Ernst Edzard
Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, Exeter, United Kingdom.
J Pain Symptom Manage. 2008 May;35(5):544-62. doi: 10.1016/j.jpainsymman.2007.07.004. Epub 2008 Feb 14.
Chiropractic was defined by D.D. Palmer as "a science of healing without drugs." About 60,000 chiropractors currently practice in North America, and, worldwide, billions are spent each year for their services. This article attempts to critically evaluate chiropractic. The specific topics include the history of chiropractic; the internal conflicts within the profession; the concepts of chiropractic, particularly those of subluxation and spinal manipulation; chiropractic practice and research; and the efficacy, safety, and cost of chiropractic. A narrative review of selected articles from the published chiropractic literature was performed. For the assessment of efficacy, safety, and cost, the evaluation relied on previously published systematic reviews. Chiropractic is rooted in mystical concepts. This led to an internal conflict within the chiropractic profession, which continues today. Currently, there are two types of chiropractors: those religiously adhering to the gospel of its founding fathers and those open to change. The core concepts of chiropractic, subluxation and spinal manipulation, are not based on sound science. Back and neck pain are the domains of chiropractic but many chiropractors treat conditions other than musculoskeletal problems. With the possible exception of back pain, chiropractic spinal manipulation has not been shown to be effective for any medical condition. Manipulation is associated with frequent mild adverse effects and with serious complications of unknown incidence. Its cost-effectiveness has not been demonstrated beyond reasonable doubt. The concepts of chiropractic are not based on solid science and its therapeutic value has not been demonstrated beyond reasonable doubt.
整脊疗法被 D.D. 帕尔默定义为“一门无药物治疗的科学”。目前在北美约有 6 万名整脊治疗师执业，在全球范围内，每年在他们的服务上花费数十亿美元。本文试图对整脊疗法进行批判性评估。具体主题包括整脊疗法的历史；该行业内部的冲突；整脊疗法的概念，特别是半脱位和脊柱推拿的概念；整脊疗法的实践与研究；以及整脊疗法的疗效、安全性和成本。对已发表的整脊疗法文献中选定的文章进行了叙述性综述。为了评估疗效、安全性和成本，评估依赖于先前发表的系统评价。整脊疗法植根于神秘主义概念。这导致了整脊疗法行业内部的冲突，这种冲突至今仍在持续。目前，有两种类型的整脊治疗师：一种虔诚地遵循其创始人的信条，另一种则愿意接受变革。整脊疗法的核心概念，半脱位和脊柱推拿，并非基于可靠的科学。背部和颈部疼痛是整脊疗法的治疗领域，但许多整脊治疗师治疗的病症并非肌肉骨骼问题。除了背痛可能是个例外，整脊疗法的脊柱推拿尚未被证明对任何医学病症有效。推拿常伴有轻微不良反应，以及发生率不明的严重并发症。其成本效益尚未得到无可置疑的证明。整脊疗法的概念并非基于坚实的科学，其治疗价值也未得到无可置疑的证明。
