“医学无法解释症状”的界定：躯体化诊断的本土视角

摘要

Medically unexplained symptoms are functional somatic symptoms which cannot be reasona-bly explained by physiological causes of experimental medicine. They are also one of the core elements of the diagnostic criteria for identifying somatic psychological disorders like somatization. The defini-tion of medically unexplained symptoms and its history reflect the dualist division between general med-icine and psychiatry in the western medical system. From the Chinese perspective characterized by an integrated whole of body and mind and by the concept of holistic medicine,the dualist division of the medical sciences is not unavoidable. This difference constitutes one of the reasons why somatization di-agnosis is not applicable in China.%医学无法解释症状是指无法通过实验医学的生理性病因进行合理解释的功能性躯体症状，也是躯体化等躯体性心理障碍诊断标准的核心条件之一。医学无法解释症状的界定及其历史变迁反映了西方医学体系中普通医学和精神病学的二元分裂。而从本土身心合一和整体医学观的视角看，医学专科的二元分裂并不是天然存在的。这种差异也成为躯体化诊断在中国产生不适应性的原因之一。