Complementary and alternative medicine and the need for evidence-based criticism.
Complementary and alternative medicine and the need for evidence-based criticism.
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补充和替代医学以及基于证据的批评的需要。
DOI：
10.1097/00001888-200209000-00006
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发表时间：
2002
期刊：
影响因子：
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通讯作者：
Astin,JohnA
中科院分区：
文献类型：
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作者：
Astin,JohnA
在阅读了发表在2001年3月号《学术医学》上的题为《替代医学：证据在医学和医学教育中的重要性》的一组论文后，我觉得有必要对作者提出的一些观点作出回应。除了Frenkel和Ben-Arye的论文非常公平和不偏不倚外，1整组论文中经常有人声称补充和替代医学(CAM)不是以证据为基础的。然而，这一组文章中包含的这一说法和许多其他说法最具讽刺意味的是，这种“缺乏证据”的说法通常没有任何支持证据本身(人们可以称之为“非基于证据的批评”)。仅举一个例子，格罗尔曼说：“今天被证明有效的草药清单包括罂粟、金鸡纳、麦角、伊佩卡卡纳、毛地黄、可可、颠茄和麻黄。”2然而，作者要么没有意识到，或者(更糟糕的)完全忽视或忽略了对其他一些草药和营养制剂的荟萃分析结果，这些药物包括治疗轻度到中度抑郁的圣约翰草，治疗良性前列腺增生症的棕榈叶，5，6治疗痴呆症的银杏叶，7阿尔茨海默病，8和帐篷间歇性跛行，9卡瓦卡瓦治疗焦虑、焦虑和营养不良。育亨宾治疗勃起功能障碍10例，氨基葡萄糖软骨素治疗骨关节炎11例。12没有举出这些证据，会使人们对作为CAM基础的科学证据基础的状况产生非常误导的印象。
After reading the recent set of papers entitled “Alternative Medicine: The Importance of Evidence in Medicine and Medical Education,” published in the March 2001 issue of Academic Medicine, I feel compelled to respond to a number of the points raised by the authors.With the exception of the paper by Frenkel and Ben-Arye, which was quite fair and even-handed, 1 throughout the set the claim is frequently made that complementary and alternative medicine (CAM) is not evidence-based. However, the great irony with this and many other statements contained in this set of articles is that such claims of “lack of evidence” are typically not backed up with any supporting evidence themselves (what one might term “non—evidence-based criticism”). To give but one example, Grollman states that “the list of demonstrably effective herbals today would consist of opium poppy, cinchona, ergot, ipecacuanha, foxglove, cocoa, belladonna, and ma huang.” 2 However, the author either appears unaware of, or (worse) completely overlooks or ignores the results of positive (or at least highly suggestive) meta-analyses for a number of other herbals and nutraceuticals, including St. John's wort for mild to moderate depression, 3, 4 saw palmetto for benign prostatic hyperplasia, 5, 6 Gingko biloba for dementia, 7 Alzheimer's disease, 8 and intermittent claudication, 9 kava kava for anxiety, 10 yohimbine for erectile dysfunction, 11 and glucosamine—chondroitin for osteoarthritis. 12 The failure to cite such evidence contributes to a very misleading picture of the state of the scientific evidence base underlying CAM.