中医药随机对照试验疾病谱的变化及趋势

目的 调查中医药治疗疾病谱的变化及其优势：方法 手工检索中医、中西医结合13种核心期刊在1999-2004年发表的随机对照试验（randomized controlled trials，RCTs），建立RCTs数据库；对所研究疾病进行系统归类，同时对常见疾病进行分析，并与1980-1998年的RCTs数据库进行疾病谱的比较结果本数据库共计7422篇RCTs文献，以消化、心血管、神经、呼吸系统疾病文献最多，分别占14．93％、11．33%、10．01%和8．68％：各系统以脑血管意外、糖尿病、冠心病和慢性阻塞性肺病的研究居多，分别占5．01％、4．86％、3．17％和2．57％：与既往比较，神经、内分泌代谢、肿瘤和妇科疾病的系统构成比均有较大幅度的上升（均P〈0．05），而消化和呼吸系统的构成比均有较大幅度的下降（均P〈0．05）。结论 中医、中西医结合工作者比较关注中医药在防治心脑血管、内分泌代谢、恶性肿瘤等方面的临床研究，中医药具有治慢性病、治未病、注重整体性、经济性和毒副反应少等优势。

Change and Trend of Disease Spectrum in Randomized Controlled Trials of Traditional Chinese Medicine

Objective To investigate the spectral changes of diseases with the treatment of traditional Chinese medicine(TCM),and to find out the advantages of TCM.Methods A manual search for papers of randomized controlled trials(RCTs) in 13 core journals of TCM and integrated Chinese and Western medicine(ICWM) published from 1999 to 2004 were performed to create a database of RCTs.Depending on the database,the diseases involved were classified systematically.Among them,the common diseases were analyzed,and the disease spectrum was compared with that gotten from the RCTs database founded from 1980-1998.Results Most of the total 7 422 articles on RCTs enclosed were concerning the diseases of digestive system(14.93%),cardiovascular system(11.33%),nervous system(10.01%),and respiratory system(8.68%),and mostly were studies on cerebrovascular accident,diabetes mellitus,coronary heart disease(CHD) and chronic obstructive pulmonary disease,accounting for 5.01%,4.86%,3.17% and 2.57%,respectively.As compared with the previous materials,the constituent ratios of nervous system disease,endocrine metabolic disease,tumor,and gynopathy from 1999 to 2004 were raised(all P<0.05),while those of digestive and respiratory system diseases were lowered(both P<0.05).Conclusion Researchers of TCM and ICWM pay more attention to the clinical studies about prevention and treatment with TCM on cerebro-/cardiovascular disease,endocrine metabolic disease and malignant tumor.TCM possesses advantages in treating chronic disease,preventing disease,emphasizing on wholism and is economic with fewer adverse reactions.