循证医学在中西医结合治疗肝癌中的作用与意义

Effect and Significance of Evidence Based Medicine on the Treating of Liver Cancer with Integrated Chinese and Western Medicine

原发性肝癌是临床上常见的恶性肿瘤之一,早期起病隐匿,缺乏特异临床表现,早期诊断困难,大多数发现时已属中晚期,失去手术根治切除或肝移植治疗机会。目前非手术治疗肝癌的方法包括肿瘤局部消融治疗、肝动脉栓塞化疗、放疗、生物免疫治疗、分子靶向药物治疗和中医药治疗等,疗效缺乏客观的评价体系。循证医学(Evidence-Based Medicine,EBM)是一种临床医学新理念、新方法,其实质是任何医疗决策的确定包括医生处理患者和制定治疗措施都应该根据现有客观的、可靠的科学依据进行,其方法在于采用严谨的科学方法,总结、研究临床问题,得到最佳答案,再升华到新的理论或方法,用以指导新的临床实践。循证医学要求根据现有的客观、可靠的证据评价中西医学治疗肝癌的方法,规范中西医结合治疗肝癌的医疗行为,在中西医结合治疗肝癌中具有重要的指导作用。

Primary liver cancer is clinically one of the common malignant tumors. It is difficult to be diagnosed early because of early insidious onste and absence of specific clinical manifestation. Most patients with liver cancer have been midlate stage, and can＇ t be performed an operation or liver transplantation. Current nonoperative treatments for liver cancer are including local ablation, transcutaneous arrerial chemotherapy embolization, radiotherapy, biological immunotherapy, molecular targeted drug therapy and herb therapy etc. The therapeutic effect of these modalities is lack of objective evaluation system. Evidence-Based Medicine （EBM） is a new idea and method of clinical medicine, its essence is to decide any medical treatment rule including which doctors treat patients and enact therapeutic measures according by objective and reliable evidences. Clinical problems can be summarized and studied by means of the scrupulous scientific methods to obtain the best answer. New theories and methods from the best answers can be used to guide new clincal pratice. The modalities of treating liver cancer with integrated chinese and western medicine can be evaluated and benchmarked according by current objective and reliable evidences from EBM. EBM is playing an important guiding role in treating liver cancer with integrated Chinese and Western medicine.