循证医学与个体化医疗_医学论文.docVIP

循证医学与个体化医疗_医学论文 循证医学与个体化医疗_医学论文 【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（生物心理社会环境精神），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 Abstract: In 21st century, clinical medicine moves toward a model of individualized health care. The development of the individualized model is based on the research findings of human genomics project including genotype and single nucleotide polymorphisms (SNPs), as well as the new health care model, that is, biologicalpsychologicalsocialenvironmentalspiritual. It reflects the idea of patientcentered care, and corresponds to the traditional practice of Chinese medicine, which addressed the individualized therapy on the basis of symptom pattern differentiation. However, the era of evidencebased medicine affords new meanings of individualized health care and promotes the research on the practice. The practice based on evidence would happen upon the integration of external research evidence, the expertise and experience of practitioners, and the value and preference of patients, so the decision of health care will be conscientious, explicit and judicious. This assay describes the meanings of individualized health care in different medical contexts, the characteristics of individualized practice in Chinese medicine, and proposals for further research in practice. Keywords: evidencebased medicine clinical practice patterns individualized medicine syndrome differentiation treatment 世界卫生组织（WHO）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20世纪70年代提出，相继出现了个体化医学（individualized medicine）、个体化治疗（individualized treatment）、个体化医疗（individualized care）、个体化医疗保健（individualized health care）和客户订制治疗（tailor）。20世纪90年代末期，西方医学领域再次提出了个性化医疗（personalized medi