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对于中医的信任的基础是对中国祖先的信任

1、信任产生质疑的根源:

问:在就医过程中,好多患者对中医药的疗效抱怀疑态度。部分患者往往出于惯性思维认为只有大医院才能治好病,小地方小门诊根本没有好大夫,事实真是这样的吗?一些患者说“西医见效快,中医见效慢”,甚至说“中医药没效果”,而很多基层老中医说治病要治本,中医疗效也不慢,还便宜、较少副作用。两种观点针锋相对。传承千年的中医药为何会遭遇疗效信任危机? 答:传统中医遭遇现代尴尬,原因很复杂。理性患者都深信:看西医重“庙”(医院)、看中医重“人”(医师)。魏氏中医眼科四代人传承的漫长岁月中积累了更多的临床经验,魏主任更加善于思考问题,魏主任诊病考虑的是个体化诊疗,因为魏医生深知医师个人的诊疗水平和用药的质量共同对疗效起决定作用。为魏氏中医眼科配送中药饮片的药材公司都是具备完善的资质证书的大型药材公司市场,选用高质量的中药材,就是为了保证疗效最大化。此外,现代社会工作和生活节奏加快,人们普遍“急功近利”,往往只求尽快“见效”,至于是“治本”还是“治标”并不很在意。魏主任说,一部分病通过治疗效果往往几天就能明显显示出来。而有些高度疑难眼科疾病则需要分步治疗,自然会给患者“慢”的感觉。如果疏于解释患者往往半途而废。放弃治疗另选他家。最终错过关键治疗时机,遗憾终生。自然中所以说医生和患者的彼此信任非常关键。

2、以西医化验指标评价中医的具体疗效:

问:既然现在许多人偏好用定量化、标准化的模式来衡量中医药,那么中医药采取西医药标准,走“西化”道路,能成功脱离被边缘化的局面吗?答:中医药国情调研组执行组长陈其广认为,造成中医药“西化”局面的原因非常复杂。一是思想意识。近代中国饱受列强欺凌,一些先行者借用西方的思想和文化来改造甚至替代中国传统社会意识和文化。中医药曾被列入被取代之列。进入现代,传统文化教育一定程度上被忽视,年轻一代不大能够理解和接受中医的传统理论。往往一切以数据作为评价标准。二是管理体制。尽管政策法规都一再明确要“中西医并重”,但从管理体制和机制上并没有得到真正落实。中医药被按照西医药的标准来要求来管理。三是经济利益,这是最直接的“西化”推动力。在目前的医疗收费体制下,不论检查、药物、手术和非药物治疗等,中医的收入明显少于西医。中药材属于种植作物,产量受到地理气候影响较大,近年来受到市场炒作等因素价格波动也较大。质量价格也会受到多方面因素的影响。在这诸多原因的推动下,中医药受“西化”影响的局面自然就出现了。

3、中医药发展能不能复制西医药的模式:

从根本上讲,中西医的治疗理论完全不同。中医药国情调研组执行组长陈其广曾说过,西医追求细分还原,往往采用人为的、非自然的方式,力求对侵害人体健康的因素“除恶务净”,但在杀灭细菌和病毒,甚至进行切割手术的同时,往往打破人体平衡状态并且造成了各种各样新的问题。而中医主要是强调整体协调平衡,“治未病”,保护和利用人体自身的免疫系统来消除病痛。中医药强调个性化的方法,因人、因地、因时制宜。因此,中医药不能简单复制西医药的模式。例如中药院内制剂是在汤药一人一方的基础上开发,用于小规模适应群体的药物,同时还是发展中成药新药的重要创新途径。云南白药、三九胃泰等都是从院内制剂发展而来的。但是,目前中药院内制剂却被要求按照西药方式管理。要进行动物实验,做药毒药理。片面强调所谓的中药“有效成分”。这就根本背离了中药的性质。业内专家曾举例说,红花油有一万多种成分,而现代化学和物理手段只能讲清楚一百多种。此外,爬行动物和直立人也是无法简单比照的。比如说,巴豆用于人是泻药,而用于老鼠却成了增肥药。“神农尝百草”,中药是经过中华民族数千年亿万人的生命实践检验的。完全用西药的标准来要求中药是根本行不通的。现行的中药管理办法无视中药是经过几千年医疗实践的产物,限制了中医优势和特色的发挥。

4、如何告别现代化尴尬?:

问:既然中西医理论基础不同,结合之路自然漫长修远。面对质疑声,中医药应该怎样做,才能发挥其应有的优势效能赢得信任?答:中西医应注重临床配合,而不是非驴非马的混合。应该发挥中西医各自的专业技能特长,让更多的患者认识到中医药的价值和治病理念。发展中医药的正道在于继承和创新并重。值得一提的是“现代中药”的科研几乎完全是在模仿西药植物药的科研。端正我国的中医药科研原创方向成为重大而且紧迫的决策问题。中西医应该各取所长,相互配合,才能真正为广大人民群众造福。专家普遍认为,现代科技迅猛发展,人们的思想观念、生活环境发生了巨大的变化,中医学遭遇到的现代“尴尬”还将持续。只有建立起既能体现中医学科的实质和精华,又能适应现代诊疗的全新中医理论体系,才是中医学发展的真正希望所在。

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