基于叙事医学“细读”方法探讨中医医案叙事分析方法

Discussion on the Narrative Analysis Method of Traditional Chinese Medical Cases based on the "Close Reading" Method of Narrative Medicine

医案作为叙事文本,可进行故事分析与叙事分析。叙事分析结果能够完善故事分析结果。叙事医学提出的细读方法是医学叙事分析方法的集大成者。为增加医案研读结果的完整度,借鉴叙事医学的细读方法,提出了分析医案"框架"、"形式"、"时间"、"情节"、"意愿"的方法,介绍了时间性、独特性、因果关系/偶然性、伦理性、主体间性特征等叙事医学概念对医案分析需求的启发。为了便于记录与规范医案叙事分析的过程,设计了医案叙事分析表。本研究丰富了医案研究方法,扩大了叙事医学细读方法的运用范围。

As narrative texts,medical records can be analyzed as stories and narrations.Narrative analysis can complete the results of story analysis.Close reading proposed by narrative medicine is an outstanding epitome of medical narrative analysis methods.To integrate the results of medical records study,inspired by method of close reading,this paper puts forward an analysis procedure with five elements:framework,form,time,plot and will.It introduces the inspiration of narrative medical concepts,such as timeliness,uniqueness,causality/contingency,ethics and intersubjectivity.In order to record and standardize the process of narrative analysis of TCM medical records,a narrative analysis table is designed.This study enriches the analysis methods of medical records and expands the narrative application of close reading.