藏医临床疗效评价的方法学思考

Study on methodology for evaluating clinical efficacy of traditional Tibetan medicine

藏医临床疗效的评价,是藏医发展过程中面临的重要科学议题。本研究介绍了国内外藏医临床疗效评价的现状和问题;通过比较分析藏医和中医在临床疗效评价方面的异同,指出两者的差异应属于细节而非本质上的差异,故藏医可有选择性地借鉴中医临床研究的经验,并结合自身特色,构建藏医临床疗效评价的方法学体系;还探讨了藏医临床疗效评价面临的方法学挑战,包括尚未制定符合藏医自身特色的临床研究指导原则、藏医病证诊断标准等;最后提出了改进藏医临床疗效评价的若干建议,包括多种研究方法的综合应用、基于整体系统研究的思路评价藏医复杂干预的疗效、选取公认、客观的疗效评价结局指标等。

The evaluation on clinical efficacy of traditional Tibetan medicine （TFM） is an important scientific subject during the development of T＇FM. Firstly, the authors introduced the current situations and problems in evaluation on clinical efficacy of traditional Tibetan medicine both at home and abroad in this study. Secondly, they compared the similarities and differences between TYM and traditional Chinese medicine （TCM） in evaluation on clinical efficacy, define their differences in details but not in nature, and pro- posed that TTM could selectively learn TCM＇s experiences in clinical research and build a specific methodology system for evaluation on clinical efficacy according to its own characteristics. Thirdly, they discussed the methodological challenges in evaluation on clinical efficacy of TTM, including the pending clinical research guidelines and disease diagnosis standards according to its own characteristics. Finally, they propound some suggestions for promoting the evaluation on clinical efficacy of TTM, including the comprehensive applica- tion of multiple research methods, overall research-based evaluation on efficacy of TTM complex intervention and selection of accepted and objective outcome indexes for efficacy evaluation.