以临床价值为导向的中药复方转化医学研究思路与方法

中药复方是中医临床用药的主要形式, 也是中医药传承创新发展的重要载体。由于物质基础不清、作用机制不明、质量控制不稳定、循证医学证据缺乏等瓶颈问题, 中药复方屡遭质疑, 难以获得国际认可, 临床应用和产业发展十分受限。如何科学有效开展中药复方基础研究, 使其更好为临床服务成了中医药发展迫切需要解决的难题。近年来, 转化医学浪潮的兴起为中医药的创新发展带来了新的契机和思路。该文简述了中药复方临床应用和开发面临的困境, 转化医学视角下开展复方研究的现状以及存在的主要问题, 进一步凝练研究思路与方法, 以期为源于中医临床的中药复方转化医学研究提供有益指导。      

循证医学,临床医学的新模式

循证医学（evidence-based medicine,EBM）是21世纪的临床医学,它的产生和发展引发了一场卫生革命,对人类卫生保健有着重大意义,对人们的医疗活动产生重要影响.自20世纪50年代以来,人类疾病谱发生了很大变化,各种慢性疾病、肿瘤等成为威胁人类健康的主要原因.     

古今中医戒烟思路方法与研究

随着人们对健康的追求及卫生知识的普及,已有越来越多的嗜烟者开始戒烟,为迎合社会需求,促进中医药发展事业,文章从古今中医药戒烟两方面谈谈中医药的戒烟思路、方法及其研究现状。     

新型医学模式呼唤人文素质教育

论述了现代医学模式发展的要求是医学科学与人文素质的融合,分析了医学院校人文素质教育的意义和存在的问题,提出强化医学生的人文素质教育的策略。     

叙事医学教育与医学专业学位研究生的培养

当前,我国医学临床专业学位研究生的培养过程中医患沟通等人文素质方面的教育仍存在许多不足。叙事医学是着眼于患者的病痛体验及其人文关怀的新的医学理论和实践模式。它的产生和成长是现代临床医学发展中的必然产物。在临床专业研究生的培养过程中灌输叙事医学的理论和方法将从战略上影响我国未来的医学诊疗局面,必将对我国的临床医学发展产生深远的影响。     

现代居家医学和周全居家医疗

随着老龄化社会逐步来到及医学技术的进展,居家医疗模式开始在世界各地受到密切关注。本文先从居家医学和居家医疗的历史渊源出发,介绍国外居家医疗的发展历程及居家医学教育、科研、服务;继而阐释居家医疗的概念内涵、服务原则、服务团队、服务内容及发展居家医疗需要注意的问题;最后介绍我国居家医疗相关的政策和初步实践雏形,希望为我国居家医疗的发展提供借鉴。     

Research on Constitution of Chinese Medicine and Implementation of Translational Medicine

Translational medicine is a new concept presented in recent decades, the core of which is to build a bridge between basic medical research and clinical application. From the beginning of constitution of Chinese medicine, clinical application has been given priority. Therefore, the idea of translational medicine is fully demonstrated in the research into the three key scientific problems of "classification of constitution of Chinese medicine", "relationship between constitution and disease" and "adjustment of constitution". Under its guidance, not only was the systematic theory of constitution of Chinese medicine established, but also the Constitution of Chinese Medicine Scale and the Standards of Classification and determination of Constitution of Chinese Medicine were developed, which translates methods of classifying the nine constitutional types into guidance for prevention of disease, management of health and clinical application. The research findings of constitution of Chinese medicine have been applied in clinical practice and public health, establishing the diagnosis and treatment model of constitution-disease-syndrome differentiation. The nationwide application of constitution differentiation has shown good effect. In the future, constitution of Chinese medicine should strengthen the evidence-based research and multi-disciplinary cooperation, and establish a research team on comprehensive constitution of Chinese medicine and translational medicine, to translate the findings into clinical practice and public health more accurately and quickly.     

从医学的主要任务谈医哲分离

通过对医哲融合的利弊分析,提出哲学概念对医学概念的替代产生了消极作用;与中医的主要任务相背,为发展中医,应该医哲分离.     

循证医学在核医学教学中的价值

循证医学是科学、系统的思维研究方法论,在核医学教学中具有重要价值,能帮助医学生树立、培养科学的医疗观和科研态度,培养新型医学人才,促进核医学教师自身素质的提高和核医学教育的进一步发展。     

中医微观辨证研究的循证医学系统评价构想

“微观辨证”对于中医传统辨证是一种很好的补充。引入循证医学的思想，对微观辨证类研究进行系统评价，是一种新的研究思路和值得探索的方法。其主要方法和步骤与传统治疗性研究及诊断性试验的系统评价类似，由于基础研究的不同，需要重点解决好文献鉴定和检索策略、研究的质量评价、研究的同质性、数据分析方法等方面的问题。本文对如何解决这些关键问题提出构想，并为进一步的研究提供建议。     

Informatics,evidence-based care,and research; implications for national policy: a report of an American Medical Informatics Association health policy conference

There is an increased level of activity in the biomedical and health informatics world (e-prescribing, electronic health records, personal health records) that, in the near future, will yield a wealth of available data that we can exploit meaningfully to strengthen knowledge building and evidence creation, and ultimately improve clinical and preventive care. The American Medical Informatics Association (AMIA) 2008 Health Policy Conference was convened to focus and propel discussions about informatics-enabled evidence-based care, clinical research, and knowledge management. Conference participants explored the potential of informatics tools and technologies to improve the evidence base on which providers and patients can draw to diagnose and treat health problems. The paper presents a model of an evidence continuum that is dynamic, collaborative, and powered by health informatics technologies. The conference''s findings are described, and recommendations on terminology harmonization, facilitation of the evidence continuum in a “wired” world, development and dissemination of clinical practice guidelines and other knowledge support strategies, and the role of diverse stakeholders in the generation and adoption of evidence are presented.     

正确认识与对待循证医学实践中的缺陷

循证医学是一种较好的指导临床实践的方法,但在循证医学实践中还存在一些缺陷,如最佳证据的过度化与绝对化,过度重视最佳证据的普遍性,忽视最佳证据获取过程中的缺陷等。在循证医学实践中,正确认识证据的相对性、普遍性和特殊性,遵循循序渐进的策略,临床医学实践将会少走弯路。     

基于转化医学和全科医学理念开展老年病学临床教学改革与实践

随着社会不断发展,我国已进入老龄化社会,培养熟练全面掌握老年病学知识的人才显得日益重要。老年病学教学是医学教育的重要组成部分,也是发展老年病学的重要环节。作者在老年病学临床教学中引入转化医学和全科医学的理念,开展老年病教学模式的改革,重视转化医学和全科医学思维的培养,同时采用传统授课模式、PBL教学法等多种授课方式,取得了良好的教学效果。     

中医和西医哲学起源的不同：探索中医的整体优势

To explore advantages of Chinese medicine (CM) by analyzing differences in the origin of philosophy for human health between CM and Western medicine (WM). Methodologically, a distinctive feature of CM is its systems theory, which is also the difference between CM and WM. Since the birth of CM, it has taken the human body as a whole from the key concepts of “qi, blood, yin-yang, viscera (Zang-Fu), and meridian and channel”, rather than a single cell or a particular organ. WM evolves from the Western philosophic way of thinking and merely uses natural sciences as the foundation. The development of WM is based on human structures, or anatomy, and therefore, research of WM is also based on the way of thinking of decomposing the whole human body into several independent parts, which is the impetus of promoting the development of WM. The core of CM includes the holistic view and the dialectical view. Chinese herbal medicines contain various components and treat a disease from multiple targets and links. Therefore, Chinese herbal medicines treat a diseased state by regulating and mobilizing the whole body rather than just regulating a single factor, since the diseased state is not only a problem in a local part of the body but a local reflection of imbalance of the whole body.     

冠心病中医药循证研究进展

中医药学有数千年的历史,是中国劳动人民长期同疾病作斗争的实践经验总结,并逐步形成、发展成为独特的医学体系。然而,由于其是一种典型的经验医学,疗效缺乏客观化、定量化的评价标准。中医药临床试验是20余年前才开始的,近10年来呈增长趋势,但在临床研究中仍存在不少问题,     

从“经验”到“证据”: 循证医学促进中医药传承创新发展

循证医学被引入中国并传播推广已有20余年, 在中医药研究领域取得了阶段性的成绩, 该文通过对循证中医药学内涵的分析, 简要梳理了循证中医药研究发展的现状、面临的挑战, 总结了目前循证中医药学发展面临着的“四多”“四少”现象。该文结合对循证医学方法学体系(包括方法论和基本研究方法)的重新认识, 提出基于循证实践的中医临床相关研究实施建议, 以期促进中医药从“经验”到“证据”的转化, 发挥中医药原创优势, 助力中医药传承与创新发展。      

Precision Medicine: Towards Complexity Science Age

Precision medicine(PM) refers to the tailoring of the prevention and treatment strategies to the individual characteristics of each patient. Following the vigorous advocacy of the U.S. President Obama and China’s President Xi, PM has now become a hot topic of common concern worldwide. PM does not merely refer to the skill set level but rather a comprehensive medical methodology. Hence, there is PM that builds on the analytical methodology of Western medical system as well as PM that builds on Chinese medicine(CM). The differences between the two systems, fundamentally speaking, are the differences in methodology to describe the body constitution that based on reductionism and holism. Today, as science advances to complex systems, the mainstream analytical reductionism advances to the holistic synthesis era, it is imperative to introduce CM’s holistic body constitution to the modern medical system in order to progress to PM. PM with its foundation on holisticbody constitution, is a medical system that integrates Western medicine and CM, is the highest attainment of "PM" in the future.     

Chinese integrative medicine: Translation toward person-centered and balanced medicine

<正>Chinese integrative medicine(CIM) focuses on the integration of conventional medicine (biomedicine) with Chinese medicine(CM).Although the CIM field has witnessed several advancements,the definition and classification of CIM is not quite clear,given that an independent theory system has not yet been established in this field.Therefore,future research and studies should focus on the following objectives:(1) emphasizing CM features,(2) improving CIM positioning,and(3) establishing CIM standards.These concerted efforts will help CIM be at par with international standards and criteria.With the development of CIM,the world will embrace a new medical system providing person-centered treatment with a balanced medicine approach.     

循证医学在中国该走向何方?

循证医学（evidence-based medicine）的概念引入中国已有近五、六年的时间了.这期间,国内众多医学专业期刊,纷纷刊载了许多介绍循证医学的述评、评论等论文,出版了相关的专著,众多学者在不同场合,纷纷登台作学术报告,传播循证医学思想.可以说,循证医学的概念从最初不为广大临床医生所知,到现在,已在国内迅速得到推广和普及.但是,近几年来,关于循证医学的认识和宣传国内却出现了一些有待商榷的现象.     

循证医学理念在中医肝病临床教学中的应用体会

介绍作者在《中医内科学》肝病临床教学中贯彻实践循证医学理念的优点、重要意义和采取的具体措施。开拓学生的视野,锻炼独立解决临床医学问题的功能,培养和提高继续教育及日后学习的良好习惯和思维能力,为提升中医本科教学质量,实现医学教育的可持续发展提供有益的探索。