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在循证医学时代发展中医药:当前证据与挑战。

Developing traditional chinese medicine in the era of evidence-based medicine: current evidences and challenges.

机构信息

Traditional Medicine Information Service, Department of Pharmacy, Singapore General Hospital, Singapore.

Department of Haematology, Singapore General Hospital, Academia, 20 College Road, Singapore 169856.

出版信息

Evid Based Complement Alternat Med. 2015;2015:425037. doi: 10.1155/2015/425037. Epub 2015 Apr 8.

Abstract

Evidence-based medicine (EBM), by integrating individual clinical expertise with the best available clinical evidence from systematic research, has in recent years been established as the standard of modern medical practice for greater treatment efficacy and safety. Traditional Chinese Medicine (TCM), on the other hand, evolved as a system of medical practice from ancient China more than 2000 years ago based on empirical knowledge as well as theories and concepts which are yet to be mapped by scientific equivalents. Despite the expanding TCM usage and the recognition of its therapeutic benefits worldwide, the lack of robust evidence from the EBM perspective is hindering acceptance of TCM by the Western medicine community and its integration into mainstream healthcare. For TCM to become an integral component of the healthcare system so that its benefits can be rationally harnessed in the best interests of patients, it is essential for TCM to demonstrate its efficacy and safety by high-level evidence in accordance with EBM, though much debate remains on the validity and feasibility of applying the EBM model on this traditional practice. This review aims to discuss the current status of research in TCM, explore the evidences available on its efficacy and safety, and highlight the issues and challenges faced in applying EBM to TCM.

摘要

循证医学(EBM)通过整合个体临床专业知识和系统研究中获得的最佳临床证据,近年来已成为现代医学实践的标准,以提高治疗效果和安全性。另一方面,中医药(TCM)是一种从 2000 多年前的中国古代发展而来的医疗实践体系,其基于经验知识以及尚未被科学等同物所描绘的理论和概念。尽管 TCM 的使用不断扩大,其治疗益处也在全球范围内得到认可,但由于缺乏 EBM 视角的有力证据,西医界对 TCM 的接受程度以及将其纳入主流医疗保健方面受到阻碍。为了使 TCM 成为医疗保健系统的一个组成部分,以便为了患者的最佳利益合理利用其益处,TCM 必须按照 EBM 用高级别的证据证明其疗效和安全性,尽管关于在这种传统实践中应用 EBM 模型的有效性和可行性仍存在很多争议。本文旨在讨论 TCM 的研究现状,探讨其疗效和安全性方面的现有证据,并强调将 EBM 应用于 TCM 所面临的问题和挑战。

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