中医经典传承与疾患慢病管理创新模式
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摘要
整体观、辨证论治及三因制宜等诊疗理念,是中医经典传承最主要的核心原则。对健康群体,侧重于传统养生之法以维持正常状态;对体质失衡群体,聚焦于传统医学调理以力求转归安康;对欲病群体,可拟定传统医学"治未病"专科诊治策略,避免往疾患方向转化;对已病群体,则应拓展优化兼融中医特色的疾患慢病管理范式,并将此模式进行社区化推广。文章围绕上述核心问题在中医经典与慢病管理的关联性、现代疾患慢病管理创新模式等方面展开论述,并就体质辨识与养生之道、病情评估与责任照护、慢病建档与随访、患者管理策略优化等方面进行相关分析,以期为当前慢病健康管理实践提供参考。
Holistic view, treatment based on syndrome differentiation, as well as decision chosen dependent on different conditions have been viewed are the core principles of TCM classical theories. For the healthy community, it should focus on the traditional health-preserving methods to maintain normal state; for the group of constitution out-of-balance, it should focus on TCM regulating approaches in order to restore the balance; for the subjects having a tendency to disease, it can formulate the diagnosis and treatment strategy of TCM ‘treat the pre-disease' so as to avoid the transformation of disease direction; for the sick group, it should expand the chronic disease management(CDM) with the TCM characteristics, and promote the model in the community. Based on the core problem and principles, this article attempted to discuss the issues such as association between TCM classical theories and CDM, CDM model involving modern chronic disease, focusing on constitution identification regarded regimen, disease assessment and responsibility of care, construction and follow-up of chronic disease, optimization of patient management strategy, and so on. It hope that all these considerations can provide references to the better understanding of health management of TCM chronic disease in clinical practice.
Holistic view, treatment based on syndrome differentiation, as well as decision chosen dependent on different conditions have been viewed are the core principles of TCM classical theories. For the healthy community, it should focus on the traditional health-preserving methods to maintain normal state; for the group of constitution out-of-balance, it should focus on TCM regulating approaches in order to restore the balance; for the subjects having a tendency to disease, it can formulate the diagnosis and treatment strategy of TCM ‘treat the pre-disease' so as to avoid the transformation of disease direction; for the sick group, it should expand the chronic disease management(CDM) with the TCM characteristics, and promote the model in the community. Based on the core problem and principles, this article attempted to discuss the issues such as association between TCM classical theories and CDM, CDM model involving modern chronic disease, focusing on constitution identification regarded regimen, disease assessment and responsibility of care, construction and follow-up of chronic disease, optimization of patient management strategy, and so on. It hope that all these considerations can provide references to the better understanding of health management of TCM chronic disease in clinical practice.
引文
[1]刘美玲,高星,董博锋.区域人群非传染性疾病控制管理基本理论与技术方法学研究.中国预防医学杂志,2017,18(6):431-436
[2]王维民,程刚,谢杰,等.强化医院慢病管理服务的实践.中国医院,2017,21(3):79-80
[3]修麓璐,高玉芳,王会会,等.以家庭为中心的慢病管理对COPD患者自我管理及生活质量的影响.中国医药导报,2017,14(11):151-154
[4]王维民,吴庆园,马靖,等.运动干预在慢病管理服务中的应用.中国慢性病预防与控制,2016,24(12):940-942
[5]黄建波,张光霁.论“治未病”理论体系建设.中华中医药杂志,2017,32(3):911-914
[6]吴长汶,朱龙,唐娜娜,等.基于治未病思想指导下的疾病风险预警系统研究.中华中医药杂志,2017,32(7):2848-2852
[7]黄少桐,刘红宁,陈晓凡.中医食疗单用或联合其他干预方式治疗中老年功能性便秘疗效比较的系统评价.中华中医药杂志,2016,31(4):1434-1439
[8]李燕燕,韩继红.中医食疗对老年骨质疏松症患者临床症状和骨密度的影响研究.护士进修杂志,2010,25(6):490-492
[9]Yeh G Y,Wang C,Wayne P M,et al.Tai chi exercise for patients with cardiovascular conditions and risk factors:A systematic review.J Cardiopulm Rehabil Prev,2009,29(3):152-160
[10]贾巧,朱俐俐.太极拳结合心理干预改善代谢综合征患者危险因素及脂联素的研究.心血管康复医学杂志,2010,19(4):337-339
[11]Wayne P M,Kiel D P,Krebs D E,et al.The effects of Tai Chi on bone mineral density in postmenopausal women:a systematic review.Archives of Physical Medicine&Rehabilitation,2007,88(5):673-680
[12]王琦.中医体质学说的研究现状与展望.山东中医药大学学报,1994,18(2):74-82
[13]李玲孺,王济,李英帅,等.中医病证关系的基础研究现状及引入中医体质维度的必要性.中华中医药杂志,2017,32(6):2347-2349
[14]杨焕新,于艳红,乔明琦.抑郁症与中医九种体质的关系探讨.中华中医药杂志,2016,31(6):2048-2050
[15]岳子敬,杨宜婷,林晓亮,等.对超重/肥胖人群采用中式体质量管理方案早期干预效果的临床观察.中华中医药杂志,2016,31(9):3838-3842
[16]张和韡,马淑然,田甜.关于五脏应时理论内涵的探讨.中华中医药杂志,2016,31(5):1764-1766
[17]陈丽如,王林恒,王红梅,等.胆汁反流性胃炎发病规律的相关调查.中国中西医结合消化杂志,2015,23(2):108-111
[18]罗颂明.基于“心应夏”理论探讨气温骤变对胸痹发病影响理论及实验研究.北京:北京中医药大学,2012
[19]李灿东,李思汉,詹杰.中医健康认知与健康管理.中华中医药杂志,2019,34(1):202-205
[20]姚远,王高玲.社会管理视角下慢病管理体系的重构.中国卫生事业管理,2017,34(2):157-160
[2]王维民,程刚,谢杰,等.强化医院慢病管理服务的实践.中国医院,2017,21(3):79-80
[3]修麓璐,高玉芳,王会会,等.以家庭为中心的慢病管理对COPD患者自我管理及生活质量的影响.中国医药导报,2017,14(11):151-154
[4]王维民,吴庆园,马靖,等.运动干预在慢病管理服务中的应用.中国慢性病预防与控制,2016,24(12):940-942
[5]黄建波,张光霁.论“治未病”理论体系建设.中华中医药杂志,2017,32(3):911-914
[6]吴长汶,朱龙,唐娜娜,等.基于治未病思想指导下的疾病风险预警系统研究.中华中医药杂志,2017,32(7):2848-2852
[7]黄少桐,刘红宁,陈晓凡.中医食疗单用或联合其他干预方式治疗中老年功能性便秘疗效比较的系统评价.中华中医药杂志,2016,31(4):1434-1439
[8]李燕燕,韩继红.中医食疗对老年骨质疏松症患者临床症状和骨密度的影响研究.护士进修杂志,2010,25(6):490-492
[9]Yeh G Y,Wang C,Wayne P M,et al.Tai chi exercise for patients with cardiovascular conditions and risk factors:A systematic review.J Cardiopulm Rehabil Prev,2009,29(3):152-160
[10]贾巧,朱俐俐.太极拳结合心理干预改善代谢综合征患者危险因素及脂联素的研究.心血管康复医学杂志,2010,19(4):337-339
[11]Wayne P M,Kiel D P,Krebs D E,et al.The effects of Tai Chi on bone mineral density in postmenopausal women:a systematic review.Archives of Physical Medicine&Rehabilitation,2007,88(5):673-680
[12]王琦.中医体质学说的研究现状与展望.山东中医药大学学报,1994,18(2):74-82
[13]李玲孺,王济,李英帅,等.中医病证关系的基础研究现状及引入中医体质维度的必要性.中华中医药杂志,2017,32(6):2347-2349
[14]杨焕新,于艳红,乔明琦.抑郁症与中医九种体质的关系探讨.中华中医药杂志,2016,31(6):2048-2050
[15]岳子敬,杨宜婷,林晓亮,等.对超重/肥胖人群采用中式体质量管理方案早期干预效果的临床观察.中华中医药杂志,2016,31(9):3838-3842
[16]张和韡,马淑然,田甜.关于五脏应时理论内涵的探讨.中华中医药杂志,2016,31(5):1764-1766
[17]陈丽如,王林恒,王红梅,等.胆汁反流性胃炎发病规律的相关调查.中国中西医结合消化杂志,2015,23(2):108-111
[18]罗颂明.基于“心应夏”理论探讨气温骤变对胸痹发病影响理论及实验研究.北京:北京中医药大学,2012
[19]李灿东,李思汉,詹杰.中医健康认知与健康管理.中华中医药杂志,2019,34(1):202-205
[20]姚远,王高玲.社会管理视角下慢病管理体系的重构.中国卫生事业管理,2017,34(2):157-160
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