中医肿瘤规范化研究与循证医学

中医治疗肿瘤历史悠久,特别是近年来的广泛深入研究,取得了相当大的成就,如在放化疗中的减毒增效作用,手术后的康复和降低复发转移,晚期患者的改善生活质量、延长生存时间等方面都得到了认可.但也还存在一定问题.中医治疗肿瘤方法的进一步推广,需要有中医肿瘤规范化治疗方案的制定和实施.方案的研究制定实际是一项系统工程,它应以中医治则治法为研究的切入点,以最优的临床证据作为制定的基础.它应在循证医学理论指导下,通过严格随机对照临床试验和系统评估对方案加以验证和优化,最终形成一份系统的、成熟的、规范化的治疗策略.目前,因为中医个体化治疗为多,临床数据分散,缺乏具有说服力的数据与结论.而要制定较为理想的规范化治疗方案或指引,需要循证医学的证据,多中心的随机化的研究结果.中医学者们已经注意到了这一问题,循证医学的研究得到了重视,并且逐步实施.随着医学理论和技术的发展,新的临床证据不断出现,但还需要不断充实、修正和提高.总之,经过努力,相信不久会有一个以循证医学为证据的规范化治疗方案的出台,它的不断完善会推动新世纪中医肿瘤学的发展.

Standardized Chinese Medical Research on Oncology and Evidence-based Medicine

Chinese medicine has a long history of handling cancer, in recent years particularly, has produced satisfying results in such fields as attenuation and synergia for chemo, post-operation convalescence, reducing recurrence or metastasis, and improving survival time also quality of life. Nevertheless standardized therapeutic regimen is necessary for further promotion. It is a system engineering that starts with therapeutic principle and method and based on optimal clinical evidences. A systematic, self-contained, standardized therapeutic regimen shall be the result of verification and optimization by rigid randomized clinical trial and system evaluation under guidance of evidence-based medicine. However, there is lack of convincing data and results due to individualized therapy and scatter clinical data. Suitable standardized therapeutic regimen or guideline results from multi-centered randomized clinical evidences. Fortunately researchers of Chinese medicine are aware of the problem and gradually take measures in this aspect. With further development of theory and technology, and increasing clinical evidence, we will hopefully welcome the advent of a evidence-based standardized therapeutic regimen, ushering in a new era of Chinese oncology.