中医肿瘤学临床研究中的动态辨证模式

Dynamic syndrome differentiation mode in clinical research of traditional Chinese medicine oncology

观察和实验都是获得新知的方式。临床研究的目的在于探究治疗效果"真值"的知识。为实现这一目的,中医肿瘤学临床研究应遵循先易后难的原则,从观察性研究做起,逐步过渡到实验性研究阶段,获得愈发接近"真值"的研究结果。临床研究的模式需要根据治疗模式而定。辨证论治、动态调整是中医肿瘤治疗的基本特点。因此,相较于关注药物治疗效果的专病专方和辨证分型的研究模式,注重评价医者疗效的动态辨证模式更符合中医肿瘤学临床实践。若能筛选出某一瘤种疗效最佳的医师,基于他的临证经验建立一套辨证论治数理模型,将有助于解决动态辨证模式的可重复性问题。

Observation and experimentation are both ways to gain new knowledge.The purpose of clinical research is to explore the knowledge of the‘true value’of treatment effects.To achieve this goal,the clinical research of traditional Chinese medicine(TCM)oncology should follow the principle of‘easy first and difficult later’starting from observational study and gradually transitioning to the experimental research stage,so as to obtain research results that are closer to the‘true value’.The mode of clinical research needs to be determined according to the mode of treatment.Syndrome differentiation and dynamic adjustment are the basic characteristics of tumor treatment in TCM.Therefore,compared with the research mode of special prescriptions and syndrome differentiation that focus on the effect of drug treatment,the dynamic syndrome differentiation mode that focuses on evaluating the efficacy of doctors is more suitable for clinical research in TCM oncology.If the doctor with the best curative effect for a certain tumor type can be selected,a mathematical mode based on syndrome differentiation and treatment of his clinical experience will help to solve the problem of repeatability of the dynamic syndrome differentiation mode.