针灸临床研究整合证据链的构建

Construction of the integrative evidence chain in clinical trial of acupuncture and moxibustion

针对针灸临床研究证据存在欠缺系统性、无法体现针灸治疗特色及说服力不足等问题,提出针灸临床研究的思路方法,旨在为此领域研究提供方法学的指导。通过系统回顾国内外针灸临床试验的注册情况、Cochrane Library数据库对针灸持推荐态度的病种分布,结合循证医学证据等级的内容及能体现针灸临床实践的个体化特点,对针灸临床研究提出一些设想及框架。要以疗效为先导,先从针灸个案经验、临床观察中初步总结针灸的优势病种及治疗方式,针对有潜力的针灸疗法,开展严格规范的临床试验以验证其疗效,最后以实验研究探索针灸的作用原理。通过定量与定性相结合的方法整合以上所有的证据,形成整合证据链。针灸临床研究整合证据链的构建,有望促进针灸的临床推广及提升针灸的学科影响力。

The research aims to propose the approaches to the clinical trial of acupuncture and moxibustion and provide the methodological guide for the research in this field in terms of the inadequate systematic collection,lack of the specific characteristics of acupuncture-moxibustion treatment and insufficient persuasion in clinical evidences of acupuncture-moxibustion research.Through a systematic review of the registration of acupuncture-moxibustion clinical trials at home and abroad,the distribution of diseases with the recommendation of acupuncture and moxibustion in Cochrane Library database,combined with the evidence grade of the evidence-based medicine and the individual characteristics of clinical practice with acupuncture and moxibustion,some research ideas and framework are proposed for the clinical trial of acupuncture and moxibustion.To take the curative effect as the forerumer,the dominant disease and therapeutic methods of acupuncture and moxibustion should be initially generalized by the case experiences and clinical observation at the first.In view of the potential function of acupuncture and moxibustion in treatment,the rigorous and standardized clinical trial should be carried out to verify their therapeutic effect.Finally,the experimental research is adopted to explore the mechanism of acupuncture and moxibustion.Through the combination of quantitative and qualitative methods,all of the evidences are integrated to form an integrative evidence chain.It is anticipated that the construction of the integrative evidence chain in clinical trial of acupuncture and moxibustion may enhance the promotion of clinical practice with acupuncture and moxibustion and increase the influence of acupuncture-moxibusiton discipline.