人类需要什么样的个体化医疗及其途径——兼论精准医疗的现实意义与科学局限性

Pharmacogenomics and Personalized Medicine Pub Date : 2022-11-02 eCollection Date: 2022-01-01 DOI:10.2147/PGPM.S380767
Bing Yuan
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引用次数: 2

摘要

精准医疗的兴起,为现代医学的发展开辟了广阔的空间,也赋予了个体化医疗理念以现实意义。精准医学正在建立一种不同于传统体系的个性化疾病分类体系。然而,近年来精准医学的研究进展并不尽如人意:很少有疾病类型可以归结为单一靶点的异常;目前的“精确”药物的效果并不理想,各种副作用仍然不可避免。精准医学的方法论仍然是还原论的,不能解决临床治疗的整合问题,反而增加了整合的难度。因此,精准医疗并不是构建个性化医疗体系的可行途径。本文在分析论证精准医学的科学局限性和中医与复杂性科学方法一致性的基础上,借鉴控制论和复杂性科学的概念和方法,提出了一套发展个体化医疗的新思路和方法。结论是:在精准医疗的道路上,无法实现理想的个体化医疗;人们最终需要的是能够实现整体整合的个性化医疗。在中医整体整合和个性化的基础上,按照科学规范和循证原则,构建以经验证据为基础的理论模型和状态描述体系,是构建个性化医疗体系的最佳途径。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

What Personalized Medicine Humans Need and Way to It --also on the Practical Significance and Scientific Limitations of Precision Medicine.

What Personalized Medicine Humans Need and Way to It --also on the Practical Significance and Scientific Limitations of Precision Medicine.

What Personalized Medicine Humans Need and Way to It --also on the Practical Significance and Scientific Limitations of Precision Medicine.

The rise of precision medicine has opened up a broad space for the development of modern medicine and has also given practical significance to the concept of personalised medicine. Precision medicine is establishing a personalized disease classification system that differs from the traditional system. However, the research progress of precision medicine in recent years is far from satisfactory: There are few disease types that can be attributed to the abnormality of a single target; the effects of current'precision' medications are not ideal, and various side effects remain unavoidable. The methodology of precision medicine is still reductionist, and it would not solve the integration problem of clinical treatment but rather would increase the difficulty of integration. Therefore, the precision medicine approach is not a feasible way to build a personalised medicine system. Based on the analysis and demonstration of the scientific limitations of precision medicine and the consistency of traditional Chinese medicine (TCM) and complexity science methods, this paper draws on the concepts and methods of cybernetics and complexity science, and proposes a fresh set of ideas and methods for the development of personalised medicine. The conclusion is as follows: Along the path of precision medicine, ideal personalised medicine cannot be achieved; what people ultimately need is personalised medicine that can achieve holistic integration. On the basis of TCM with the characteristics of holistic integration and personalisation, and according to scientific norms and the principle of evidence, building a theoretical model and state description system grounded in empirical evidence is the best way to establish a personalised medicine system.

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