《中國的中醫(yī)藥》白皮書（全文）
White Paper: Traditional Chinese Medicine in China
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| 三、中醫(yī)藥的傳承與發(fā)展 | III. Carrying Forward the Tradition and Ensuring the Development of TCM |
| 基本建立起覆蓋城鄉(xiāng)的中醫(yī)醫(yī)療服務(wù)體系。在城市，形成以中醫(yī)（民族醫(yī)、中西醫(yī)結(jié)合）醫(yī)院、中醫(yī)類門診部和診所以及綜合醫(yī)院中醫(yī)類臨床科室、社區(qū)衛(wèi)生服務(wù)機構(gòu)為主的城市中醫(yī)醫(yī)療服務(wù)網(wǎng)絡(luò)。在農(nóng)村，形成由縣級中醫(yī)醫(yī)院、綜合醫(yī)院（?？漆t(yī)院、婦幼保健院）中醫(yī)臨床科室、鄉(xiāng)鎮(zhèn)衛(wèi)生院中醫(yī)科和村衛(wèi)生室為主的農(nóng)村中醫(yī)醫(yī)療服務(wù)網(wǎng)絡(luò)，提供基本中醫(yī)醫(yī)療預(yù)防保健服務(wù)。截至2015年年底，全國有中醫(yī)類醫(yī)院3966所，其中民族醫(yī)醫(yī)院253所，中西醫(yī)結(jié)合醫(yī)院446所。中醫(yī)類別執(zhí)業(yè)（助理）醫(yī)師45.2萬人（含民族醫(yī)醫(yī)師、中西醫(yī)結(jié)合醫(yī)師）。中醫(yī)類門診部、診所42528個，其中民族醫(yī)門診部、診所550個，中西醫(yī)結(jié)合門診部、診所7706個。2015年，全國中醫(yī)類醫(yī)療衛(wèi)生機構(gòu)總診療人次達(dá)9.1億，全國中醫(yī)類醫(yī)療衛(wèi)生機構(gòu)出院人數(shù)2691.5萬人。中醫(yī)藥除在常見病、多發(fā)病、疑難雜癥的防治中貢獻力量外，在重大疫情防治和突發(fā)公共事件醫(yī)療救治中也發(fā)揮了重要作用。中醫(yī)、中西醫(yī)結(jié)合治療傳染性非典型肺炎，療效得到世界衛(wèi)生組織肯定。中醫(yī)治療甲型H1N1流感，取得良好效果，成果引起國際社會關(guān)注。同時，中醫(yī)藥在防治艾滋病、手足口病、人感染H7N9禽流感等傳染病，以及四川汶川特大地震、甘肅舟曲特大泥石流等突發(fā)公共事件醫(yī)療救治中，都發(fā)揮了獨特作用。 | Establishment of a TCM medical care system covering both urban and rural areas. An urban TCM medical care network, mainly comprising hospitals for TCM (including ethnic minority medicine and integrated Chinese and Western medicine), TCM clinics and general hospitals' TCM clinical departments, and community health centers, has been formed. A rural TCM medical care network has been established, mainly composed of county-level TCM hospitals, TCM clinical departments of general hospitals (specialized hospitals and maternal & child health centers), TCM departments of township-level health centers, and village health clinics, which provides basic TCM healthcare services. Statistics collected at the end of 2015 show that there were 3,966 TCM hospitals across the country, including 253 hospitals of ethnic minority medicine and 446 hospitals of integrated Chinese and Western medicine; there were 452,000 practitioners and assistant practitioners of TCM (including practitioners of ethnic minority medicine and integrated Chinese and Western medicine); there were 42,528 TCM clinics, including 550 for ethnic minority medicine and 7,706 for integrated medicine; there were 910 million visits that year to TCM medical and health service units across the country and 26,915,000 inpatients treated. In addition to making contribution to the prevention and treatment of common, endemic and difficult diseases, TCM has played an important role in the prevention and treatment of major epidemics and medical relief in public emergencies and natural disasters. The contribution of TCM and integrated Chinese and Western medicine in treating SARS (severe acute respiratory syndrome) has been affirmed by the World Health Organization (WHO). TCM treatment of influenza A virus subtype H1N1 has yielded satisfactory results, arousing widespread attention in the international community. In addition, TCM has made distinctive contributions to the prevention and control of epidemics such as HIV/AIDS (Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome), HFMD (Hand, Foot and Mouth Disease), and Influenza A virus subtype H7N9 in humans, as well as to medical relief following the Wenchuan earthquake, the Zhouqu mudslide and other public emergencies and natural disasters. |
| 中醫(yī)預(yù)防保健服務(wù)加快發(fā)展。推進中醫(yī)預(yù)防保健服務(wù)體系建設(shè)，在二級以上中醫(yī)醫(yī)院設(shè)立“治未病”科室，在基層醫(yī)療衛(wèi)生機構(gòu)、婦幼保健機構(gòu)、療養(yǎng)院等開展“治未病”服務(wù)，社會中醫(yī)養(yǎng)生保健機構(gòu)發(fā)展迅速。推進中醫(yī)藥健康服務(wù)發(fā)展，開展中醫(yī)藥健康旅游、醫(yī)養(yǎng)結(jié)合。中醫(yī)藥健康管理項目作為單獨一類列入國家基本公共衛(wèi)生服務(wù)項目，中醫(yī)藥在公共衛(wèi)生服務(wù)中的潛力和優(yōu)勢正逐步釋放，推動衛(wèi)生發(fā)展模式從重疾病治療向全面健康管理轉(zhuǎn)變。 | Expedited development of TCM disease prevention and healthcare services. The system of TCM disease prevention and healthcare services has been expedited by establishing preventative healthcare departments at TCM hospitals at/above the second class and providing TCM preventative medical care services at community-level medical and health service institutions, maternal & child health centers and rehabilitation centers. Also seen is rapid growth in the number of privately run TCM healthcare institutions. Endeavor has been made to promote the development of TCM health services and carry out TCM health tourism and TCM integrated treatment and convalesce. TCM health management program has been incorporated as a separate category into the national basic public health service program, gradually releasing the potential and strengths of TCM in public health services, thus fostering a shift from treatment of serious diseases to comprehensive health management in the mode of health development. |
| 中醫(yī)藥在醫(yī)藥衛(wèi)生體制改革中發(fā)揮重要作用。在深化醫(yī)藥衛(wèi)生體制改革中，充分發(fā)揮中醫(yī)藥臨床療效確切、預(yù)防保健作用獨特、治療方式靈活、費用相對低廉的特色優(yōu)勢，放大了醫(yī)改的惠民效果，豐富了中國特色基本醫(yī)療衛(wèi)生制度的內(nèi)涵。中醫(yī)藥以較低的投入，提供了與資源份額相比較高的服務(wù)份額，2009年至2015年，中醫(yī)類醫(yī)療機構(gòu)診療服務(wù)量占醫(yī)療服務(wù)總量由14.3%上升到15.7%。2015年，公立中醫(yī)類醫(yī)院比公立醫(yī)院門診次均費用低11.5%，住院人均費用低24%。 | Important role played by TCM in the reform of the medical care system. In the course of advancing the reform, TCM's distinct strengths, such as its clinical effectiveness, its unique role, flexible ways of treatment and relatively low cost in disease prevention and healthcare, have been fully exploited to augment benefits of reform for the people and enriched the connotation of China's basic medical care system with distinct characteristics. With relatively low cost, TCM has contributed rather a higher share of services in relation to the resources it is entitled to. The medical care services provided by TCM institutions in the national total increased from 14.3 percent to 15.7 percent in the few years from 2009 to 2015. In 2015, out-patient expenses per visit and in-patient expenses per capita at public TCM hospitals were, respectively, 11.5 percent and 24 percent lower than those at general public hospitals. |
| 建立起獨具特色的中醫(yī)藥人才培養(yǎng)體系。把人才培養(yǎng)作為中醫(yī)藥事業(yè)發(fā)展的根本，大力發(fā)展中醫(yī)藥教育，基本形成院校教育、畢業(yè)后教育、繼續(xù)教育有機銜接，師承教育貫穿始終的中醫(yī)藥人才培養(yǎng)體系，初步建立社區(qū)、農(nóng)村基層中醫(yī)藥實用型人才培養(yǎng)機制，實現(xiàn)從中高職、本科、碩士到博士的中醫(yī)學(xué)、中藥學(xué)、中西醫(yī)結(jié)合、民族醫(yī)藥等多層次、多學(xué)科、多元化教育全覆蓋。截至2015年年底，全國有高等中醫(yī)藥院校42所（其中獨立設(shè)置的本科中醫(yī)藥院校25所），200余所高等西醫(yī)藥院?；蚍轻t(yī)藥院校設(shè)置中醫(yī)藥專業(yè)，在校學(xué)生總數(shù)達(dá)75.2萬人。實施中醫(yī)藥傳承與創(chuàng)新人才工程，開展第五批全國名老中醫(yī)藥專家學(xué)術(shù)經(jīng)驗繼承工作，建設(shè)了1016個全國名老中醫(yī)藥專家傳承工作室、200個全國基層名老中醫(yī)藥專家傳承工作室，為64個中醫(yī)學(xué)術(shù)流派建立傳承工作室。開展全國優(yōu)秀中醫(yī)臨床人才研修、中藥特色技術(shù)傳承骨干人才培訓(xùn)、鄉(xiāng)村醫(yī)生中醫(yī)藥知識技能培訓(xùn)等高層次和基層中醫(yī)藥人才培養(yǎng)項目。124名中醫(yī)藥傳承博士后正在出站考核。探索建立引導(dǎo)優(yōu)秀人才脫穎而出的褒獎機制，開展了兩屆國醫(yī)大師評選，60位從事中醫(yī)藥、民族醫(yī)藥工作的老專家獲得“國醫(yī)大師”榮譽稱號。 | Building a distinctive system of training for TCM professionals. Training of professionals is essential for the development of TCM. Thus, great efforts have been made to promote development of education in TCM, basically putting in place a system of training for TCM professionals that features an organic link-up between college, graduate and continuing education, and run through master-apprenticeship training. This, together with a mechanism for training of practical TCM professionals geared toward the needs of the urban and rural communities that has also been initially established, forms a multi-dimensional education network covering multiple disciplines at different levels, including TCM, traditional Chinese pharmacology, integrated Chinese and Western medicine, and ethnic minority medicine at secondary and higher vocational schools, colleges, postgraduate and doctoral studies. By the end of 2015, there were throughout the country 42 institutions of higher learning in TCM (including 25 TCM colleges), and more than 200 Western medicine institutions of higher learning or non-medical higher learning institutions offering programs in TCM, enrolling in total as many as 752,000 students. In the course of implementing the program of training professionals for inheritance and innovation in TCM, efforts have been made to conserve and disseminate the academic ideas and practical experience of the fifth batch of prominent TCM experts. By 2015, 1,016 studios had been set up for carrying forward their expertise; 200 studios had been set up for passing on the expertise of prominent TCM experts at the grassroots level; 64 studios had been established for promoting various schools of TCM. TCM training programs targeted at professionals at both grassroots and higher levels have been held, such as training in TCM knowledge and skills for village doctors, training for conserving special traditional pharmacological skills, and advanced training for outstanding TCM clinical practitioners. Together, 124 researchers are finishing postdoctoral studies in TCM inheritance at the Chinese Academy of Chinese Medical Sciences and their work is being evaluated. Exploration has been made in establishing an incentive mechanism for outstanding TCM workers to come to the fore. By 2015, the title of TCM Master had been awarded to a total of 60 experts practicing TCM and ethnic minority medicine. |
| 中醫(yī)藥科學(xué)研究取得積極進展。組織開展16個國家級中醫(yī)臨床研究基地建設(shè)及中醫(yī)藥防治傳染病和慢性非傳染性疾病臨床科研體系建設(shè)，建立了涵蓋中醫(yī)藥各學(xué)科領(lǐng)域的重點研究室和科研實驗室，建設(shè)了一批國家工程（技術(shù)）研究中心、工程實驗室，形成了以獨立中醫(yī)藥科研機構(gòu)、中醫(yī)藥大學(xué)、省級以上中醫(yī)醫(yī)院為研究主體，綜合性大學(xué)、綜合醫(yī)院、中藥企業(yè)等參與的中醫(yī)藥科技創(chuàng)新體系。近年來，有45項中醫(yī)藥科研成果獲得國家科技獎勵，其中科技進步一等獎5項。屠呦呦因發(fā)現(xiàn)“青蒿素——一種用于治療瘧疾的藥物”，榮獲2011年美國拉斯克臨床醫(yī)學(xué)獎和2015年諾貝爾生理學(xué)或醫(yī)學(xué)獎。因?qū)鹘y(tǒng)中藥的砷劑與西藥結(jié)合治療急性早幼粒細(xì)胞白血病的療效明顯提高，王振義、陳竺獲得第七屆圣捷爾吉癌癥研究創(chuàng)新成就獎。開展中藥資源普查試點工作，并初步建成由1個中心平臺、28個省級中心、65個監(jiān)測站組成的中藥資源動態(tài)監(jiān)測信息和技術(shù)服務(wù)體系，以及16個中藥材種子種苗繁育基地和2個種質(zhì)資源庫。組織開展民族醫(yī)藥文獻整理與適宜技術(shù)篩選推廣工作，涉及150部重要民族醫(yī)藥文獻、140項適宜技術(shù)。這些科研成果的轉(zhuǎn)化應(yīng)用，為提高臨床療效、保障中藥質(zhì)量、促進中藥產(chǎn)業(yè)健康發(fā)展提供了支撐。 | Positive progress made in TCM scientific research. Sixteen national TCM clinical research bases have been built as part of the clinical research system for preventing and treating infectious diseases and chronic non-infectious diseases with TCM. This, together with a number of key research centers and labs covering all disciplines of TCM and national engineering (technology) research centers and labs in this respect, have brought into being a TCM sci-tech innovation system that is based on independent TCM research institutes, TCM universities, and TCM hospitals at and above the provincial level, and participated by comprehensive universities, general hospitals and TCM enterprises. In recent years, 45 TCM research achievements have been awarded national sci-tech prizes, of which five were first-prize winners of the National Science and Technology Progress Award. Tu Youyou won the 2011 Lasker Award in clinical medicine and the 2015 Nobel Prize in Physiology or Medicine for discovering qinghaosu (artemisinin). Wang Zhenyi and Chen Zhu were awarded the Seventh Annual Szent-Gyorgyi Prize for Progress in Cancer Research for combining the Western medicine ATRA and the TCM compound arsenic trioxide to treat acute promyelocytic leukemia (APL). A pilot program for Chinese medicinal resources survey has been implemented, forming a dynamic information and technology system with one central platform, 28 provincial-level centers, and 65 monitoring stations. Sixteen seed and seedling bases for Chinese medicinal plants and two germplasm banks have been established. Organizational work has been done for collation of literature and screening of appropriate skills of ethnic minority medicine, involving 150 works on ethnic minority medicine and 140 appropriate skills. The transformation and application of these research results has provided support for enhancing clinical effectiveness, ensuring the quality of Chinese medicine, and fostering the sound development of the TCM pharmaceutical industry. |
| 中藥產(chǎn)業(yè)快速發(fā)展。頒布實施一系列加強野生中藥資源保護的法律法規(guī)，建立一批國家級或地方性的自然保護區(qū)，開展珍稀瀕危中藥資源保護研究，部分緊缺或瀕危資源已實現(xiàn)人工生產(chǎn)或野生撫育?；窘⒘艘灾嗅t(yī)藥理論為指導(dǎo)、突出中醫(yī)藥特色、強調(diào)臨床實踐基礎(chǔ)、鼓勵創(chuàng)新的中藥注冊管理制度。目前，國產(chǎn)中藥民族藥約有6萬個藥品批準(zhǔn)文號。全國有2088家通過藥品生產(chǎn)質(zhì)量管理規(guī)范（GMP）認(rèn)證的制藥企業(yè)生產(chǎn)中成藥，中藥已從丸、散、膏、丹等傳統(tǒng)劑型，發(fā)展到現(xiàn)在的滴丸、片劑、膜劑、膠囊等40多種劑型，中藥產(chǎn)品生產(chǎn)工藝水平有了很大提高，基本建立了以藥材生產(chǎn)為基礎(chǔ)、工業(yè)為主體、商業(yè)為紐帶的現(xiàn)代中藥產(chǎn)業(yè)體系。2015年中藥工業(yè)總產(chǎn)值7866億元，占醫(yī)藥產(chǎn)業(yè)規(guī)模的28.55%，成為新的經(jīng)濟增長點；中藥材種植成為農(nóng)村產(chǎn)業(yè)結(jié)構(gòu)調(diào)整、生態(tài)環(huán)境改善、農(nóng)民增收的重要舉措；中藥產(chǎn)品貿(mào)易額保持較快增長，2015年中藥出口額達(dá)37.2億美元，顯示出巨大的海外市場發(fā)展?jié)摿ΑＶ兴幃a(chǎn)業(yè)逐漸成為國民經(jīng)濟與社會發(fā)展中具有獨特優(yōu)勢和廣闊市場前景的戰(zhàn)略性產(chǎn)業(yè)。 | Rapid development of the TCM pharmaceutical industry. A number of laws and regulations have been enacted and implemented on strengthening the protection of TCM wild medicinal resources; a number of national and local nature reserves have been established; research has been conducted on the protection of rare and endangered Chinese medicinal resources; and artificial production or wild tending have been carried out for certain scarce and endangered resources. A registration management system has been basically established for TCM pharmaceuticals under the guidance of theories of traditional Chinese medicine and pharmacology, highlighting the strengths of TCM, setting great store by clinical practice and encouraging innovation. To date, 60,000 TCM and ethnic minority medical drugs have been approved, and 2,088 pharmaceutical enterprises that have been approved by the Good Manufacturing Practice (GMP) of Medical Products are manufacturing Chinese patent medicines. The dosage forms of TCM medicines have increased from a traditionally limited number of forms such as pills, powders, ointments and pellets into more than 40, including dropping pills, tablets, pods and capsules, indicating marked improvement in the technological level of Chinese medicinal drug production, and initial establishment of a modern Chinese medicine industry based on the production of medicinal materials and industrial production and tied together by commerce. In 2015, the total output value of the TCM pharmaceutical industry was RMB786.6 billion, accounting for 28.55 percent of the total generated by the country's pharmaceutical industry, and becoming a new source of growth in China's economy. Planting Chinese medicinal herbs has become a key means of adjusting the rural industrial structure, improving the eco-environment, and increasing farmers' incomes. Trade in Chinese medicinal products has maintained rapid growth, and the export value of Chinese medicines amounted to US$3.72 billion in 2015, signifying the great potential of Chinese medicines in overseas markets. The TCM pharmaceutical industry has gradually developed into an industry with distinctive strengths and broad market prospects, which is of strategic importance to national economic and social development. |
| 中醫(yī)藥文化建設(shè)邁出新步伐。中國政府重視和保護中醫(yī)藥的文化價值，積極推進中醫(yī)藥傳統(tǒng)文化傳承體系建設(shè)，已有130個中醫(yī)藥類項目列入國家級非物質(zhì)文化遺產(chǎn)代表性項目名錄，“中醫(yī)針灸”列入聯(lián)合國教科文組織人類非物質(zhì)文化遺產(chǎn)代表作名錄，《黃帝內(nèi)經(jīng)》和《本草綱目》入選世界記憶名錄。加強中醫(yī)藥健康知識的宣傳普及，持續(xù)開展“中醫(yī)中藥中國行”大型科普活動，利用各種媒介和中醫(yī)藥文化宣傳教育基地，向公眾講授中醫(yī)藥養(yǎng)生保健、防病治病的基本知識和技能，全社會利用中醫(yī)藥進行自我保健的意識和能力不斷增強，促進了公眾健康素養(yǎng)提高。 | New progress in TCM culture. The Chinese government treasures and protects the cultural value of TCM, and endeavors to build a system for passing on the traditional culture of TCM. In total, 130 TCM elements have been incorporated into the Representative List of National Intangible Cultural Heritage, with TCM acupuncture and moxibustion being included in the Representative List of the Intangible Cultural Heritage of Humanity by UNESCO, and the Huang Di Nei Jing (Yellow Emperor's Inner Canon) and Ben Cao Gang Mu (Compendium of Materia Medica) are listed in the Memory of the World Register. Efforts have been reinforced to promote public awareness in TCM healthcare, including events under the campaign of Traditional Chinese Medicine Across China. Public talks have been organized through media and TCM education bases popularizing basic knowledge and skills of TCM healthcare and prevention and treatment of illnesses. In this way, public awareness of and ability to practice TCM healthcare has been enhanced, and general public health has improved. |
| 中醫(yī)藥標(biāo)準(zhǔn)化工作取得積極進展。制定實施《中醫(yī)藥標(biāo)準(zhǔn)化中長期發(fā)展規(guī)劃綱要（2011－2020年）》，中醫(yī)藥標(biāo)準(zhǔn)體系初步形成，標(biāo)準(zhǔn)數(shù)量達(dá)649項，年平均增長率29%。中醫(yī)、針灸、中藥、中西醫(yī)結(jié)合、中藥材種子種苗5個全國標(biāo)準(zhǔn)化技術(shù)委員會及廣東、上海、甘肅等地方中醫(yī)藥標(biāo)準(zhǔn)化技術(shù)委員會相繼成立。42家中醫(yī)藥標(biāo)準(zhǔn)研究推廣基地建設(shè)穩(wěn)步推進，常見病中醫(yī)診療指南和針灸治療指南臨床應(yīng)用良好。民族醫(yī)藥標(biāo)準(zhǔn)化工作不斷推進，常見病診療指南的研制有序開展，14項維醫(yī)診療指南和療效評價標(biāo)準(zhǔn)率先發(fā)布，首個地方藏醫(yī)藥標(biāo)準(zhǔn)化技術(shù)委員會在西藏自治區(qū)成立，民族醫(yī)藥機構(gòu)和人員的標(biāo)準(zhǔn)化工作能力不斷提高。 | Positive progress in TCM standardization. The Outline of the Medium- and Long-term Development Plan for the Standardization of Traditional Chinese Medicine (2011-2020) has been issued and implemented, putting in place initially a system of TCM standards which amount to 649, showing an average annual growth of 29 percent. Five national technical committees of standardization have been established for, respectively, Chinese medicine, acupuncture and moxibustion, TCM drugs, integrated Chinese and Western medicine, and seeds and seedlings of Chinese medicinal plants, with local standardization technical committees of traditional Chinese medicine and pharmaceuticals being set up in Guangdong, Shanghai, Gansu and some other localities. The building of 42 research and application bases for TCM standardization is proceeding smoothly, and the clinical application of guidelines for TCM diagnosis and treatment of commonly seen diseases and guidelines for acupuncture and moxibustion is proving effective. Steady progress has also been witnessed in standardization of ethnic minority medicine, so has been orderly advancement in the formulation of guidelines for diagnosis and treatment of commonly seen diseases. In this regard, Uyghur medicine has taken the lead, with the publishing of 14 guidelines for disease diagnosis and treatment, and curative effect evaluation. The first local technical committee for standardization of Tibetan medicine has been established in the Tibet Autonomous Region. Constant improvement has been observed in the competence and efficiency of institutions and workers in relation to the standardization of ethnic minority medicine and pharmacology. |
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