{"id":5502,"date":"2016-08-26T00:00:00","date_gmt":"2016-08-25T16:00:00","guid":{"rendered":"\/\/www.afterroberto.com\/?guid=830dd87f26eb56938f6624813f9aa2a3"},"modified":"2018-08-22T15:06:37","modified_gmt":"2018-08-22T07:06:37","slug":"%e9%86%ab%e5%be%b9%e4%b8%ad%e8%a5%bf%ef%bc%9a%e4%b8%ad%e8%a5%bf%e9%86%ab%e5%90%88%e4%bd%9c%e9%9a%9c%e7%a4%99-%e7%97%85%e4%ba%ba%e7%84%a1%e6%89%80%e9%81%a9%e5%be%9e","status":"publish","type":"post","link":"\/\/www.afterroberto.com\/%e9%86%ab%e5%be%b9%e4%b8%ad%e8%a5%bf%ef%bc%9a%e4%b8%ad%e8%a5%bf%e9%86%ab%e5%90%88%e4%bd%9c%e9%9a%9c%e7%a4%99-%e7%97%85%e4%ba%ba%e7%84%a1%e6%89%80%e9%81%a9%e5%be%9e\/","title":{"rendered":"\u3010\u4e2d\u91ab\u6cbb\u7642\u3011\u91ab\u5fb9\u4e2d\u897f\uff1a\u4e2d\u897f\u91ab\u5408\u4f5c\u969c\u7919 \u75c5\u4eba\u7121\u6240\u9069\u5f9e"},"content":{"rendered":"

\u3010\u660e\u5831\u5c08\u8a0a\u3011\u4f59\u91ab\u751f\u548c\u6881\u91ab\u751f\u90fd\u66fe\u7d93\u63d0\u5230\u4e2d\u897f\u91ab\u5408\u4f5c\u5b58\u5728\u5f88\u591a\u554f\u984c\uff0c\u4f7f\u75c5\u4eba\u548c\u5bb6\u5c6c\u7121\u6240\u9069\u5f9e\u3002\u7b46\u8005\u6df1\u6709\u540c\u611f\u3002<\/p>\n

\u4f86\u56de\u4e2d\u897f\u91ab\u6cbb\u7642\u8178\u764c<\/p>\n

\u6709\u4e00\u6b21\u4e00\u4f4d\u8178\u764c\u75c5\u4eba\u4f86\u91ab\u9662\u6c42\u8a3a\uff0c\u4ed6\u7684\u8178\u764c\u5df2\u7d93\u64f4\u6563\uff0c\u6211\u5011\u5efa\u8b70\u4ed6\u9032\u884c\u5316\u7642\u7d50\u5408\u6a19\u9776\u85e5\u6cbb\u7642\u3002\u4ed6\u62d2\u7d55\uff0c\u8aaa\u6b63\u5728\u63a5\u53d7\u4e00\u4f4d\u4e2d\u91ab\u5e2b\u7684\u6cbb\u7642\uff0c\u5c0d\u65b9\u5efa\u8b70\u4ed6\u4e0d\u8981\u505a\u5316\u7642\uff0c\u800c\u4e14\u4ed6\u8a8d\u70ba\u5403\u4e86\u4e2d\u85e5\u5f8c\u5fb5\u72c0\u6b63\u5728\u597d\u8f49\uff0c\u6240\u4ee5\u4e0d\u60f3\u505a\u8f03\u8f9b\u82e6\u7684\u5316\u7642\u3002\u7b46\u8005\u5c0a\u91cd\u4ed6\u7684\u610f\u9858\uff0c\u4e26\u4e14\u53eb\u4ed6\u5b9a\u671f\u56de\u4f86\u91ab\u9662\u8986\u8a3a\u3002\u4ed6\u5e7e\u661f\u671f\u5f8c\u56de\u4f86\uff0c\u764c\u6307\u6578\u4e00\u76f4\u4e0a\u5347\uff0c\u70ba\u4ed6\u5b89\u6392\u4e86X\u5149\u548c\u96fb\u8166\u6383\u63cf\u3002\u518d\u904e\u5e7e\u661f\u671f\uff0c\u764c\u6307\u6578\u7e7c\u7e8c\u4e0a\u5347\uff0c\u800c\u4e14X\u5149\u548c\u96fb\u8166\u6383\u63cf\u986f\u793a\u75be\u75c5\u6b63\u5728\u8fc5\u901f\u60e1\u5316\u3002\u6211\u554f\u4ed6\u6709\u5426\u8ddf\u4e2d\u91ab\u5e2b\u63d0\u53ca\u764c\u6307\u6578\u6b63\u5728\u4e0a\u5347\uff0c\u53ef\u80fd\u63d0\u793a\u75be\u75c5\u4e0d\u80fd\u53d7\u63a7\u3002<\/p>\n

\u75c5\u4eba\u8aaa\u4ed6\u5df2\u544a\u8a34\u4e2d\u91ab\u5e2b\uff0c \u4f46\u4e2d\u91ab\u5e2b\u6c92\u6709\u6539\u8b8a\u6cbb\u7642\u65b9\u6cd5\u3002\u65bc\u662f\u7b46\u8005\u5728\u9580\u8a3a\u99ac\u4e0a\u6253\u96fb\u8a71\u7d66\u9019\u4f4d\u4e2d\u91ab\u5e2b\uff0c\u4e26\u77e5\u6703\u4e2d\u91ab\u5e2b\u6709\u95dcX\u5149\u548c\u96fb\u8166\u6383\u63cf\u7684\u7d50\u679c\uff0c\u90a3\u4f4d\u4e2d\u91ab\u5e2b\u8aaa\u770b\u4f86\u75c5\u60c5\u771f\u7684\u7121\u6cd5\u53d7\u5230\u63a7\u5236\uff0c\u4f46\u662f\u85e5\u65b9\u61c9\u8a72\u5c0d\u75c7\uff0c\u53eb\u75c5\u4eba\u518d\u53bb\u4ed6\u90a3\u88cf\u8986\u8a3a\u3002\u5f8c\u4f86\u75c5\u4eba\u518d\u56de\u5230\u90a3\u4f4d\u4e2d\u91ab\u5e2b\u7684\u8a3a\u6240\u6c42\u8a3a\uff0c\u628a\u4e2d\u85e5\u65b9\u5e36\u56de\u4f86\u7d66\u7b46\u8005\u770b\uff0c\u85e5\u65b9\u8ddf\u4e4b\u524d\u7684\u6c92\u6709\u5927\u6539\u8b8a\u3002\u5728\u904e\u4e86\u5169\u661f\u671f\uff0c\u75c5\u4eba\u89ba\u5f97\u75c5\u60c5\u7121\u6cd5\u63a7\u5236\uff0c\u540c\u610f\u9032\u884c\u5316\u7642\u6a19\u9776\u85e5\u6cbb\u7642\u3002<\/p>\n

\u5728\u6b64\u4f8b\u5b50\u4e2d\u770b\u5230\u5e7e\u500b\u554f\u984c\u3002 \u7b2c\u4e00\uff0c\u5982\u679c\u4e2d\u897f\u91ab\u5169\u8005\u80fd\u5920\u76f4\u63a5\u5c0d\u8a71\uff0c\u5927\u5bb6\u7121\u5206\u9ad8\u4f4e\u5730\u8ac7\u8ad6\u75c5\u60c5\uff0c\u63a2\u8a0e\u6700\u4f73\u6cbb\u7642\u65b9\u6cd5\uff0c\u9996\u5148\u5f97\u76ca\u7684\u662f\u75c5\u4eba\u3002\u7b2c\u4e8c\uff0c\u4e2d\u91ab\u4e0d\u80fd\u770b\u5230\u653f\u5e9c\u91ab\u9662\u6240\u505a\u7684X\u5149\u3001\u96fb\u8166\u6383\u63cf\u3001\u62bd\u8840\u5831\u544a\u7b49\u6aa2\u67e5\u7d50\u679c\uff0c\u589e\u52a0\u4e86\u5168\u9762\u4e86\u89e3\u75c5\u60c5\u7684\u96e3\u5ea6\u3002 \u7b2c\u4e09\uff0c\u5176\u5be6\u4e2d\u897f\u91ab\u6bcb\u9808\u4e92\u76f8\u8cb6\u4f4e\u5c0d\u65b9\u7684\u7642\u6cd5\u3002\u5728\u4ee5\u4e0a\u4f8b\u5b50\u4e2d\uff0c\u4e2d\u85e5\u5e6b\u52a9\u4e86\u75c5\u4eba\u7684\u5be6\u969b\u611f\u89ba\uff0c\u7d13\u7de9\u4e86\u5fb5\u72c0\uff0c\u5f8c\u4f86\u75c5\u4eba\u7684\u75c5\u60c5\uff0c\u4ea6\u56e0\u70ba\u5316\u7642\u800c\u5f97\u5230\u6e1b\u6162\u3002\u4f46\u5be6\u969b\u4e0a\u57fa\u65bc\u75c5\u4eba\u7684\u5b89\u5168\u8003\u616e\uff0c\u897f\u91ab\u4e00\u822c\u53eb\u75c5\u4eba\u4e0d\u8981\u670d\u98df\u4e2d\u85e5\uff0c\u7576\u7136\u9019\u88cf\u4e5f\u6709\u6cd5\u5f8b\u8cac\u4efb\u7684\u56e0\u7d20\uff0c\u4f46\u5f88\u591a\u4e2d\u91ab\u807d\u5f8c\uff0c\u5c31\u89ba\u5f97\u9019\u662f\u897f\u91ab\u7684\u6253\u58d3\u3002\u6240\u4ee5\u6709\u4e9b\u4e2d\u91ab\u5c0d\u897f\u65b9\u91ab\u5b78\u7522\u751f\u7684\u6575\u610f\uff0c\u5e38\u5e38\u53cd\u904e\u4f86\u53eb\u75c5\u4eba\u4e0d\u8981\u5403\u897f\u91ab\u7684\u300c\u6bd2\u85e5\u300d\u3002<\/p>\n

\u4e92\u4e0d\u4e86\u89e3 \u7919\u5408\u4f5c\u6dfb\u8aa4\u6703<\/p>\n

\u7b46\u8005\u6709\u5e78\u63a5\u53d7\u5169\u65b9\u9762\u7684\u8a13\u7df4\uff0c\u4ea6\u8a8d\u8b58\u4e2d\u897f\u91ab\u5169\u754c\u4e0d\u5c11\u540c\u9053\u3002\u5176\u5be6\u5927\u90e8\u5206\u897f\u91ab\u4e26\u6c92\u6709\u6392\u64e0\u4e2d\u91ab\u6253\u58d3\u4e2d\u91ab\u7684\u5fc3\u614b\uff0c\u53ea\u662f\u51fa\u65bc\u8cac\u4efb\u554f\u984c\uff0c\u5f88\u96e3\u5efa\u8b70\u75c5\u4eba\u53bb\u4f7f\u7528\u4e00\u4e9b\u81ea\u5df1\u4e0d\u719f\u6089\u7684\u85e5\u7269\u6216\u7642\u6cd5\u3002\u53cd\u904e\u4f86\u4e2d\u91ab\u4ea6\u672a\u5fc5\u80fd\u5168\u9762\u638c\u63e1\u897f\u91ab\u7642\u6cd5\u7684\u4f5c\u7528\u548c\u526f\u4f5c\u7528\uff0c\u5176\u5be6\u6839\u672c\u662f\u4e00\u500b\u6e9d\u901a\u7684\u554f\u984c\u3002<\/p>\n

\u53ef\u5e78\u7684\u662f\uff0c \u73fe\u5728\u6709\u4e0d\u5c11\u5b78\u6703\u9f13\u52f5\u4e2d\u897f\u91ab\u5408\u4f5c\uff0c\u800c\u653f\u5e9c\u4ea6\u5728\u516c\u7acb\u91ab\u9662\u63a8\u884c\u4e2d\u897f\u91ab\u5408\u4f5c\u5148\u5c0e\u8a08\u5283\u3002\u7b46\u8005\u4ea6\u7559\u610f\u5230\u4e0d\u5c11\u79c1\u71df\u9580\u8a3a\u540c\u6642\u6709\u4e2d\u897f\u91ab\u99d0\u8a3a\u3002\u4e2d\u897f\u91ab\u6e9d\u901a\u7684\u6a4b\u6a11\u6b63\u5728\u642d\u5efa\uff0c\u5c0d\u75c5\u4eba\u4f86\u8aaa\u7d55\u5c0d\u662f\u4e00\u500b\u798f\u97f3\u3002<\/p>\n

\u5176\u4e2d\u4e2d\u91ab\u754c\u5b58\u5728\u4e00\u500b\u96b1\u6182\u3002\u6839\u64da\u8fd1\u4f86\u67d0\u5831\u7d19\u5831\u9053\uff0c\u67d0\u4e9b\u4e2d\u570b\u5927\u9678\u9662\u6821\u7684\u6536\u751f\u8cea\u7d20\u548c\u8a13\u7df4\u65b9\u6cd5\u503c\u5f97\u8cea\u7591\u3002\u518d\u52a0\u4e0a\u64da\u8aaa\u5ee3\u6771\u7684\u4e2d\u91ab\u9662\u6821\u8fd1\u5e74\u5927\u91cf\u6536\u6e2f\u751f\uff0c\u55ae\u5728\u5ee3\u6771\u8b80\u4e2d\u91ab\u7684\u9999\u6e2f\u5b78\u751f\u6709\u8d85\u904e\u4e00\u5343\u4eba\u3002\u9019\u76f8\u6bd4\u897f\u91ab\u5b78\u9662\u7684\u5b78\u751f\u5927\u591a\u662f\u5165\u5b78\u6642\u5b78\u696d\u4e0a\u6700\u9802\u5c16\u7684\u5b78\u751f\uff0c\u6709\u986f\u8457\u7684\u5dee\u5225\u3002\u7576\u7136\u4e00\u500b\u4eba\u7684\u5b78\u696d\u6210\u7e3e\u4e0d\u4ee3\u8868\u5c07\u4f86\u7684\u80fd\u529b\uff0c\u4f46\u5c0d\u65bc\u91ab\u5b78\u9019\u9580\u56b4\u8b39\u7684\u5b78\u79d1\uff0c\u7684\u78ba\u9700\u8981\u7fd2\u91ab\u8005\u7684\u5c08\u6ce8\u548c\u80fd\u529b\u624d\u80fd\u6210\u529f\u3002\u9019\u53ef\u80fd\u5c0d\u5c07\u4f86\u4e2d\u897f\u91ab\u5408\u4f5c\u5e36\u4f86\u56f0\u96e3\u3002<\/p>\n

\u5728\u6b64\u5e0c\u671b\u6709\u95dc\u7576\u5c40\u80fd\u5920\u7e7c\u7e8c\u5b8c\u5584\u91ab\u7642\u5c08\u696d\u7684\u76e3\u7ba1\u548c\u767c\u5c55\u3002<\/p>\n

\u6587\uff1a\u9999\u6e2f\u5927\u5b78\u81e8\u7240\u816b\u7624\u5b78\u7cfb\u81e8\u7240\u52a9\u7406\u6559\u6388\u3001\u8a3b\u518a\u4e2d\u91ab\u8607\u5b50\u8b19<\/p>\n

\/\/www.afterroberto.com\/wp-content\/uploads\/2017\/07\/whbb.jpg;<\/inline><\/p>\n","protected":false},"excerpt":{"rendered":"

【明報專訊】余醫生和梁醫生都曾經提到中西醫合作存在很多問題，使病人和家屬無所適從。筆者深有同感。<\/p>\n

來回中西醫治療腸癌<\/p>\n

有一次一位腸癌病人來醫院求診，他的腸癌已經擴散，我們建議他進行化療結合標靶藥治療。他拒絕，說正在接受一位中醫師的治療，對方建議他不要做化療，而且他認為吃了中藥後徵狀正在好轉，所以不想做較辛苦的化療。筆者尊重他的意願，並且叫他定期回來醫院覆診。他幾星期後回來，癌指數一直上升，為他安排了X光和電腦掃描。再過幾星期，癌指數繼續上升，而且X光和電腦掃描顯示疾病正在迅速惡化。我問他有否跟中醫師提及癌指數正在上升，可能提示疾病不能受控。<\/p>\n

病人說他已告訴中醫師， 但中醫師沒有改變治療方法。於是筆者在門診馬上打電話給這位中醫師，並知會中醫師有關X光和電腦掃描的結果，那位中醫師說看來病情真的無法受到控制，但是藥方應該對症，叫病人再去他那裏覆診。後來病人再回到那位中醫師的診所求診，把中藥方帶回來給筆者看，藥方跟之前的沒有大改變。在過了兩星期，病人覺得病情無法控制，同意進行化療標靶藥治療。<\/p>\n

在此例子中看到幾個問題。 第一，如果中西醫兩者能夠直接對話，大家無分高低地談論病情，探討最佳治療方法，首先得益的是病人。第二，中醫不能看到政府醫院所做的X光、電腦掃描、抽血報告等檢查結果，增加了全面了解病情的難度。 第三，其實中西醫毋須互相貶低對方的療法。在以上例子中，中藥幫助了病人的實際感覺，紓緩了徵狀，後來病人的病情，亦因為化療而得到減慢。但實際上基於病人的安全考慮，西醫一般叫病人不要服食中藥，當然這裏也有法律責任的因素，但很多中醫聽後，就覺得這是西醫的打壓。所以有些中醫對西方醫學產生的敵意，常常反過來叫病人不要吃西醫的「毒藥」。<\/p>\n

互不了解 礙合作添誤會<\/p>\n

筆者有幸接受兩方面的訓練，亦認識中西醫兩界不少同道。其實大部分西醫並沒有排擠中醫打壓中醫的心態，只是出於責任問題，很難建議病人去使用一些自己不熟悉的藥物或療法。反過來中醫亦未必能全面掌握西醫療法的作用和副作用，其實根本是一個溝通的問題。<\/p>\n

可幸的是， 現在有不少學會鼓勵中西醫合作，而政府亦在公立醫院推行中西醫合作先導計劃。筆者亦留意到不少私營門診同時有中西醫駐診。中西醫溝通的橋樑正在搭建，對病人來說絕對是一個福音。<\/p>\n

其中中醫界存在一個隱憂。根據近來某報紙報道，某些中國大陸院校的收生質素和訓練方法值得質疑。再加上據說廣東的中醫院校近年大量收港生，單在廣東讀中醫的香港學生有超過一千人。這相比西醫學院的學生大多是入學時學業上最頂尖的學生，有顯著的差別。當然一個人的學業成績不代表將來的能力，但對於醫學這門嚴謹的學科，的確需要習醫者的專注和能力才能成功。這可能對將來中西醫合作帶來困難。<\/p>\n

在此希望有關當局能夠繼續完善醫療專業的監管和發展。<\/p>\n

文：香港大學臨牀腫瘤學系臨牀助理教授、註冊中醫蘇子謙<\/p>\n

<\/inline><\/p>\n","protected":false},"author":2,"featured_media":6331,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"rank_math_lock_modified_date":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[4],"tags":[282,854,216],"class_list":["post-5502","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-4","tag-282","tag-854","tag-216"],"publishpress_future_action":{"enabled":false,"date":"2026-11-22 14:33:09","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/posts\/5502"}],"collection":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/comments?post=5502"}],"version-history":[{"count":0,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/posts\/5502\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/media\/6331"}],"wp:attachment":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/media?parent=5502"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/categories?post=5502"},{"taxonomy":"post_tag","embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/tags?post=5502"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}