针灸临床研究的现状及探讨  

Acupuncture Clinical Studies and Evidence-based Medicine——An Update

作　　者：劳力行[1] 

机构地区：[1]美国马里兰大学医学院结合医学中心,马里兰21207

出　　处：《针刺研究》2008年第1期53-61,共9页Acupuncture Research

基　　金：针刺治疗骨关节炎的研究由美国补充与替代医学中心和国家卫生研究院骨关节炎及肌肉骨骼皮肤疾病研究所资助(NIH资助号:U01AT00171).

摘　　要：循证医学在西方的兴起为针灸研究带来新的评估方法及新的挑战,近年来发表的针灸研究文章的数量不断增加,而对这些研究的系统评价不仅帮助我们了解当前研究的结果,同时也使我们认识到在研究设计方面存在的不足之处,单凭一种设计并不能回答所有问题。目前西方采用多种针灸对照方法进行的不同试验设计已有报道。从循证医学的观点看,许多中国的针灸试验在设计方法方面存在不足,使结果不具说服力。这些不足主要包括随机方法不恰当或无随机、对照组设立不合理、缺少客观的疗效评价方法、研究者未进行适当的隐蔽、随访时间太短以及统计方法不恰当等。为提高中国针灸临床研究质量,推动中国针灸研究发展到领先水平,应根据针灸本身的特点,努力探索和创新,走具有中医特色的研究之路,而不是盲目照搬西方药物研究的方法。应发展出既能被严格的现代科学研究标准所接受,又不失中医针灸临床实践精髓的研究方法,从而恰当评价针灸在现代社会中的地位。Acupuncture has been widely used in the West in recent years and demand has been growing for scientific evaluation of its clinical efficacy. The practice of evidence-based medicine has brought new challenges in the design of acupuncture research, and publication of randomized clinical trials on acupuncture has significantly increased. While systematic reviews of these trials have advanced our current knowledge, they have exposed deficiencies in research design and revealed that one design can not answer all research questions. Few clinical studies conducted in China have been published in the West, and most published in Chinese suffer from methodological design flaws that render the results unreliable and unconvincing. Such flaws include inadequate or no randomization, inadequate control, unsatisfactory outcome measurements, lack of proper concealment, insufficient followup, and improper statistical analysis. To foster high quality acupuncture clinical research in China, we must cultivate innovation and creativity in research design. It is unwise to simply follow or copy the research methodology of Western pharmaceutical stud- ies. Acupuncture and traditional Chinese medicine （TCM） must be evaluated using rigorous scientific methods that preserve the essence of TCM concepts, so that acupuncture and TCM, these ancient healing arts, can continue to play an important role in the health care systems of modern societies.

关 键 词：针灸 循证医学 系统评价 临床研究方法 

分 类 号：R2-03[医药卫生—中医学]