中、西醫合璧？─台灣中西整合醫學趨勢與未來發展

The integration of Chinese & Western Medicine? -- The trend and future development of Integrated Medicine in Taiwan

何瑞(Jui Ho)

指導教授 ： 陳榮基

共同指導教授 ： 陳家帶(Chia-Tai Chen)

國立臺灣大學/社會科學院/新聞研究所/碩士(2006年)

https://doi.org/10.6342/NTU.2006.03156

摘要

近年來，中醫藥逐漸邁入現代醫學的殿堂，成為另類醫學研究中最重要的一環。全球化脈絡下，台灣中醫藥不但融入了現代科學的元素，也開始有中西整合醫學的討論，「多重醫事人員資格者執業管理辦法」訂定後，兼具中西醫雙執照的「中西整合專科醫師」，也具備執業的適法性。
本研究擬從「病人」的角度出發，描繪初步發展的新醫學－中西醫合併治療，所提供的醫療服務與醫療品質；並點出在鉅觀的醫療環境與微觀的醫療互動中，中西醫合併治療所必須面對的一些問題。研究使用參與觀察、深度訪談的方式，並輔以文獻資料的回顧整理。筆者雖不屬於醫界，但期以報導文學的方式，整理醫師專家、學者們的意見，替剛萌芽的新醫學提供些許養分，也希望醫界、甚至全體公民，對中西醫整合的議題能有些不同的思考。
研究結果發現，「截長補短、相輔相成」是中西醫合併治療最大的優勢，由「中西整合專科醫師」進行中西醫合併治療，治療效果更勝中、西醫會診。「西醫辨病、中醫辨證」的合作方式與中醫「循證醫學」(EBCM)，是目前中西整合醫學發展的共識。
研究中指出，鉅觀的醫療環境，諸如健保制度的設計、醫療政策的規劃及中醫特考所產生的問題等，都是短時間難以解決的阻礙。而在微觀的醫療互動，中、西醫雙方也會因意願、認知及其他顧慮造成治療效果打折。近程而言，多數受訪者對台灣中西醫整合都抱持悲觀態度；但都認為「科學進展」對中西整合醫學所注入的活力相當可觀，若就長期來看，則對台灣中醫藥未來的發展是樂觀的。
中西醫整合的議題雖然已紛擾多年，但至目前都還是個初步發展的領域，無法深度討論，很容易淪為中、西醫雙方各說各話。本文研究結果部分呼應了先前的研究，但透過實際的訪談了解到，中西醫整合問題是由相當複雜的面向彼此交構而成，不單單僅有醫政的責任，諸多因素都牽涉到未來醫學發展的不確定性。

關鍵字

中醫 ； 中西醫 ； 新醫學 ； 中西合璧 ； 中西醫整合 ； 醫學趨勢

並列摘要

In recent years, Chinese medicine are gradually getting into the field of modern medicine, being the most important part of the alternative medicine study. In this consequence, Chinese-medicine in Taiwan not only adds some scientific elements in its sphere, but also begins the discussion of the Chinese and Western Integrated Medicine. Double-certificated doctors have the proper method of management after the related law making.
This research draws up to set out from patient’s view, describing the New Medicine—Chinese & Western Integrated Treatment, provided medical serve and medical treatment quality. And also point out some problems in the medical treatment environment of the huge view and the medical treatment interaction of the tiny view.
Writer adopts the participated and observation method, depth interview, and assists by the review of cultural heritage data. Although the writer doesn't belong to the medical boundary, the writer hope to provide some nutrient for the lately- sprouted new medical science, and to provide some different thinking for medical sphere and all citizens by tiding up the opinion of doctors, experts, and the scholars with the reportage.
Results show that "balance shortage with abundance, complement each other" is the biggest advantage of integrated treatment. Merger treatment by “integration specialty doctor" may be better than doctor consultation. “Western medicine recognizes the disease; Chinese medicine recognizes the symptom” and “Evidenced-based Chinese medicine”(EBCM) are the current consensus.
The medical treatment environment, such as the design of health insurance system, the program of medical treatment policy, and the problems caused by Chinese-medicine-special-test etc., are all bars to solve in a short time. And in the medical treatment interaction, cure result may be worse because of the doctors’ will, cognition and other worries. In short-term, most interviewees embrace a pessimistic attitude to the integrated medicine in Taiwan; but all think that “science progress” make considerable vitality into the integrated medicine, if long-term to see, then all interviewees are optimistic to the development in the future.
The study partly responds to the previous researches, but through the actual interviews, we understand the integrated medicine is a rather complicated problem. Not only the responsibility of the government, many factors all cause the “uncertainty” of the medical science development.

並列關鍵字

Chinese medicine ； integrated doctor ； medical trend ； new medical science ； merger treatment ； Chinese and western integrated medicine

參考文獻

林昭庚主編（2004）。《台灣中醫發展史》。中華民國中醫師公會全國聯合會。

陳可冀（2002）。〈第二次世界中西醫結合大會論文摘要〉。

李卓倫、纪駿輝、賴俊雄（1995）。〈1981~1994年中醫政策研究之回顧〉，《中華公共衛生雜誌》。

論文部分

李端容（2003）。《台灣中醫藥研究現況與趨勢之研究》。台北護理學院中西醫結合護理研究所碩士論文。