Reinharez D
Phlebologie. 1978 Oct-Dec;31(4):313-20.
The difficulties inherent in clinical experimentation in phlebology, stem from the fact that they concern highly subjective functional problems, and are thus difficult to measure. The answer to these difficulties seems to be found in the use of the double blind method. This method, however, contains numerous causes of errors in phlebology, since in order to be mathematically applied to computer use, it is too sketchy and does not take into account many additional factors, incidental parameters and unfavorable coincidences related either to chronobiology (weather, seasonal changes), to hormonal problems (periods of the cycle, pregnancies, contraception, menopause), to the environment (professional posture, ground heat, periods of vacation or work), or associated diseases (neuro-vegetative and rheumatic disorders, excessive weight, metabolic disorders), etc. It seems that in such cases, wide experimentation, with a very critical clinician, who attributes the improvement obtained to the drugs prescribed only when left with no other possibility and after having eliminated all the coincidental factors, gives results closer to reality than double blind experiments, behind whose pseudo-scientific appearance lies a sketchiness that is the cause of numerous errors.
静脉学临床实验中固有的困难,源于这样一个事实,即这些实验涉及高度主观的功能问题,因此难以测量。解决这些困难的答案似乎在于使用双盲法。然而,这种方法在静脉学中存在许多误差来源,因为为了在数学上应用于计算机使用,它过于粗略,没有考虑到许多其他因素、偶然参数以及与生物钟学(天气、季节变化)、激素问题(月经周期、怀孕、避孕、更年期)、环境(职业姿势、地面热量、假期或工作时间)或相关疾病(神经植物性和风湿性疾病、超重、代谢紊乱)等相关的不利巧合。在这种情况下,由非常严谨的临床医生进行广泛的实验,只有在排除所有偶然因素且别无他法时,才将所获得的改善归因于所开的药物,这样得出的结果似乎比双盲实验更接近现实,双盲实验表面上看似科学,但其粗略性却导致了许多错误。