摘要
中医学在现今临床上高度重视慢性疑难病、“未病”的治疗,而对急危重症的治疗提及不多,甚至在急诊、急救领域大有阵地不断萎缩趋势。急危重症是指在临床上具有病情急、病势重、进展快、死亡率高的一类疾病。历代中医名家的成长心路历程,无一不是在处理急危重症的实践经历中磨练砥砺而成。《伤寒论》是一部治疗急危重症的专著,而经方尤为《伤寒论》中治疗急危重症的核心与精华。在临床现状方面,突破现行普遍认为的只有门诊上的慢性疾病、调理类疾病才是中医学的“优势病种”的思维定势,寻找中医在急危重症领域的临床优势切入点,探索《伤寒论》与重症医学的学科交叉,提升经方治疗急危重症能力,建立经方治疗急危重症的学科体系,揭示经方治疗急危重症的临床证据,提升中医学在急危重症领域的贡献度,已成为现今中医临床的强烈呼唤与需求。在关键科学问题方面,经方治疗急危重症的体系涵盖伤寒本质、六经实质、条文内涵与经方剂量等传统核心理论。在未来的学术传承与体系构建上,以临床难题为导向,突破现行传统经典学科体系存在的模式单一,创新能力薄弱,转化能力不足等问题,建议明确急危重症领域的中医优势病种,倡导基于“病机结合病理,药性结合药理”的研究模式,树立多学科的综合思维模式,鼓励倡导医教研产协同创新研究,为完善经方治疗急危重症体系构建的路径与关键。
In contemporary clinical practice of traditional Chinese medicine(TCM),there is a strong emphasis on treating chronic difficult diseases and preventing diseases before they occur("pre-disease"treatment).However,the treatment of critical care medicine has not received as much attention and is even facing a trend of diminishing influence in the field of emergency medicine and critical care.Critical care medicine refers to a class of diseases that are characterized by rapid onset,severity,quick progression,and high mortality rates in clinical practice.The growth and development of renowned TCM experts throughout history have invariably been honed through practical experiences in managing critical care medicine.Treatise on Cold Damage(《伤寒论》)is a dedicated work for treating critical care medicine,and the classic prescriptions in Treatise on Cold Damage are particularly central to the treatment of these diseases.In the current clinical context,it is important to break through the prevailing mindset that the strengths of TCM lie solely in treating chronic diseases and maintenance-type illnesses,identify the entry point of TCM in the clinical advantages in the field of critical care medicine,explore the interdisciplinary relationship between Treatise on Cold Damage and critical care medicine,enhance the ability to treat critical care medicine using classic prescriptions,establish a disciplinary system for prescription-based treatment of critical care medicine,reveal clinical evidence for prescription-based treatment of these diseases,and elevate the contribution of TCM in the domain of critical care medicine.These have become a strong call and demand in contemporary TCM clinical practice.Regarding key scientific issues,the system of using classic prescriptions to treat critical care medicine encompasses traditional core theories such as the nature of cold damage,the essence of the six meridians,the implications of specific clauses,and the dosages of classic prescriptions.In the context of future academic inheritance and system construction,it is recommended to focus on clinical challenges,break away from the current limitations of traditional classical disciplinary systems,such as their singular patterns and weak innovative and translational capabilities,suggest defining diseases in critical care medicine responding specifically to TCM,advocate a research model based on combining disease mechanisms with pathology and combining medicinal properties with pharmacology,establish a comprehensive multidisciplinary thinking mode,and encourage collaborative innovative research among medical,educational,research,and manufacturing institutions.This will help chart the path and address key aspects of constructing a comprehensive system for prescription-based treatment of critical care medicine.
作者
熊兴江
XIONG Xingjiang(Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2023年第20期169-174,共6页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金项目(81403375)
中国科协青年人才托举工程项目(2017QNRC001)
中国中医科学院育苗基金培育专项(ZZ11-073)
中国中医科学院优秀青年科技人才专项(ZZ13-YQ-018,ZZ13-YQ-018-B1)。
关键词
经方
《伤寒论》
急危重症
体系构建
classical prescriptions
Treatise on Cold Damage
critical care medicine
system building
