Cherkin D C
Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington 98101, USA.
Spine (Phila Pa 1976). 1998 Sep 15;23(18):1997-2002. doi: 10.1097/00007632-199809150-00017.
The past few years have witnessed an explosion of primary care-relevant research on low back pain. The descriptive studies have helped elucidate the diagnostic and therapeutic interventions that are in current use. The literature syntheses have clarified what is known about the usefulness of these interventions. The randomized trials have pushed the frontiers of knowledge in several important areas. The quality of research in this field is mixed but has improved significantly in recent years. If research is to lead to substantial improvements in primary care for low back pain, however, the focus must be broadened to embrace an existing but neglected paradigm, the biopsychosocial model. It must be understood how the physician can become a more effective healer and counselor for the patient with back pain. This will require that greater attention be paid to literature outside of the field and that communication and collaboration with researchers in other disciplines increase. Modern distractions such as technology, litigation, and disability compensation have interfered with the ability of physicians to meet their patients' needs. If physicians are to become more effective managers of such common problems as low back pain, they must rediscover their ability to help their patients cope with illness and suffering.
在过去几年里，与初级保健相关的腰痛研究呈爆发式增长。描述性研究有助于阐明当前使用的诊断和治疗干预措施。文献综述明确了这些干预措施的效用。随机试验在几个重要领域拓展了知识前沿。该领域的研究质量参差不齐，但近年来有了显著提高。然而，如果研究要大幅改善腰痛的初级保健，就必须拓宽视野，接纳一种现有的但被忽视的模式——生物心理社会模式。必须明白医生如何才能成为更有效的腰痛患者治疗者和咨询者。这将需要更加关注该领域之外的文献，并加强与其他学科研究人员的沟通与合作。诸如技术、诉讼和残疾补偿等现代干扰因素已经影响了医生满足患者需求的能力。如果医生要更有效地管理腰痛等常见问题，他们必须重新找回帮助患者应对疾病和痛苦的能力。
