补充/替代医学研究:个人评论

E. Ernst
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引用次数: 1

摘要

1. 例如,在互联网上、流行书籍、报纸文章等中,关于CAM的错误或误导性信息的数量是巨大的,远远超过了神经病学、妇科、风湿病学或任何其他医学领域。根据我们的经验,以下三种误解最为普遍:(a)支持者经常声称CAM在某种程度上违背了科学评估。然而,他们更愿意参考cam的科学测试——只要结果是肯定的(例如,matie, 2003)。(b) CAM的狂热者经常声称这些治疗是无风险的。然而,已经确定了几乎所有CAM模式的重要直接和间接风险(Ernst, Pittler, Wider, & Boddy, 2006)。(c) CAM的反对者和支持者出于不同的理由,经常坚持认为CAM或CAM的某些部分没有或只有很少的科学证据。然而,仔细观察,人们发现至少在CAM的几乎所有领域都有一些初步证据(Ernst et al., 2006)。2. 辅助医学的临床实践明显缺乏科学依据。大多数从业人员仍然坚持认为,他们的直觉和经验比严格的临床试验结果更可靠。因此,如果现有的最佳证据表明它们没有特定的效果,甚至可能有害,他们就不愿意放弃它们的治疗方法。我的印象是,对于一些从业者和许多患者来说,CAM更像是一种宗教,而不是一种医疗保健形式。对他们来说,信念比事实更重要。3.尽管存在这些障碍,对CAM的研究已经取得了相当大的进展。我估计,在过去的十年里,大约有5000个CAM的临床试验被发表。当然,它们的质量和效果参差不齐。基于这些数据,可以将CAM分为三类(Ernst et al., 2006)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Research Into Complementary/Alternative Medicine: A Personal Comment
1. The amount of wrong or misleading information on CAM, for example, on the Internet, in popular books, newspaper articles, and so on, is colossal and by far exceeds that in neurology, gynaecology, rheumatology, or any other medical field. The following three misconceptions are, in our experience, the most widespread: (a) Proponents often claim that CAM somehow defies scientific evaluation. Yet they are more than willing to refer to scientific tests of CAM—as long as the results are positive (e.g., Mathie, 2003). (b) Enthusiasts of CAM frequently contend that the treatments are risk-free. However, important direct and indirect risks have been identified for virtually all CAM modalities (Ernst, Pittler, Wider, & Boddy, 2006). (c) Both opponents and proponents of CAM, for different reasons, often maintain that there is no or very little scientific evidence in CAM or sections of CAM. Yet, on closer inspection, one finds at least some preliminary evidence in almost all areas of CAM (Ernst et al., 2006). 2. The clinical practice of CAM is remarkably resistant to scientific evidence. Most practitioners continue to insist that their intuition and experience are more reliable than the results of rigorous clinical trials. They are thus unwilling to abandon their treatments if the best available evidence shows they have no specific effects or might even be harmful. It is my impression that, for some practitioners and for many patients, CAM is more akin to a religion than to a form of healthcare. To them, belief counts more than facts. 3. Despite these obstacles, research into CAM has made considerable progress. I estimate that approximately 5,000 clinical trials of CAM have been published during the last decade. Their quality and results are, of course, mixed. Based on these data, it is possible to classify CAM into three categories (Ernst et al., 2006).
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