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临床生态学——环境医学背景下一种未经证实的方法。

Clinical ecology--an unproved approach in the context of environmental medicine.

作者信息

Eis D

机构信息

Robert Koch-Institut (RKI), Berlin, Germany.

出版信息

Zentralbl Hyg Umweltmed. 1999 Aug;202(2-4):291-330.

Abstract

This contribution outlines the historic development of Clinical Ecology (CE) and the differences it poses to scientific environmental medicine. The pathogenic, diagnostic and therapeutic concepts of clinical ecology are presented and critically acknowledged. Particular attention is given to behavioral and mental illnesses which, according to the beliefs of clinical ecologists, are related to food and chemicals, whereby this occurrence is considered a "cerebral allergy". The term "allergy" is, however, understood in the broader sense, as opposed to the usual medical term, to include non-immunological, pseudo-allergic and other intolerance reactions. Below are details of the validity and effectiveness of clinical ecology methods. Clinical ecology is concerned, not least, with unspecified, little understood health disorders and chronically fluctuating illnesses which are mainly attributed by clinical medicine to psychosomatic complaints. Many patients are critical of the lack of an adequate, literally "integral" treatment, i.e. one which also includes psychosocial aspects. They tend to search for simple answers and "alternative" treatment possibilities associated with it. Clinical ecologists and other "alternative practitioners" respond to this demand. They initially confirm or suggest to the patient the possibility of poisoning and offer a therapy that is allegedly causal and effective. The iatrogene fixation of patients with environment related illnesses has become a problem for the person in question, clinical medicine and the insured. Of course, those affected interpret their situation in another way. They consider themselves to be the victims of medical ignorance. The challenge posed by unconventional schools of medical thought should be met by increased efforts to create "sound medical practice" and by the attempt to achieve generally binding criteria for quality in the sense of effective "consumer protection".

摘要

本文概述了临床生态学(CE)的历史发展及其与科学环境医学的差异。介绍并批判性地审视了临床生态学的致病、诊断和治疗概念。特别关注行为和精神疾病,临床生态学家认为这些疾病与食物和化学物质有关,这种情况被视为“大脑过敏”。然而,“过敏”一词在这里是从更广泛的意义上理解的,与通常的医学术语不同,它包括非免疫性、假性过敏和其他不耐受反应。以下是临床生态学方法的有效性和效果的详细信息。临床生态学尤其关注未明确、了解甚少的健康障碍以及长期波动的疾病,临床医学主要将这些疾病归因于心身疾病。许多患者批评缺乏一种充分的、真正“整体”的治疗方法,即一种也包括心理社会方面的治疗方法。他们倾向于寻找简单的答案以及与之相关的“替代”治疗可能性。临床生态学家和其他“替代疗法从业者”回应了这种需求。他们首先向患者确认或暗示中毒的可能性,并提供一种据称有因果关系且有效的疗法。患有与环境相关疾病的患者的医源性固定已经成为患者本人、临床医学和保险公司面临的一个问题。当然,那些受影响的人对自己情况的理解有所不同。他们认为自己是医学无知的受害者。应该通过加大努力创造“合理的医疗实践”,并尝试制定有效“消费者保护”意义上具有普遍约束力的质量标准,来应对非传统医学思想流派带来的挑战。

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