方证辨证在住院医师规范化培训师承临床教学中的应用

The Application of Prescription Syndrome Differentiation in the Clinical Teaching of Residential Training

目的:探讨方证辨证在住院医师规范化培训师承临床教学中的运用,突出方证"辨"的特色,培养学生树立方证的概念和以方证为核心的临床辨治思维。方法:选择2018级住院医师规范化培训医师及专硕并轨住院医师规范化培训医师共60人为研究对象,按随机数字表法分为试验组和对照组,每组30人。试验组采用"方证辨证教学模式"教学,对照组采用"传统辨证论治教学模式"教学,两组学生经过一年跟师临床学习后,每个学生选取10位患者,由学生独立完成诊治,开具处方,同时带教老师也对同一患者开具处方,最后考核师徒处方的吻合率。结果:试验组师徒处方吻合率高于对照组,差异有统计学意义(P<0.05)。结论:方证辨证教学模式可培养学生树立方证的概念和以方证为核心的临床辨治思维,有助于提高临床疗效,符合当代医学教育改革趋势和目标要求。

Objective: To discuss the application of prescription syndrome differentiation in the clinical teaching of residential training, and to highlight the characteristics of prescription syndrome differentiation, then to cultivate students to establish the concept of syndromes and the clinical differentiation and treatment thinking based on syndromes. Methods: A total of 60 doctors in the 2018 level of live training and masters and masters were selected as the research subjects. They were divided into experimental group and control group according to the random number table method, with 30 doctors in each group. The experimental group adopts the "Teaching Mode of Syndrome Differentiation and Treatment" for one year, and the control group adopts the traditional "Teaching Mode of Syndrome Differentiation and Treatment". After one year of clinical study with the teacher,each student selects 10 patients, then complete the entire diagnosis and treatment process independently, and finally write out the prescription. At the same time, the teacher also writes a prescription for the same patient,and finally evaluates the coincidence rate of the master-disciple prescription. Results: The anastomosis rate of the experimental group was significantly higher than that of the control group(P <0.05). Conclusion: The new teaching mode of "differentiation of prescriptions and syndromes" trains students to establish the concept of syndromes and the thinking of clinical differentiation based on prescriptions and syndromes, and improve clinical efficacy, which is in line with contemporary medical education reform trends and goals.