立足学科特点,澄清针灸标准化的若干认识问题
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摘要
当前针灸标准化工作还存在认识不到位、基本理论混淆的情况,为更好地推进下一步的工作,有必要回顾来路,澄清认识。本文根据标准化的定义、原则和方法,结合针灸标准化实践,分析了针灸标准化与针灸现代化、针灸标准化与个体化诊疗、现代标准与传统经典,以及标准研制与针灸科研4个方面的关系,提出①要立足学科发展,客观地分析国内与国际、科研与临床的不同需求,明确针灸标准化的真正目的;②既不能借个体化一味地排斥标准化,也不能简单地用标准化的理念和方法改造针灸;③需要回到针灸学自身,以标准化的视角,重新审视针灸学,深入分析和思考针灸学的哪些特征需要标准化、如何标准化等问题;④应将科研与标准研制有机结合,以书写经典的态度来编写标准,提高标准质量,从而真正发挥以针灸标准化促进学科发展的目的。
At present, there is still a underrecognition of the standardization work of acupuncture and moxibustion and the confusion of the basic theory. In order to better advance the next step, it is necessary to review the way and clarify the understanding. Based on the definition, principles and methods of standardization, combined with the practice of standardization of acupuncture and moxibustion, this paper analyzes the relationship between standardization and modernization, standardization and individualization diagnosis and treatment, modern standards and traditional classics,as well as standard development and research, it is proposed to base on the development of disciplines, objectively analyze the different needs at home and abroad, as well as scientific research and clinical practice, and clarify the true purpose of standardization of acupuncture and moxibustion. Standard cannot be simply developed on the base of the individual characteristics of acupuncture, and it is not possible to simply develop acupuncture with standardized concepts and methods. It is necessary to return to acupuncture itself and re-examine acupuncture and moxibustion from a standardized perspective, e.g.in-depth analysis and reflection on which characteristics of acupuncture need to be standardized, how to standardize. It is proposed that the scientific research should be organically combined with the development of standards, and drafting should be in compliance with the rules and the quality of the standard should be improved, so as to truly promote the development of the discipline of acupuncture.
At present, there is still a underrecognition of the standardization work of acupuncture and moxibustion and the confusion of the basic theory. In order to better advance the next step, it is necessary to review the way and clarify the understanding. Based on the definition, principles and methods of standardization, combined with the practice of standardization of acupuncture and moxibustion, this paper analyzes the relationship between standardization and modernization, standardization and individualization diagnosis and treatment, modern standards and traditional classics,as well as standard development and research, it is proposed to base on the development of disciplines, objectively analyze the different needs at home and abroad, as well as scientific research and clinical practice, and clarify the true purpose of standardization of acupuncture and moxibustion. Standard cannot be simply developed on the base of the individual characteristics of acupuncture, and it is not possible to simply develop acupuncture with standardized concepts and methods. It is necessary to return to acupuncture itself and re-examine acupuncture and moxibustion from a standardized perspective, e.g.in-depth analysis and reflection on which characteristics of acupuncture need to be standardized, how to standardize. It is proposed that the scientific research should be organically combined with the development of standards, and drafting should be in compliance with the rules and the quality of the standard should be improved, so as to truly promote the development of the discipline of acupuncture.
引文
[1]中华人民共和国国家质量监督检验检疫总局,中国国家标准化管理委员会.腧穴名称与定位(GB/T 12346-2006)[S].北京:中国标准出版社,2006.
[2]孙文善.试论针灸学研究的标准化与规范化[J].针灸临床杂志,1996,12(9):3-4.
[3]Hinman RS,McCrory P,Pirotta M,et al.Acupuncture for chronic knee pain:a randomized clinical trial[J].JAMA,2014,312(13):1313-1322.
[4]周蔓仪.多国学者捍卫针灸疗效[N].中国中医药报,2015-02-16(002).
[5]胡彬.用过硬结果证实针灸疗效[N].中国中医药报,2015-03-11(001).
[6]刘炜宏,郝洋,李荫龙,等.针刺真的对膝关节痛无效吗?--从JAMA的一项研究报告谈起(英文)[J].World JAcup-Moxi,2015,25(4):1-4,19.
[7]景向红.我国针灸理论和经验要传出去[N].中国中医药报,2015-03-11(003).
[8]陈超,刘炜宏,王宏才,等.国外临床实践指南相关针灸内容的调查与分析[J].中国针灸,2018,38(4):425-429.
[9]王皓然.针灸不能一味地标准化[N].经济参考报,2015-08-28(023).
[10]武晓冬,刘保延.我国针灸标准化的现状及面临的挑战与对策[J].中国针灸,2019,39(4):345-346.
[11]李鸿涛.余瀛鳌通治方验案按[M].北京:北京科学技术出版社,2017:20-28.
[12]帅建忠.高血压治疗的标准化与个体化[J].北方药学,2011,8(5):66.
[13]范钊坤,周小青,曾逸笛,等.对中医诊断标准化与治疗个体化的思考[A]//中华中医药学会中医诊断学分会第十五次中医诊断学术年会论文集.晋江:中医中医药学会,2014.
[14]杨兴华,王莹莹,詹思延,等.中医师临床实践参阅文献状况的访谈分析[J].医学与哲学(人文社会医学版),2009,30(8):60.
[15]黄煌,许志泉.标准化与中医学的发展[J].中医药信息,1988(2):3-7.
[16]白殿一.标准的编写[M].北京:中国标准出版社,2009:72.
[17]陈泽林,郭义,李桂兰.国家标准《针灸技术操作规范第4部分:三棱针》的若干问题探讨[J].中国针灸,2009,29(2):152.
[18]徐慧青.浅析炭药的炮制质量控制[J].浙江医学教育,2009,8(4):43-44.
[19]常存库,王宜静,梁晓平.中医药学技术操作系统研究纲要[J].医学与哲学,2002(10):58-59.
[20]谭亚芹,马昕婷,王琦,等.国家标准《腧穴名称与定位》(GB/T 12346-2006)使用情况调查研究[J].中国针灸,2016,36(8):873.
[21]黄龙祥.表面解剖学、影像学、人体测量学方法在针灸腧穴定位标准化研究中的综合应用[J].针刺研究,2007,32(4):268-272.
[2]孙文善.试论针灸学研究的标准化与规范化[J].针灸临床杂志,1996,12(9):3-4.
[3]Hinman RS,McCrory P,Pirotta M,et al.Acupuncture for chronic knee pain:a randomized clinical trial[J].JAMA,2014,312(13):1313-1322.
[4]周蔓仪.多国学者捍卫针灸疗效[N].中国中医药报,2015-02-16(002).
[5]胡彬.用过硬结果证实针灸疗效[N].中国中医药报,2015-03-11(001).
[6]刘炜宏,郝洋,李荫龙,等.针刺真的对膝关节痛无效吗?--从JAMA的一项研究报告谈起(英文)[J].World JAcup-Moxi,2015,25(4):1-4,19.
[7]景向红.我国针灸理论和经验要传出去[N].中国中医药报,2015-03-11(003).
[8]陈超,刘炜宏,王宏才,等.国外临床实践指南相关针灸内容的调查与分析[J].中国针灸,2018,38(4):425-429.
[9]王皓然.针灸不能一味地标准化[N].经济参考报,2015-08-28(023).
[10]武晓冬,刘保延.我国针灸标准化的现状及面临的挑战与对策[J].中国针灸,2019,39(4):345-346.
[11]李鸿涛.余瀛鳌通治方验案按[M].北京:北京科学技术出版社,2017:20-28.
[12]帅建忠.高血压治疗的标准化与个体化[J].北方药学,2011,8(5):66.
[13]范钊坤,周小青,曾逸笛,等.对中医诊断标准化与治疗个体化的思考[A]//中华中医药学会中医诊断学分会第十五次中医诊断学术年会论文集.晋江:中医中医药学会,2014.
[14]杨兴华,王莹莹,詹思延,等.中医师临床实践参阅文献状况的访谈分析[J].医学与哲学(人文社会医学版),2009,30(8):60.
[15]黄煌,许志泉.标准化与中医学的发展[J].中医药信息,1988(2):3-7.
[16]白殿一.标准的编写[M].北京:中国标准出版社,2009:72.
[17]陈泽林,郭义,李桂兰.国家标准《针灸技术操作规范第4部分:三棱针》的若干问题探讨[J].中国针灸,2009,29(2):152.
[18]徐慧青.浅析炭药的炮制质量控制[J].浙江医学教育,2009,8(4):43-44.
[19]常存库,王宜静,梁晓平.中医药学技术操作系统研究纲要[J].医学与哲学,2002(10):58-59.
[20]谭亚芹,马昕婷,王琦,等.国家标准《腧穴名称与定位》(GB/T 12346-2006)使用情况调查研究[J].中国针灸,2016,36(8):873.
[21]黄龙祥.表面解剖学、影像学、人体测量学方法在针灸腧穴定位标准化研究中的综合应用[J].针刺研究,2007,32(4):268-272.
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