基于“防微安和”理念的复发性流产社区干预体系探微

复发性流产是现代妇科常见多发病之一，其不仅是一个医学问题，更是成为一个逐渐影响婚姻生活及家庭和谐的社会问题，对育龄期女性的身心健康造成了严重困扰。复发性流产具有“应期而堕”的特点，明确流产原因，积极调理身体，及早地预防干预能更有效地避免流产再次发生。社区干预旨在以综合干预手段改变人群的行为习惯与生活方式，进而干预疾病发生、发展中的危险因素，充分体现了三级预防的内涵。传统社区干预手段为复发性流产的防治起到了积极作用，但干预项目影响力多局限于试点阶段与试点区域，难以大范围推广应用。针对复发性流产社区干预的系列问题，系统整理了导师姜丽娟教授“防微安和”理念，从“气血和”，分期调养；“志意和”，调畅情志；“寒温和”，重视人群体质；“医患和”，增强疾病观念4个方面具体阐述了在社区实践中如何针对复发性流产患者进行有效干预，并构建了系统的社区干预体系。“防微安和”理念不仅适用于复发性流产，对其他疾病社区干预的开展亦有参考价值，将中医理论同社区干预相结合并发挥中医全科医生的主体地位，才能最大限度地优化干预计划中各项资源的配置，提高干预实践的实效和质量。以中医理论为指导的社区干预将是未来全科医学在基层卫生保健事业中防治疾病、促进健康的有力武器。 

Exploring the community intervention of recurrent abortion based on the concept of "preventing disease from the beginning makes the human body peaceful"

Recurrent abortion is one of the common and frequently occurring diseases in modern gynaecology. It is not only a medical problem but also a social burden that gradually affects marriage life and family harmony, causing serious problems to the physical and mental health of women in childbearing age. Recurrent abortion has the characteristics of "abortion will occur at a specific time". It is more effective to avoid the recurrence of abortion by clarifying the causes of abortion, actively regulating the body and early prevention and intervention. Community intervention aims to change people' s behaviour, habits and lifestyles through comprehensive intervention and then intervene the risk factors in the occurrence and development of diseases. This process fully reflects the connotation of three-level prevention. Traditional community intervention has played a positive role in the prevention and control of recurrent abortion, but the influence of intervention projects is mostly limited to the pilot stage and the pilot area, which is difficult to promote and apply in a large scale. In view of the series of problems of community intervention for recurrent abortion, the writer systematically sorted out Professor Jiang Li-juan' s concept of "prevent disease from the beginning makes the human body peaceful", and specifically elaborated how to carry out effective intervention for patients with recurrent abortion in community practice and built a systematic community intervention system from the "harmony of Qi and blood", phased recuperating; "harmony of will", regulating emotion; "harmony cold and mild", attaching importance to people' s physique; and "doctor-patient harmony", enhancing the concept of disease. This concept is not only applicable to recurrent abortion but also has reference value for the development of community intervention for other diseases. Combining the theory of traditional Chinese medicine with community intervention and giving play to the dominant position of general practitioners of traditional Chinese medicine can optimise the allocation of various resources in the intervention plan to the maximum extent and improve the effectiveness and quality of the intervention practice. Community interventions guided by TCM theory will be a powerful tool for the future of general medicine in primary health care to prevent and treat diseases and promote health.