从科学革命的视角看《中医内科学》教材的结构性范式

Study of Structural Paradigm in Textbook Internal Medicine of Traditional Chinese Medicine from the Perspective of Scientific Revolution

为中医内科学的理论革新建立哲学基础,满足当今医学实践的需要,借用范式理论,着重于对现行《中医内科学》教材的“结构性范式”进行哲学考察。《中医内科学》教材的“结构性范式”本质上是以证素为核心的病机语言体系和以二分法为特征的分析逻辑体系。原有的《中医内科学》范式已不能适应当代中医实践复杂性的要求,故有必要对其进行“科学革命”。革命的重点在于:保留“多维度”的思维,引导“二分法”向“层次论”转变,并且抛开“中西”意识形态的成见,践行医学的“西体中用”以弥补自身的不足。

To establish a philosophical foundation for the theoretical innovation of Traditional Chinese Medicine(TCM)internal medicine and meet the needs of today’s medical practice, the article focuses on the philosophical investigation of the "structural paradigm" in the current textbook Internal Medicine of TCM with the theory of paradigm. The "structural paradigm" of the textbook Internal Medicine of TCM is essentially a pathogenic language system with evidence as the core and an analytical logic system characterized by dichotomy. The original paradigm of Internal Medicine of TCM can no longer meet the requirements of the complexity of contemporary TCM practice, so a "scientific revolution" is quite necessary. The focus of the revolution is to retain "multidimensional" thinking and guide the transition from "dichotomy" to "hierarchy". The differences in Chinese and western ideologies should be abandoned. Western medicine system could also be applied as a complement in TCM.