经方医学体系的循证医学理念和精准医学特征

The concept of evidence-based medicine and the characteristics of precision medicine in the classical prescriptions medicine system

汉代及汉代之前,中医学分为两大学术体系,即医经体系与经方体系,《汉书·艺文志》阐述了经方医学体系的概念及医经与经方两大体系的区别。中医学的科学性体现在其具有循证医学理念和精准医学的特征。从证据的获得与评价、证据的分级、推荐意见的形成与推荐强度的确定等3个方面研究表明,经方体系具备循证医学理念,辨方证、药症加减化裁及方剂用量、用法3个方面体现了经方医学体系的精准辨证和精准治疗的特征。经方医学是一门科学,是最古老的循证医学,是一门“精准医学”,经方医学体系与循证医学的深度融合是循证中医药学的发展方向。

Before and during the Han Dynasty, traditional Chinese medicine was divided into two academic systems, namely, the medical classics system and the classical prescriptions medicine system. Han Shu · Yiwenzhi expounds the concept of the medicine system of classical prescriptions and the differences between the two systems. The scientificity of traditional Chinese medicine is embodied in its concept of evidence-based medicine and its characteristics of precision medicine. This paper demonstrates that the classical prescriptions medicine system has the concept of evidence-based medicine from the following three aspects: the acquisition and evaluation of evidences, the classification of evidences, the formation of recommendation opinions and the determination of recommendation strengths. The characteristics of precise syndrome differentiation and precise treatment in the medicine system of classical prescriptions are reflected from another three aspects: drawing up prescriptions according to syndrome differentiation, modifying medications according to specific symptoms, and determining dosages and usages of prescriptions. Therefore, the classical prescriptions medicine system is a science, the oldest evidence-based medicine and a “precision medicine”. It is proposed that the deep integration of the classical prescriptions medicine system and evidence-based medicine is the development direction of evidence-based Chinese medicine.