中医治疗方案的“效果择优”及其应用朝向

Effectiveness Prioritization in Chinese Medicine Treatment and Application Orientation

中医临床施治环节,针对具体病证,何药有效?存在多种治疗方案时,何药最优?是医生频繁抉择的临床问题。随着中药复方有效性证据知识的增加,"何药有效"正逐步被回答,而"何药最优"成为新近研究热点。基于上述认识,本研究提出效果择优的概念,进而阐明其对临床决策的价值,例举出现阶段可用于中医药效果择优研究的两类研究方法——间接比较法和多准则决策分析法,分析其方法学原理和具体应用环节。同时,针对多种慢病难治环节,提出中医药效果择优研究的基本流程及应用前景,为推动中医药高质量证据进入指南提供方法学实践策略。

During the clinical practice involving Chinese medicine, two questions repeatedly confronts the practition- ers are what prescription is effective and which prescription works better. As the trial and experimental evidences accumu- lating, the former has been better answered, while the latter, which is currently quite another story, increasingly fails into the interests of researchers. Based upon this situation, this paper proposed and tried to define the concept of effectiveness prioritization and clarified what sense it will make to Chinese medicine. Further, two practically available methods for such an end--indirect effectiveness comparison and multi -criteria decision -making process, were introduced with respect to their fundamental rationales and application prospects. Meanwhile, the authors also looked at the promise Of these methods in Chinese medicine and drafted its underlying workflow. All of these endeavors aim at better introducing high - quality evidence into clinical guideline.