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迈向适用于个性化医疗的临床疗效评估系统。

Towards a Clinical Efficacy Evaluation System Adapted for Personalized Medicine.

作者信息

Yuan Bing

机构信息

HK Modern Chinese Medicine R&D Center, Hong Kong.

出版信息

Pharmgenomics Pers Med. 2021 Apr 28;14:487-496. doi: 10.2147/PGPM.S304420. eCollection 2021.

Abstract

The rise of precision medicine (PM) has initiated the transition of mainstream medicine from disease-based medicine to personalized medicine, alongside which the US FDA has begun to establish a clinical trial and efficacy evaluation (CTEE) system compatible with personalized medicine based on biological markers. Outside of modern medicine, however, there has always existed a personalized medical system, traditional Chinese medicine (TCM), that is, a personalized medical system built at the organism level with a similar concept and method to today's complexity science. However, under the current CTEE system, TCM has not usually been shown to be effective. The CTEE system of modern medicine has now begun to embrace personalized medicine at the microlevel. Therefore, there is no reason to continue to reject TCM, which is a type of personalized medicine at the organism level. This paper analyzes and compares the commonality and differences between a personalized medical system based on biomarkers established by PM and a personalized medical system based on syndromes in TCM; the results clearly reveal structural relationships between the two medical systems. On this basis, through rigorous logical reasoning, the feasibility of applying the CTEE method which is used in PM to evaluate the efficacy of TCM treatments is demonstrated. The relationship among biomarkers by which PM describes personalized states and modern medical diseases and the relationship among TCM syndromes and diseases are completely consistent. Because of this consistency, the new CTEE system established by the US FDA to promote the development of PM is fully applicable to the clinical trial and efficacy evaluation of TCM treatment methods. Clinical trials and efficacy evaluations based on this system can scientifically prove the effectiveness of TCM, and TCM is expected to be incorporated into the modern medical system based on scientific norms.

摘要

精准医学(PM)的兴起开启了主流医学从疾病医学向个性化医学的转变,与此同时,美国食品药品监督管理局(FDA)已开始建立基于生物标志物的、与个性化医学相兼容的临床试验与疗效评估(CTEE)体系。然而,在现代医学之外,一直存在着一种个性化医疗体系,即传统中医(TCM),它是一种在机体层面构建的个性化医疗体系,其理念和方法与当今的复杂性科学有相似之处。然而,在当前的CTEE体系下,中医通常未被证明是有效的。现代医学的CTEE体系如今已开始在微观层面接纳个性化医学。因此,没有理由继续排斥作为机体层面个性化医学的中医。本文分析并比较了PM所建立的基于生物标志物的个性化医疗体系与中医基于证候的个性化医疗体系之间的共性与差异;结果清晰地揭示了这两种医疗体系之间的结构关系。在此基础上,通过严谨的逻辑推理,论证了将PM中用于评估疗效的CTEE方法应用于中医治疗疗效评估的可行性。PM描述个性化状态的生物标志物与现代医学疾病之间的关系,以及中医证候与疾病之间的关系完全一致。正因这种一致性,美国FDA为推动PM发展而建立的新CTEE体系完全适用于中医治疗方法的临床试验与疗效评估。基于该体系的临床试验和疗效评估能够科学地证明中医的有效性,中医有望基于科学规范被纳入现代医学体系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04c9/8092347/dc4734bbdc8f/PGPM-14-487-g0001.jpg

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