Gong Chang-Zhen, Liu Wei
American Academy of Acupuncture and Oriental Medicine, Roseville, MN, 55113, USA.
Chin J Integr Med. 2017 Nov;23(11):803-808. doi: 10.1007/s11655-017-2787-2. Epub 2017 Oct 28.
Ten acupuncture-related articles were published in The Journal of the American Medical Association (JAMA) between 1998 and 2017. Five studies showed positive results in terms of the effectiveness of acupuncture/Chinese medicine (CM); five studies showed negative results. This article summarizes the acupuncturerelated clinical trials published over the last 20 years in JAMA, and addresses what seems to be a fundamental ambivalence in Western medical journals regarding the scientific validity of acupuncture/CM. As yet there has been no consensus on the role of acupuncture in healthcare in Western countries. This is hardly surprising, considering the conflicting evidence found in published studies. Skepticism regarding acupuncture/CM is largely grounded in the fact that an accurate model for assessing the true clinical effects of acupuncture has yet to be created. This article discusses some of the pitfalls which result from applying Western-based scientific principles to CM, and suggests that in many cases, "negative" studies have been misinterpreted. The clinical experience of acupuncture practitioners is often in direct conflict with many of the negative conclusions published in journals. We are in need of an accurate model for sham and placebo treatments, and must analyze all published studies for design flaws and faulty conclusions.
1998年至2017年间，有十篇与针灸相关的文章发表在美国医学会杂志（JAMA）上。五项研究表明针灸/中医（CM）疗法有效；五项研究则显示了负面结果。本文总结了过去20年在JAMA上发表的与针灸相关的临床试验，并探讨了西方医学期刊对针灸/中医科学有效性所表现出的一种基本矛盾态度。在西方国家，对于针灸在医疗保健中的作用尚未达成共识。考虑到已发表研究中相互矛盾的证据，这并不奇怪。对针灸/中医的怀疑主要基于这样一个事实，即尚未建立一个准确评估针灸真实临床效果的模型。本文讨论了将西方科学原则应用于中医所导致的一些缺陷，并指出在许多情况下，“负面”研究被误解了。针灸从业者的临床经验常常与期刊上发表的许多负面结论直接冲突。我们需要一个准确的假治疗和安慰剂治疗模型，并且必须分析所有已发表研究中的设计缺陷和错误结论。
