Wayne Peter M, Kaptchuk Ted J
Osher Research Center, Harvard Medical School, Boston, MA 02215, USA.
J Altern Complement Med. 2008 Mar;14(2):191-7. doi: 10.1089/acm.2007.7170b.
Although a growing body of clinical research has begun to evaluate the efficacy and safety of t'ai chi as a therapeutic tool for a variety of health conditions, little attention has been devoted to evaluating "how" t'ai chi is scientifically studied, and the advantages or limitations of different methodological approaches. In a companion to this paper (Part I), we argued that t'ai chi is a complex, multicomponent intervention, which poses unique challenges regarding the distinction of specific versus nonspecific effects and limitations regarding the use of reductionistic research frameworks. In this second, companion paper, we discuss additional obstacles inherent in precisely defining the t'ai chi intervention in an experimental paradigm. These challenges include t'ai chi's pluralism, the concept of t'ai chi dosage, and long- versus short-term evaluations of t'ai chi's efficacy and safety. To address these challenges, and with a goal to provide complete and unbiased evidence, we propose a pluralistic methodological approach to clinical research that includes controlled randomized trials of fixed protocols, community-based pragmatic trials, cross-sectional studies of long-term practitioners, and studies that integrate qualitative methods.
尽管越来越多的临床研究已开始评估太极拳作为治疗多种健康状况的工具的疗效和安全性，但很少有人关注评估太极拳是“如何”进行科学研究的，以及不同方法学途径的优势或局限性。在本文的姊妹篇（第一部分）中，我们认为太极拳是一种复杂的、多成分的干预措施，在区分特定效应与非特定效应方面存在独特挑战，并且在使用简化研究框架方面存在局限性。在这第二篇姊妹篇论文中，我们讨论了在实验范式中精确界定太极拳干预措施所固有的其他障碍。这些挑战包括太极拳的多元性、太极拳剂量的概念，以及对太极拳疗效和安全性的长期与短期评估。为应对这些挑战，并旨在提供完整且无偏见的证据，我们提出一种临床研究的多元方法学途径，其中包括固定方案的对照随机试验、基于社区的实用试验、长期习练者的横断面研究，以及整合定性方法的研究。
