借鉴循证医学实践方法探究中医古籍思索.docVIP

借鉴循证医学实践方法探究中医古籍思索 　 作者：刘迈兰 吴曦 任玉兰 马婷婷 梁繁荣 【摘要】 循证医学是基于证据的新型临床方法学，着重评价临床研究和临床实践的真实性和有效性，通过提出问题、检索证据、评价证据、运用证据和后效评价开展循证实践。中医学是理论与实践、思想与经验，高度和谐与统一的医学体系。中医学，其根基在于临床疗效，其古代医籍中蕴藏的丰富资源，不仅是中医学理论发展和实践探索的源泉和动力，而且对现代研究具有启发和指导作用。文章拟从以下几方面思考借鉴循证医学实践方法研究中医古籍：以临床问题-治疗方法模式，分类挖掘整理临证案例;完善数据库建设，将中医学特色与循证理念融入数据库建设;借鉴循证证据的拟定，制定标准，对古籍本身及实践经验分级;运用证据，指导临床实践。 【关键词】 循证医学实践; 中医古籍研究 　　Abstract：Evidence based medicine (EBM) is a new clinical methodology based on evidence, put emphasis on the review of validity and effectivity of clinical researches and practices, and carry out practice through posing a question, retrieving, evaluating and applying evidence, and emphasizing outcome evaluation. Chinese medicine is a highly harmonious and integral medicine between theory and practice, between tought and experience. Traditional Chinese medicine(TCM) lays foundation on clinical efficacy, whose ancient literatures were rich in classical theories and typical clinical cases, which is not only the development sources and forces of TCM, but also the guidance of clinical researches and practices. This thesis will do some researches on ancient literatures of TCM in view of methods of evidence based practice(EBP). First of all, to classify and arrange clinical cases using a clinical question-treatment mode; then, to perfect the construction of databases incorporating the features of TCM and the concept of EBM; third, to identify the standardization to assess the grade of ancient literatures in view of the identification of evidentiary of EBM; finally, to apply the evidence and serve for the clinic well. 　　Key words：Evidence based practice(EBP); Researches on ancient literatures of TCM 　　伴随着现代医疗模式的转变和评价方法的更新，尤其是循证医学的兴起和发展，医学已经日益聚焦于临床疗效的有无与高低。循证医学是基于证据的新型临床方法学，着重评价临床研究和临床实践的真实性和有效性，为中医学的发展带来了机遇和挑战。中医学，其根基在于临床疗效，其古代医籍中富于经典理论和临证案例，能指导临床，启迪现代研究。本文拟从循证医学实践方法的角度探讨中医古籍的研究。 　　1 循证医学及循证医学实践 　　循证医学(Evidence based medicine, EBM)强调将临床医生的专业技能和临床经验、当前所能获得的最佳科学证据、病人的价值和愿望，三者完美结合制定医疗决策[1]，着眼于临床疗效的真实性和有效性。其优势表现在[2,3]：为临床医生提