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中医疗效不宜“张冠李戴”
王君平
2009年12月14日08:25 来源：人民网-《人民日报》
近来，金银花、板蓝根、连翘、夏枯草、大青叶等和防治流感相关的药材价格都一路上涨。板蓝根的价格比非典时期还要高，金银花卖出金银价，去年才20—30元一公斤，现在已经200多元，而且一天一个价。
中药材看涨，说明公众对中医疗效是肯定的，对中医是认可的。医学追求的目的是疗效，群众认可中医中药，对中医药事业发展是利好。
然而，中医的疗效该如何判断？回答起来却没那么简单。疗效不仅要靠更多人的切身体验，还要有一个说得清、道得明的客观评价体系。而目前最突出的问题是，中医还没有这样一个完整、有效的评价体系，往往是套用西医的判定标准来衡量中医，中西医疗效虽有共通之处，但毕竟治疗思维差别甚大，这种“张冠李戴”式的评判，有时未必合适。
以中医药治疗艾滋病为例：接受中医治疗后，患者能吃能喝，还能下地干活，生活质量明显改善；但目前国际公认的艾滋病治疗疗效的指标如免疫功能和病毒载量并没有明显改变。这算有疗效，还是没疗效？
如何形成一个行之有效的疗效判定标准，是事关中医发展的重大课题。
中医艾滋病疗效评价指标体系初步建立，可以说是中医疗效标准建立的一个有益的尝试：为了客观反映中医药治疗HIV/AIDS的效果，我国采用循证医学方法，引入了生存质量评价量表和基于HIV/AIDS病人报告的临床结局评价，从患者对自己健康状况的测量等方面进行评价。这一指标体系参考我国和国际上较为通用的评价方法和指标，体现中医药特色与优势，得到了初步的认可，已列入国家“十一五”重大传染病专项，观察样本已经扩大到全国。
业内人士指出，需要用中医的脚来走路，而不是拄着西医的拐杖，才能真正创建出适用于中医辨证论治的评价模式，而这正是发展中医之必需。
Efficacy of traditional Chinese medicine should not be "wrongly tagged"
Wang Junping
At 08:25 on December 14, 2009 Source: People's Network - "People's Daily"
Recently, honeysuckle, Banlangen, Forsythia, Prunella, Daqingye such as medicine and prevention of influenza-related prices all the way up. Banlangen the price is even higher than the SARS period, honeysuckle selling gold and silver price of 20-30 yuan a kilogram last year, now more than 200 yuan, and the day a price.
Chinese herbal medicines bullish, indicating the public is in the affirmative effect of Chinese medicine, Chinese medicine is recognized. The purpose of the pursuit of medical efficacy accepted by the masses of Chinese medicine, Chinese medicine is a good career development.
However, how to judge the efficacy of traditional Chinese medicine? Not so easy to answer them. Effects depend not only on more people's personal experience, but also there is a clear where we stand, way too out in an objective evaluation system. At present, the most prominent problem is that Chinese medicine has not done a complete and effective evaluation system, is often applied to determine the standards of Western medicine, despite efficacy of Chinese and Western medicine in common, but after all, the large difference in the treatment of thinking, this " wrongly tagged "type of judge, and sometimes may not be appropriate.
Traditional Chinese medicine to treat AIDS as an example: After receiving TCM treatment, the patient can eat and drink, but also work in the fields marked improvement in the quality of life; but internationally recognized indicators of AIDS therapy, such as immune function and viral load, and no significant change. This calculation is effective or not effective?
How to determine the efficacy of the formation of an effective standard of Chinese medicine is a matter of the development of a major issue.
Chinese AIDS Clinical evaluation index system was initially established, efficacy of the standard can be said that the establishment of Chinese medicine as a useful attempt: In order to objectively reflect the Chinese medicine treatment of HIV / AIDS results, our use of evidence-based medicine approach, the introduction of quality of life rating scale and based on HIV / AIDS patients in the clinical outcome evaluation of the report, from the patient's own state of health in areas such as evaluation of the measurement. The indicators refer to our country and internationally the more common evaluation methods and indicators to reflect the features and advantages of Chinese medicine, received the preliminary approval have been included in the national "Eleventh Five-Year" major infectious diseases special to observe the sample has been expanded to the whole country .
Insiders pointed out that the need to use traditional Chinese medicine the feet to walk, rather than leaning on a cane Western medicine can really apply to TCM syndrome differentiation to create the evaluation model, which is necessary for the development of traditional Chinese medicine.
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