医学时代 整体医学时代思维方式 形象思维 逻辑思维 辩证思维医学模式 自然哲学医学模式 生物医学模式 生物自然社会 心理个体医学模式研究内容 阴阳五行、藏象 解剖、生理、病理、研究中西医对人体和 气血、四诊八纲 病因、诊疗技术等 疾病的认识进行比较 经络、七情等 研究研究方法 观察法、直接领悟 实验的分析方法 分析与综合统一的 取类比象 研究方法特点 注重天人合一、整体 注重局部

20、和微观研究 宏观整体、微观分子 性、心理因素、治疗 水平相结合 个体化 A Comparison of Three MedicineChinesemedicinewestern medicineIntegration of TraditionalChinese and WesternmedicineoriginatingeraExperiencedmedicineexperimentalmedicine integrated medicineThinking Modeimaging modelogic modedialectical modeMedicalpatternNaturalphilo

21、sophicmedicineBio-medicineBio-natural-socia-psycho-individual medicinestudycontentyinyangwuxingzangxiang qixuesizen jingluoqiqingAnatomyPhysiologyPathologydiagnosis andtreatment EtiologyKnowledge of disease andhuman body by way ofboth Chinese Technologyof medicine and westernmedicine comparetivelyst

22、udymethodsObservationDirectcomprehensionAnalogyExperimentalanalysisAn unified researchmethod of analysis andsynthesisCharacte-risticsUnifying of manand the universeEntirety ofthingspsychologicalfactorIndividualizedtreatmentstress on partialand localexpression andmicrocosmic studyCombining macros-cop

23、icentirety with microcosmicmolecular level 中中西西医医结结合合的的“代代桥桥”作作用用The effect of“generation bridge of the Integration ofTraditional Chinese and Western Medicine三未来医学发展赋予中医和中西医结合的三未来医学发展赋予中医和中西医结合的历史任务历史任务The growth of future medicine had entrusted a historical task tothe Integration of Traditional and

24、 Western Medicine.中医药现代化基础理论研究与中西医结中医药现代化基础理论研究与中西医结合合The basic theory Study of the modernization of ChineseMedicine and its herbs and the Integration of Traditionaland Western Medicine.人口谱和疾病谱的变化为中医发展人口谱和疾病谱的变化为中医发展 提供提供 了历史机遇了历史机遇 The alteration of the population spectrum and the disease spectrum

25、provides a historical opportunity for the growth of Chinese medicine.人口谱人口谱 老龄化老龄化Aopulation spectrum Aging of population 疾病谱疾病谱:Disease spectrum:传染病传染病 代谢性疾病代谢性疾病 Infectious diseases Metabolism diseases人口老龄化与中医保健人口老龄化与中医保健 Aging of population and health care in Traditional Chinese medicine 老年健康老年健康

26、 the aged health 延缓衰老延缓衰老 postponing the ageing 养生、摄生学养生、摄生学keeping in good health and fit代谢性疾病与中医药的整体调节作用代谢性疾病与中医药的整体调节作用 Metabolic disease and integrated regulation of the Traditional Chinese Medicine and herbs 饮食结构变化与环境污染饮食结构变化与环境污染 代谢性疾病代谢性疾病 糖尿病、肥胖症、骨质疏糖尿病、肥胖症、骨质疏松松、高脂血症高脂血症(心脑血管疾心脑血管疾病病)、肿瘤、精神

27、分裂症、肿瘤、精神分裂症、先天畸形先天畸形The dietary constructive andenvironmental alteration andenvironmental pollution Metabolic disease Hyperlipidemia,cardiocerebrovascular disease,diabetes,obesity,cancer,osteoporosis,senile dementia,psychosis and disease of hereditary deficiency 治疗观：辨证施治治疗观：辨证施治 中药复方：理法方药，君臣佐使中药复方：

28、理法方药，君臣佐使 饮食疗法：饮食疗法：“还药于食”“还药于食”针灸、气功、太极拳针灸、气功、太极拳中医药的中医药的整体调节整体调节Entity regulation of the Traditional Chinese Medicine and herbsTherapy:treat patient by syndrome differentiationRecipe of Chinese medicinal herbs:a principle of Li,Fa,Fang,Yno and rule of Jun,chen,Zuo,and ShiDietary therapy:making the

29、 drugs as the foodAcupunctrue qigong taijiquan“人体第三状态”与中医“人体第三状态”与中医“不治已病治未病”“不治已病治未病”第一状态健康状态第一状态健康状态 “辨证论治”“辨证论治”,饮食饮食,睡眠睡眠,心理心理,工作工作,锻炼锻炼 第三状态第三状态“有症无病”“有症无病”第二状态疾病状态第二状态疾病状态人体三人体三种状态种状态及转归及转归“The third state of human body”and prevention without disease in the Traditional Chinese Medicine The fir

30、st state state of health treat patient by syndrome differentiation、diet、sleep、psychary、work、exercise The third state“syndrome without disease”The second state state of diseasThree statesof humanbody andtransforma-tion第三条给药途径与中医第三条给药途径与中医“内病外治内病外治”法法 The third route of administration and “external tr

31、eatment for internal disease”absorbtion through skin andpreparation absorbed through skin point administrationabsorbtionthrough skinand pointadministrationThere must be the extrnalmenifestation if there is theinternal diseasDrugs of chennals andbelong to the viscera andbowelsPhysical and chemicalthe

32、rapy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.对中医研究提出对中医研究提出的新问题的新问题 1 1藏象研究如何从藏象研究如何从单纯解剖学观点单纯解剖学观点 生理功能体系发展生理功能体系发展 2 2证的本质是什么？证的本质是什么？能否寻找单一指标？能否寻找单一指标？The new problems coming out The new problems coming out in studying on the in studying o

33、n the Traditional Chinese Traditional Chinese Medicine Medicine 1.How to transformation of 1.How to transformation of study on Zang and Xiang from study on Zang and Xiang from simple anatomy to Physical simple anatomy to Physical function.function.2.What is the essence of 2.What is the essence of sy

34、ndrome in Traditional syndrome in Traditional Chinese Medicine.Are there Chinese Medicine.Are there the peculiar index for the peculiar index for syndrome in Traditional syndrome in Traditional Chinese MedicineChinese Medicine3 3中医的整体调中医的整体调节用还原论分析节用还原论分析方法，怎么反映方法，怎么反映整体变化整体变化4 4医学模式转变医学模式转变与七情研究怎样与

35、七情研究怎样客观化、标准化？客观化、标准化？3.How to inflect the 3.How to inflect the entity change under entity change under the entity regulation the entity regulation of Traditional of Traditional Chinese Medicine by Chinese Medicine by the analyzed method the analyzed method of reductionism of reductionism 4.Alternat

36、ion of 4.Alternation of medicine model and medicine model and the objectivation and the objectivation and standardization of standardization of QiQing(QiQing(七情七情)5.Whether the ingredient of 5.Whether the ingredient of Chinese Medicinal herbs Chinese Medicinal herbs is not the alternative of is not

37、the alternative of the recipe of Chinese the recipe of Chinese medicinal herbs.How to medicinal herbs.How to analysis the of the analysis the of the recipe of Chinese recipe of Chinese medicinal herbs.What is medicinal herbs.What is the medium of drugs the medium of drugs leading other drugs into le

38、ading other drugs into the channel and drugs the channel and drugs belonging to the channel.belonging to the channel.Whether the used Chinese Whether the used Chinese medicinal herbs are not medicinal herbs are not the new function.What is the new function.What is the mechanism of the mechanism of d

39、iregulation of Chinese diregulation of Chinese medicinal herbs.medicinal herbs.6.What is the essence of 6.What is the essence of channels and collaterals.channels and collaterals.5.5.中药单体成分能中药单体成分能否代表该药？复否代表该药？复方如何分析？引方如何分析？引经药、归经药作经药、归经药作用介质是什么？用介质是什么？中药有无中药有无“老药老药新用新用”？中药双？中药双向调节机理是什向调节机理是什么？么？6.6

40、.经络本质是什么？经络本质是什么？如何评价如何评价“实体实体”研究？研究？“内病外内病外治治”与经络所属与经络所属脏腑关系。脏腑关系。五中西医结合医学模式与思路方法五中西医结合医学模式与思路方法 Medical Development model of the Integration of Traditional Chinese Medicine(TCM)and Western Medicine(WM)中西医结合医学模式中西医结合医学模式对生物医学对生物医学模式和恩格尔（模式和恩格尔（GL.Enger）医学模式）医学模式的评价的评价 Concept on nature (Corresponde

41、nce of nature and man to each other)integrated concept (psycho-somatic unity)therapeutic concept (treatments based on syndrome differentiation)Bio Natur Socio psycho-Individ 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

42、病的认识必然是身心统一的整体观。1.First 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 shoul

43、d be incarnated in studying 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

44、 concept that physical and mental activities are united.3同一种疾病在不同同一种疾病在不同人身上，具有不同的表人身上，具有不同的表现，出现了个体差异。现，出现了个体差异。在治疗上，中医提出了在治疗上，中医提出了同病异治和异病同治的同病异治和异病同治的个体医学，突出了中医个体医学，突出了中医辨证施治的治疗观。辨证施治的治疗观。4.随着人口谱和疾病随着人口谱和疾病谱的转变，自然环境的谱的转变，自然环境的变化和社会的进步，运变化和社会的进步，运用天人合一的自然观，用天人合一的自然观，身心统一的整体观和辨身心统一的整体观和辨证施治的治疗观证施治的

45、治疗观(三观三观)，指导医学研究，必将促指导医学研究，必将促进医学发展。进医学发展。3.Individual difference means that different symptoms and signs of the same disease may appear in different human beings.In TCM,that same treatment for different disease and different treatments for one disease,as a kind of individualized medicine is offered

46、 giving prominence to the therapeutic concept that treatments are based on syndrome differentiation.4.In pace with the transformation in the pedigree of population and diseases,the change in natural environment and the progress of the society,the development of medicine will undoubtedly be promoted

47、by applying the above three concepts in medical studies.中西医结合的思路与方法中西医结合的思路与方法需要解决的五个问题需要解决的五个问题 The thinking route and working method in the Integration of Traditional and Western Medicinefive problems must be solved1.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形象思维与中医自然哲学医学模式的形成医学模式的形成逻辑思维与生物医学模式逻辑思维与生物医学模式两种思维方式的

48、统一：两种思维方式的统一：“从特殊到一般的道路是从特殊到一般的道路是直觉的，而从一般到特殊直觉的，而从一般到特殊的道路则是逻辑性的道路则是逻辑性”(爱爱因斯坦因斯坦)系统论、控制论、信息论系统论、控制论、信息论为一切科学提供了新理论为一切科学提供了新理论和新方法和新方法 The integraty of imaging thinking and logic thinkingimaging thinking and forma-tion imaging thinking and forma-tion of natural philosophic medicine of natural philo

49、sophic medicine in Traditional Chinese Medicinein Traditional Chinese Medicine 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

50、 belongs to logic.the birth of system atology,cybernetics and informatics(three theories)supplie a new theory and method for scientific research work.2 2局部和整体的关系 The relationship between a part and a whole局部组织器官的局部组织器官的作用与整体的关作用与整体的关系系微观分子水平与微观分子水平与宏观整体的统一宏观整体的统一(对抗癌疗效的对抗癌疗效的评价评价)中药复方研究的中药复方研究的指导思想指