Shim Jae-Mahn
Department of Sociology, University of Seoul, 163 Seoulsiripdae-ro, Dongdaemun-gu, Seoul, 130-743, Korea.
Global Health. 2015 Apr 25;11:17. doi: 10.1186/s12992-015-0103-2.
Complementary and alternative medicine (CAM), such as acupuncture and herbal medicine, is popular in many countries. Yet, treatment outcomes of CAM are found to vary significantly between medical trials in different social environments. This paper addresses how the social organization of medicine affects medical treatment outcomes. In particular, it examines the extent to which two popular complementary and alternative medicine (CAM) interventions (acupuncture and herbal medicine) are coordinated with biomedicine and how coordination characteristics are related to the treatment outcomes of the two CAM interventions.
This paper conducts an archival analysis of the institutional settings of the CAM interventions in Japan and the U.S. It also conducts a systematic content analysis of the treatment outcomes in 246 acupuncture reports and 528 herbal medicine reports that are conducted in Japan or the U.S. and registered in the Cochrane Library's Central Register of Controlled Trials (CENTRAL), and 716 acupuncture reports and 3,485 herbal medicine reports that are from Japan or the U.S. and listed in MEDLINE. It examines the association between the treatment outcomes of the two interventions and the geographical location of the reports; it also explores how the institutional settings of the interventions are related to the treatment outcomes.
Japanese herbal medicine is integrated into the national medical system the most and American herbal medicine the least; American acupuncture and Japanese acupuncture fall in the middle. Treatment outcomes are the most favorable for Japanese herbal medicine and the least favorable for American herbal medicine. The outcomes of American acupuncture and Japanese acupuncture fall in the middle.
The co-utilization of CAM with biomedicine can produce difficulties due to tensions between CAM and biomedicine. These difficulties and subsequent CAM treatment outcomes vary, depending on how CAM is institutionalized in relation to biomedicine in the national medical system. Coordinated CAM interventions are more likely to be effective and synergic with biomedicine, when compared to uncoordinated ones.
补充和替代医学（CAM），如针灸和草药医学，在许多国家都很流行。然而，在不同社会环境下的医学试验中，补充和替代医学的治疗效果差异显著。本文探讨医学的社会组织如何影响医疗治疗效果。具体而言，研究两种流行的补充和替代医学（CAM）干预措施（针灸和草药医学）与生物医学的协调程度，以及协调特征与这两种CAM干预措施的治疗效果之间的关系。
本文对日本和美国的CAM干预措施的机构设置进行了档案分析。还对在日本或美国进行并在Cochrane图书馆的对照试验中央注册库（CENTRAL）中注册的246份针灸报告和528份草药医学报告，以及来自日本或美国并列入MEDLINE的716份针灸报告和3485份草药医学报告中的治疗效果进行了系统的内容分析。研究这两种干预措施的治疗效果与报告地理位置之间的关联；还探讨干预措施的机构设置与治疗效果之间的关系。
日本的草药医学与国家医疗体系整合程度最高，美国的草药医学最低；美国的针灸和日本的针灸处于中间水平。治疗效果对日本草药医学最有利，对美国草药医学最不利。美国针灸和日本针灸的效果处于中间水平。
由于补充和替代医学与生物医学之间的紧张关系，CAM与生物医学的共同使用可能会产生困难。这些困难以及随后的CAM治疗效果各不相同，这取决于CAM在国家医疗体系中与生物医学的制度化方式。与未协调的CAM干预措施相比，协调的CAM干预措施更有可能与生物医学有效协同。
