循证医学与个体化医疗

基金项目:国家重点基础研究发展计划(973计划)资助项目(No.2006CB504602)

Correspondence :Jian 2ping L IU ,MD ,Professor ;Tel :010*********;E 2mail :jianping_l @

Editorial 专论　

循证医学与个体化医疗

刘建平

北京中医药大学循证医学中心,北京100029

摘要:21世纪临床医学强调个体化医疗模式,这种模式的提出是基于人类基因组计划(基因分型和多核苷酸多态性)的发现以及新的医疗模式(生物2心理2社会2环境2精神),充分体现了以人为本的医疗理念,这与中医药数千年来的个体化辨证论治有不谋而合之处。循证医学时代对个体化医疗的理解和要求促进了对个体化医疗的实践研究,真正使外部研究证据、医生个人技能和经验与患者的价值观和偏爱有机结合,做出明智、合理的医疗决策。本文论述了个体化医疗的含义以及中医的个体化诊疗特征,就循证医学时代如何开展个体化诊疗和实践研究提出了建议。

关键词:循证医学;临床医疗模式;个体化医学;辨证论治

Liu J P.J Chin I nteg r Med.2009;7(6):5052508.

Received April 13,2009;accepted April 24,2009;published online J une 15,2009.

Indexed/abstracted in and f ull text link 2out at PubMed.Journal title in PubMed :Zhong X i Yi J ie He X ue B ao.Free f ull text (H TML and PDF )is available at .Forward linking and reference linking via CrossRef.DOI :10.3736/jcim20090602Open Access

Evi de nce 2bas e d m e dici ne a n d i n di vi d ualiz e d heal t h care

J ian 2ping L IU

Center for Evidence 2Based Chinese Medicine ,Beijing University of Chinese Medicine ,Beijing 100029,China

Abstract :In 21s t century ,clinical me dicine moves toward a model of individualize d health care.The

develop ment of the individualize d model is bas e d on the res earch findings of human genomics project including genotyp e and single nucle otide p olymorphis ms (SNPs ),as well as the new health care model ,that is ,biological 2p s ychological 2s ocial 2environmental 2spiritual.It reflects the ide a of p atient 2centere d care ,and corresp onds to the tra ditional practice of Chines e me dicine ,which a ddres s e d the individualize d therap y on the basis of s ymptom p attern differentiation.Howe ver ,the era of e vidence 2bas e d me dicine affords new meanings of individualize d he alth care and promotes the res e arch on the practice.The practice bas e d on evidence would happ en up on the inte gration of external res e arch evidence ,the exp ertis e and exp erience of practitioners ,and the value and preference of p atients ,s o the decision of health care will be cons cientious ,explicit and judicious.This as s ay des cribes the me anings of individualize d health care in different me dical contexts ,the characteris tics of individualize d practice in Chines e me dicine ,and prop os als for further res earch in practice.

K eyw ords :evidence 2bas e d me dicine ;

clinical practice p atterns ;individualize d me dicine ;s yndrome

differentiation treatment

世界卫生组织(W HO )指出21世纪的医学将从疾病医学向健康医学发展,从群体治疗向个体治疗发展。个体化医疗的模式,反映了医疗卫生领域学科发展的前沿,在未来医学发展中具有举足轻重的作用。个体化医疗也是传统中医诊疗实践的基本

方法。

1　中西医两种医疗体系下个体化医疗的含义

中西医两种不同的医疗体系对个体化医疗的理解不同。西方医学中,个体化医疗的概念最早于