中医之“无形叙事”对叙事医学的启示

Enlightenment of“Invisible Narrative”in traditional Chinese medicine to narrative medicine

面对全球公共卫生领域日益突出的思想价值有关问题,叙事医学应运而生。探究中医学特点发现,人文精神贯穿疾病诊疗的始终,因此中医学的“叙事”性质与生俱来。在诊疗中,中医医者通过“四诊合参”“见微知著”记录以患者为主角的平行病历,并结合病机、辨证、处方要素形成“无形叙事”逻辑,最终使医患双方真正做到在精神层面上的理解与信任,这充分体现叙事医学三要素:关注,再现和归属。基于此,在我国医疗现状下探讨中医“无形叙事”理念,以期为叙事医学达到医患共情的最终目的提供借鉴。

In the face of the increasingly prominent ideological value-related issues in the global public health field,narrative medicine has emerged as the times require.Exploring the characteristics of traditional Chinese medicine in that the humanistic spirit runs through the diagnosis and treatment of diseases,so the“narrative”nature of traditional Chinese medicine is inherent.In diagnosis and treatment,traditional Chinese medicine practitioners record parallel medical records with the patient as the protagonist through the“four diagnoses combined with reference”and“seeing the micro-knowledge”,and combine pathogenesis,syndrome differentiation,and prescription elements to form an“invisible narrative”logic.Finally,both doctors and patients can truly understand and trust on the spiritual level.This fully embodies the three elements of narrative medicine:attention,reproduction and belonging.Based on this,the concept of“invisible narrative”in Chinese medicine is explored under the current medical situation in China,in order to provide a reference for narrative medicine to achieve the ultimate goal of doctor-patient empathy.