反思"中西医结合"

1　中医、西医的特点及缺陷1 1　中医的特点和缺陷。中医是在总结医疗实践经验的基础上 ,以整体综合的观察方法 ,在不干扰原有生理病理状态的情况下 ,借助朴素唯物论和自发的辩证法 ,探讨人体一般反应性问题 ,形成的高度概括的医学理论。它在整体上和原则上客观地反映生命运动的规律性 ,对于疾病的发生、发展、转归以及对药物作用的认识 ,都充分体现了对立统一 (矛盾 )的整体观念。中医的最大长处 ,在于不是单纯着眼于病变局部或者只着眼于祛除病因 ,而是着眼于机体的整体治疗。疾病是由于各种病因作用于机体所产生的整体反应 ,通过“望、闻…     

人体系统的非优性与疾病的时空特征（续）

人体系统的非优性与疾病的时空特征（续）重庆第三军医大学（６３００３８）吴延瑞（４）交叉点Ｄ此点为熵与社会年龄的第二交叉点，处于熵增态中期，交叉点Ｂ后，即４０岁至５０岁之间。其标志为生活哲学已固，表现出相当的自信与守旧，一般说来是对旧的不满足，对新的看...     

论疾病治疗的自然观

人体本身对各类疾病有着强大的自我抵制和修复能力,疾病的发生和康复有其自然的进展规律,治疗疾病的过程应遵循相关规律,并辅助人体的这些能力去促进机体的修复。而现实医疗中,人们在享受医学科技成果和医疗保障实惠的同时,常常伴有过度的医疗处置或过度忽视疾病的存在,从而影响疾病本身的自然康复进程,或加重病情,甚至造成二次伤害。本文从疾病治疗自然观的角度探讨了医生和患者在应对疾病时需了解的辩证思想,并就如何认识和应用疾病治疗的自然观去诊治疾病做一探讨。     

论“中医学”的定义

“医学”是“研究人类生命过程以及同疾病作斗争的一门科学”。作为“科学”下位的两个种概念,即“中医学”与“西医学”,至今没有见到确切的定义。中医研究的是整体层次上的机体反应状态;西医研究的是组成整体的各个局部的结构与功能。中医运用的阴阳五行学说实质上是朴素、自发的系统方法;西医则选择了还原性研究方法。中医理论是综合、演绎的机体反应状态变化规律的系统状态模型;西医理论是分析、归纳的人体结构与功能的物质     

对中医体质理论应用的几点思考

1　体质与辨证辨证论治是公认的中医学的最主要特点和理论核心 ,对现代医学而言 ,也是最值得借鉴的。而“证”是对疾病发展到某一阶段的病理特点的高度概括。而病理特点的不同恰恰以体质差异为根据。中医理论认为 ,疾病的发生是以脏腑为核心 ,外感六淫 ,七情、饮食、劳逸等因素作用于人体 ,由于各脏腑禀赋强弱不同 ,从而决定着机体对某些致病因素的易感性及病变类型的倾向性。当致病因素侵犯人体 ,会随着人体阴阳的偏盛偏衰、寒热虚实的差异而发生病理性质的变化。如 :阳热偏盛之体 ,感受湿邪 ,易从热化 ,而至湿热为患。脾阳不足之人则易从…     

人类基因组伦理：问题与前景

人灰基因组计谋（HGP）试图在分子层次上更深入、更全面的认识人体,为战胜疾病增进健康提供科学依据。从而造福人类。这是人类认识生命、认识自身的自然而又必然的结果。必须反对“基因决定论”,保护基因隐私,防止基因歧视,警惕“优生运动”死灰复燃。HGP与生老病死密切相关,对伦理特别敏感,尤其要强调伦理的规范和引导作用,而不能把科技与伦理对立起来。     

城市儿童易患感觉统合失调症

日前,南京铁道医学院附属医院对南京市2486名6岁至11岁的学龄儿童通过规范、系统的测试,结果有34.9％的学龄儿童存在着不同程度的感觉统合失调。专家介绍,感觉统合失调是指外部的感觉刺激信息不能在孩子中枢神经系统进行有效的组合,从而使整个机体不能和谐的运作,久而久之,便会造成各种各样的心理障碍与疾病。     

试论熵概念与人类学习

熵概念在现代科学中已有着广泛的运用,尤其是运用它来探讨社会科学中的一些理论性问题越来越引人注目。熵是描述系统状态的物理量.用熵概念表述热力学第二定律(孤立系统的熵永不减少)表明,熵产生只能是正或零。孤立系统的熵实质是系统中微观粒子无规则运动的混乱程度的量度。相对地说,高熵对应于系统内部结构混乱程度高或有序化程度低的状度,低熵对应于系统内部结构混乱程度低或有序化程度高的状态。现代物理学已阐明,孤立系统的熵概念的内涵仍然适用于开放系统,并在开放系统中得到了发展。在一定时间内开放体系的熵改     

论中医治病求本的系统观

系统是自然物质的存在形式 ,要素、结构、功能、环境是规定一个完备系统的必要条件 ,系统观要求在系统和要素、要素和要素、系统和环境的相互作用和联系中 ,动态地、系统地考察对象。在疾病的治疗过程中 ,亦须把握疾病系统发展变化的规律和趋势 ,决定最佳目的 ,实现最佳控制。1　求本的整体性原理 :知本求本 ,注重了解并遵循天地阴阳变化规律 ,人体阴阳变化规律 ,以及人体阴阳与天地阴阳的相应关系。强调疾病要素间、疾病与人体系统、人体整体与外环境的时空变化保持动态联系 ,归为阴阳一体 ,反映了整体观的深层本质 ,即求本的整体性原理。2…     

疾病的病痛反应面面观

疾病对人体的系统作用即包括疾病自身对躯体所造成的不适,也包括各种疾病在人们日常生活或疾病过程中所引起的人们心理行为的变化,即病痛反应.疾病对人体的系统影响即包括客观部分,也包括主观部分；疾病是客观的,病痛反应是主观的；医者以客观认知为诊治的基础,患者或他人以主观认识为就医的动力.就疾病而言,客观认识永远不能代替主观认识,主观认识也永远达不到客观认识的高度.人们应当探索出一个更符合控制疾病对人体系统影响的医学模式.     

Illness perceptions in dialysis patients and their association with quality of life

The present study explored illness perceptions of end stage renal disease (ESRD) patients on both haemodialysis (HD) and peritoneal dialysis (PD) treatment, and their associations with quality of life. Leventhal's self-regulation model (SRM) was used as a theoretical framework. Illness perceptions and quality of life were assessed with the IPQ-R and the SF-36 in 91 HD and 42 PD patients participating in the NECOSAD-study. Compared to HD patients, PD patients experienced more personal control and had a better understanding of the illness. Illness perceptions explained from 17 to 51% of the variance in quality of life scores. Perception of more symptoms, more consequences and lower personal control were associated with lower well-being. The concept of illness perceptions is useful in understanding the impact of ESRD and of dialysis treatment on quality of life. Interventions aimed at providing more knowledge about ESRD and dialysis, and provision of skills to coping with the illness and its consequences may improve quality of life in dialysis patients.     

Psychological impact of illness intrusiveness in epilepsy - comparison of treatments

Chronic illnesses are associated with multiple stressors that compromise quality of life (QOL). Implicit in many of these is the concept of illness intrusiveness, the disruption of lifestyles and activities attributable to constraints imposed by chronic disease and its treatment. This study tested the illness intrusiveness theoretical framework in epilepsy and compared the impact of pharmacological and surgical treatments on illness intrusiveness and QOL. Cross-sectional data compared three epilepsy groups (N = 145): (a) 40 patients admitted for presurgical evaluation to an Epilepsy Monitoring Unit; (b) 52 patients treated pharmacologically; and (c) 53 post-surgical patients. Illness intrusiveness differed significantly across epilepsy patients with the differences primarily related to seizure control. Illness intrusiveness varied inversely with seizure control (p < .05). Seizure freedom, whether achieved by surgical or pharmacological treatments, was associated with maximal reduction of illness intrusiveness. Increased illness intrusiveness correlated significantly with decreased QOL and increased depressive symptoms. Perceived control over diverse life domains correlated positively with QOL and psychosocial outcomes. Path analysis supported the validity of the illness intrusiveness theoretical framework in epilepsy. Illness intrusiveness is an important determinant of the psychosocial impact of epilepsy and its treatment. Effective pharmacological or surgical treatment may reduce illness intrusiveness in epilepsy. Findings also offer encouragement that QOL in epilepsy, as in other chronic conditions, may be enhanced by multidisciplinary bio-psychosocial efforts. Health care providers should consider multifaceted interventions to reduce illness intrusiveness and, thereby, improve QOL.     

On the connection between sickness and sin: a commentary.

In response to the articles by Eibach and Groenhut in this issue, I argue that there is a general connection between sickness and the entrance of sin into the world. There are times when there is a causal link between more specific sin and sickness, though often the patient is the one who has been sinned against. Illness can also expose sin in a patient's life. Integrating the reality of illness into the life history of a patient is a significant pastoral care issue and can be done with humility and sensitivity if done in accordance with the teaching of Job and Ecclesiastes. These books argue that "under the sun" or this side of eternity, human beings can't grasp the coherence of life, including the "why" of illness. Rather, God provides His loving presence, through His people as a comfort to those suffering from illness.     

Illness, phenomenology, and philosophical method

In this article, I propose that illness is philosophically revealing and can be used to explore human experience. I suggest that illness is a limit case of embodied experience. By pushing embodied experience to its limit, illness sheds light on normal experience, revealing its ordinary and thus overlooked structure. Illness produces a distancing effect, which allows us to observe normal human behavior and cognition via their pathological counterpart. I suggest that these characteristics warrant illness a philosophical role that has not been articulated. Illness can be used as a philosophical tool for the study of normally tacit aspects of human existence. I argue that illness itself can be integral to philosophical method, insofar as it facilitates a distancing from everyday practices. This method relies on pathological or limit cases to illuminate normally overlooked aspects of human perception and action. I offer Merleau-Ponty’s analysis of the case of Schneider as an example of this method.     

Test of reliability of perception of parental and childhood illness behavior

This report details the reliability of perceived parental and childhood illness behavior. Three versions of the Illness Behavior Inventory were created to assess perceived illness behavior of one's mother, father, and oneself as a child. The measures were administered twice to 32 students of linguistics at a major university with a 2-wk. interval between administrations. Each measure across administrations correlated highly and significantly (.98 to .99). It was concluded that perceptions of parental and childhood illness behavior are reliable over time but their sensitivity to actual historical events remains an empirical question.     

Health Anxiety in Children: Development and Psychometric Properties of the Childhood Illness Attitude Scales

The course of severe anxiety surrounding health issues is unknown. The available literature suggests that adults who are overly anxious about health issues often interpret or misinterpret their bodily signs and symptoms to be indicative of a serious illness. The construct of health anxiety has not been examined in children and, to date, there has not been an instrument developed for this purpose. The Illness Attitude Scales is one of the most commonly used instruments for evaluating fears, beliefs, and attitudes that are associated with hypochondriasis and abnormal illness behaviour in adults. We sought to adapt the Illness Attitude Scales for use with children ages 8–15 years. The adapted Illness Attitude Scales was renamed the Childhood Illness Attitude Scales. Revisions to the adult version consisted of simplification of language, revision of Likert scale (i.e. 5-point to 3-point scale), and the addition of 7 questions to evaluate the role parents/guardians play in facilitating medical attention or treatment. Correlations between Childhood Illness Attitude Scales total scores and other self-report measures were supportive of the construct-related validity of the Childhood Illness Attitude Scales and suggested that it is a useful measure of health anxiety in school-age children. Practical and theoretical implications of the present results are discussed.     

Health anxiety in children: development and psychometric properties of the Childhood Illness Attitude Scales

The course of severe anxiety surrounding health issues is unknown. The available literature suggests that adults who are overly anxious about health issues often interpret or misinterpret their bodily signs and symptoms to be indicative of a serious illness. The construct of health anxiety has not been examined in children and, to date, there has not been an instrument developed for this purpose. The Illness Attitude Scales is one of the most commonly used instruments for evaluating fears, beliefs, and attitudes that are associated with hypochondriasis and abnormal illness behaviour in adults. We sought to adapt the Illness Attitude Scales for use with children ages 8-15 years. The adapted Illness Attitude Scales was renamed the Childhood Illness Attitude Scales. Revisions to the adult version consisted of simplification of language, revision of Likert scale (i.e. 5-point to 3-point scale), and the addition of 7 questions to evaluate the role parents/guardians play in facilitating medical attention or treatment. Correlations between Childhood Illness Attitude Scales total scores and other self-report measures were supportive of the construct-related validity of the Childhood Illness Attitude Scales and suggested that it is a useful measure of health anxiety in school-age children. Practical and theoretical implications of the present results are discussed.     

NEAR‐DEATH EXPERIENCES AND SPIRITUALITY

Abstract. Some individuals when they come close to death report having experiences that they interpret as spiritual or religious. These so‐called near‐death experiences (NDEs) often include a sense of separation from the physical body and encounters with religious figures and a mystical or divine presence. They share with mystical experiences a sense of cosmic unity or oneness, transcendence of time and space, deeply felt positive mood, sense of sacredness, noetic quality or intuitive illumination, paradoxicality, ineffability, transiency, and persistent positive aftereffects. Although there is no relationship between NDEs and religious belief prior to the experience, there are strong associations between depth of NDE and religious change after the experience. NDEs often change experiencers' values, decreasing their fear of death and giving their lives new meaning. NDEs lead to a shift from ego‐centered to other‐centered consciousness, disposition to love unconditionally, heightened empathy, decreased interest in status symbols and material possessions, reduced fear of death, and deepened spiritual consciousness. Many experiencers become more empathic and spiritually oriented and express the beliefs that death is not fearsome, that life continues beyond, that love is more important than material possessions, and that everything happens for a reason. These changes meet the definition of spiritual transformation as “a dramatic change in religious belief, attitude, and behavior that occurs over a relatively short period of time.” NDEs do not necessarily promote any one particular religious or spiritual tradition over others, but they do foster general spiritual growth both in the experiencers themselves and in human society at large.     

Association between quality of life of adolescents with type 1 diabetes and parents’ illness perception as evaluated by adolescents

Children and adolescents account for half of all cases of type 1 diabetes, which is one of the most common pediatric chronic diseases. The disease’s effects and the treatment/disease-management protocols patients must follow can lead to a marked deterioration in quality of life, especially for adolescents. Patients’ illness perceptions have been shown to impact their quality of life, but do other people’s illness perceptions also have an effect? The present study addressed this question by investigating possible links between the quality of life of adolescent patients with type 1 diabetes and illness perceptions, measured in terms of the adolescents’ self-perceptions, parents’ self-perceptions, and the adolescents’ evaluations of their parents’ perceptions. We asked 41 adolescents (M = 13.9 years; SD = 1.9) who had been undergoing treatment for type 1 diabetes for at least a year (M = 6.6 years; SD = 3.7) to complete the Diabetes Quality of Life for Youth Questionnaire-Short Form (DQOLY-SF) and the Illness Perception Questionnaire-Revised (IPQ-R). They completed the IPQ-R twice, once to state their own opinions (self-report) and once to give their evaluations of their parents’ perceptions. At the same time, but in a different room, their parents (N = 47) completed the IPQ-R (self-report). Quality of life was predicted by gender (p < .05) and by the parents’ emotional representations (p < .01) and perceptions of consequences (p < .01) as evaluated by the adolescents. This new approach provides new insights into the impact of parents’ perceptions on the quality of life of adolescents with type 1 diabetes.     

Transforming illness into choice: a spiritual perspective

Illness is seen as the enemy in today's world, while spirituality might be considered counter-cultural. This article explores the positive attributes of illness seen through the eyes of spirituality. By identifying spiritual themes in a person's life, especially evident in times of illness, one may maximize the experience of illness for its benefit rather than its curse.