问题导向—证据贯通—范式重构:中西医融合研究的方法学路径OA

More than seven decades of coordinated practice involving traditional Chinese medicine(TCM)and Western medicine have generated extensive experience.However,the coordinated use of the two systems in clinical practice does not in itself constitute deep integration at the level of research paradigms.Existing research continues to face three major barriers:difficulty aligning concepts,poor reproducibility of intervention protocols,and limited translation of evidence.This article argues that research integrating TCM and Western medicine should move from knowledge-juxtaposing"combination"towards problem-oriented"integration".This transition requires the theories,methods,and technologies of both medical systems to be reconfigured around shared clinical and scientific questions,thereby generating new explanatory frameworks,research designs,and modes of practice.Three cases at different stages of development are used to illustrate three corresponding pathways.Theoretical cross-interpretation between the traditional holistic understanding of the heart and brain and contemporary research on heart-brain interactions can generate testable scientific propositions.Technical cross-validation between traditional experience with auricular therapies and transcutaneous auricular vagus nerve stimulation can yield standardized and reproducible interventions.Translational co-creation,exemplified by the transformation of clinical observations concerning arsenic therapy into risk-adapted treatment for acute promyelocytic leukemia,can produce scalable clinical regimens.Together,these pathways suggest that the key to integrating TCM and Western medicine lies not in matching concepts or simply adding methods,but in establishing a complete chain linking problem formulation,intervention specification,evidence generation and validation,and patient benefit.This article aims to provide a methodological framework and practical reference for advancing research on the integration of TCM and Western medicine.