基于“四回归九系统”的中医经典病房全要素构建的思考与探索

Consideration and exploration of total elements construction in classical wards of Chinese medicine based on‘four regression and nine systems’

中医药在新时代国家战略中已上升为中西医并重,近期启动的中医经典病房建设,反映了学术界对中医药在住院病房中充分应用的担忧和希望。目前中医药在住院病房的应用存在边缘化和形式化的问题。笔者认为,经典中医在病房的完整实现有赖于4个回归,即回归中医经典思维、回归中医经典目的、回归中医经典方法以及回归中医经典文化。在“四回归”的牵引和指导下,以包含收治病种界定、诊断辨证思维形成、中医病案记录系统开发、诊疗护理方法集成、经典查房系统设计、临床经典集成教学、临床经典研究、医疗安全保障和中医文化展陈等“九系统”全要素整体构建为框架,延续和深化中医药特色,强化现代进展和临床解释,是设计中医经典病房的关键所在。

Traditional Chinese medicine(TCM)has been promoted to attach equal importance to both Chinese and western medicine in the national strategy of the new era.The construction of classical wards of TCM launched recently also reflected the worries and hopes of leaders and academia about the full application of TCM in inpatient wards.At present,the application of TCM in the inpatient ward had some problems of marginalization and formalization.We believed that the return of TCM to the main clinical battlefield and the complete realization of TCM inward depend on four regressions,namely,the return to classical thinking of TCM,the return to the classical purpose of TCM,the return to classical methods of TCM and the return to classical culture of TCM.Under the guidance of the‘four regressions’,taking the total element construction of‘nine systems’as the framework which including the definition of disease types,the formation of diagnostic and dialectical thinking,the development of medical record system,the integration of diagnostic,therapeutic and nursing methods,the design of classical ward rounds system,the integrated teaching of clinical classics,the research of clinical classics,medical security and the exhibition of TCM culture,continuing and deepening the characteristics of TCM,as well as strengthening the modern progress and clinical interpretation,was the key to design the classical wards of TCM.