Naugler Christopher T
Department of Pathology and Laboratory Medicine, Dalhousie University, 5788 University Ave, Halifax, NS B3H 2Y9.
Can Fam Physician. 2008 Sep;54(9):1265-9.
To review the relevance of evolutionary medicine to family practice and family physician training.
Articles were located through a MEDLINE search, using the key words evolution, Darwin, and adaptation. Most references presented level III evidence (expert opinion), while a minority provided level II evidence (epidemiologic studies).
Evolutionary medicine deals with the interplay of biology and the environment in the understanding of human disease. Yet medical schools have virtually ignored the need for family physicians to have more than a cursory knowledge of this topic. A review of the main trends in this field most relevant to family practice revealed that a basic knowledge of evolutionary medicine might help in explaining the causation of diseases to patients. Evolutionary medicine has also proven key to explaining the reasons for the development of antibiotic resistance and has the potential to explain cancer pathogenesis. As an organizing principle, this field also has potential in the teaching of family medicine.
Evolutionary medicine should be studied further and incorporated into medical training and practice. Its practical utility will be proven through the generation of testable hypotheses and their application in relation to disease causation and possible prevention.
探讨进化医学与家庭医疗及家庭医生培训的相关性。
通过医学文献数据库检索，使用关键词“进化”“达尔文”和“适应”查找相关文章。多数参考文献为Ⅲ级证据（专家意见），少数为Ⅱ级证据（流行病学研究）。
进化医学探讨生物学与环境在理解人类疾病中的相互作用。然而，医学院校几乎忽视了家庭医生对该主题深入了解的必要性。回顾该领域与家庭医疗最相关的主要趋势发现，进化医学基础知识可能有助于向患者解释疾病病因。进化医学也已被证明是解释抗生素耐药性产生原因的关键，并且有可能解释癌症发病机制。作为一种组织原则，该领域在家庭医学教学中也具有潜力。
进化医学应进一步研究并纳入医学培训与实践。其实际效用将通过产生可检验的假设并将其应用于疾病病因及可能的预防方面得到验证。
