循证医学与个体化医疗

21世纪临床医学强调个体化医疗模式，这种模式的提出是基于人类基因组计划（基因分型和多核苷酸多态性）的发现以及新的医疗模式（生物心理一社会一环境一精神），充分体现了以人为本的医疗理念，这与中医药数千年来的个体化辨证论治有不谋而合之处。循证医学时代对个体化医疗的理解和要求促进了对个体化医疗的实践研究，真正使外部研究证据、医生个人技能和经验与患者的价值观和偏爱有机结合，做出明智、合理的医疗决策。本文论述了个体化医疗的含义以及中医的个体化诊疗特征，就循证医学时代如何开展个体化诊疗和实践研究提出了建议。

Evidence-based medicine and individualized health care

In 21st century, clinical medicine moves toward a model of individualized health care. The development of the individualized model is based on the research findings of human genomics project including genotype and single nucleotide polymorphisms （SNPs）, as well as the new health care model, that is, biological-psychological-social-environmental-spiritual. It reflects the idea of patient-centered care, and corresponds to the traditional practice of Chinese medicine, which addressed the individualized therapy on the basis of symptom pattern differentiation. However, the era of evidence-based medicine affords new meanings of individualized health care and promotes the research on the practice. The practice based on evidence would happen upon the integration of external research evidence, the expertise and experience of practitioners, and the value and preference of patients, so the decision of health care will be conscientious, explicit and judicious. This assay describes the meanings of individualized health care in different medical contexts, the characteristics of individualized practice in Chinese medicine, and proposals for further research in practice.