中医(Traditional Chinese Medicine)指中国传统医学,是研究人体生理、病理以及疾病的诊断和防治等的一门学科。它承载着中国古代人民同疾病作斗争的经验和理论知识,是在古代朴素的唯物论和自发的辨证法思想指导下,通过长期医疗实践逐步形成并发展成的医学理论体系。在研究方法上,以整体观相似观为主导思想,以脏腑经络的生理、病理为基础,以辨证论治为诊疗依据,具有朴素的系统论、控制论,分形论和信息论内容。
在国际上,针灸在引起医学界极大兴趣,世界卫生组织的观点认为,针灸已被证实在减轻手术后疼痛、怀孕期反胃、化疗所产生的反胃和呕吐、牙齿疼痛方面是有效的且其副作用非常低。最近,一项有关针灸的新研究——迄今为止最严格和详细的治疗分析——表明,针灸能缓解偏头痛、关节炎和其他形式的慢性疼痛。这一发现为这项古老的治疗方法提供了强有力的科学支持,估计每年大约有300万美国人接受针灸治疗。新的研究超过五年之久,由美国国家卫生研究院(National Institutes of Health)资助,分析的早期研究数据涵盖近1.8万名患者。研究人员已经把结果发表在《内科学文献》(Archives of Internal Medicine)上,表明针灸在骨关节炎、偏头痛,以及慢性背部、颈部和肩部疼痛的患者中,治疗效果优于安慰治疗和标准护理。
但值得注意,在英文中的“针灸学(Acupuncture)”或“针灸师(Acupuncturists)”一词,意思等同于“中医”和“中医师”。以首个州份立法监管针灸学的加州为例,跟据《商业和专业条例(Business and Professions Code)》第4937条,“针灸师”是指为改善、保持和复原健康,而提供针疗、电力针疗、中式按摩、穴位按摩、灸疗、拔罐、呼吸技巧疗法、运动疗法、热疗、冷疗、磁力疗法、营养学疗法、饮食疗养、草药疗法、植物疗法、动物疗法、矿物疗法、膳食补充疗法等治疗的专业人员[16]。所以,美国的“针灸师”就是“中医师”。
New York Time 关于针灸研究的最近报道: Acupuncture Provides True Pain Relief in Study
By ANAHAD O'CONNOR October 19, 2012
研究发现针灸确实能缓解慢性疼痛
ANAHAD O'CONNOR 报道 2012年10月19日
A new study of acupuncture - the most rigorous and detailed analysis of the treatment to date - found that it can ease migraines and arthritis and other forms of chronic pain.
The findings provide strong scientific support for an age-old therapy used by an estimated three million Americans each year. Though acupuncture has been studied for decades, the body of medical research on it has been mixed and mired to some extent by small and poor-quality studies. Financed by the National Institutes of Health and carried out over about half a decade, the new research was a detailed analysis of earlier research that involved data on nearly 18,000 patients.
这一发现为这项古老的治疗方法提供了强有力的科学支持,估计每年大约有300万美国人接受针灸治疗。虽然针灸已经被研究了数十年,但大多是小型低质量的研究,因此使这类医学研究陷入混乱。新的研究超过五年之久,由美国国家卫生研究院(National Institutes of Health)资助,分析的早期研究数据涵盖近1.8万名患者。
The researchers, who published their results in Archives of Internal Medicine, found that acupuncture outperformed sham treatments and standard care when used by people suffering from osteoarthritis, migraines and chronic back, neck and shoulder pain.
研究人员已经把结果发表在《内科学文献》(Archives of Internal Medicine)上,表明针灸在骨关节炎、偏头痛,以及慢性背部、颈部和肩部疼痛的患者中,治疗效果优于安慰治疗和标准护理。
"This has been a controversial subject for a long time," said Dr. Andrew J. Vickers, attending research methodologist at Memorial Sloan-Kettering Cancer Center in New York and the lead author of the study. "But when you try to answer the question the right way, as we did, you get very clear answers.
“长期以来,这都是一个有争议的话题。” 纽约纪念斯隆-凯特琳癌症中心(Memorial Sloan-Kettering Cancer Center)的主诊研究方法论学者、也是本次研究的主要作者安德鲁·J·维克斯博士(Dr. Andrew J. Vickers)这样说:“但一旦你像我们这样正确解答问题,答案就非常明晰了。”
"We think there's firm evidence supporting acupuncture for the treatment of chronic pain."
“我们认为,有确凿的证据支持针灸能治疗慢性疼痛。”
Acupuncture, which involves inserting needles at various places on the body to stimulate so-called acupoints, is among the most widely practiced forms of alternative medicine in the country and is offered by many hospitals. Most commonly the treatment is sought by adults looking for relief from chronic pain, though it is also used with growing frequency in children. According to government estimates, about 150,000 children in the United States underwent acupuncture in 2007.
But for all its popularity, questions about its efficacy have long been commonplace. Are those who swear by it experiencing true relief or the psychological balm of the placebo effect?
Dr. Vickers and a team of scientists from around the world - England, Germany, Sweden and elsewhere - sought an answer by pooling years of data. Rather than averaging the results or conclusions from years of previous studies, a common but less rigorous form of meta-analysis, Dr. Vickers and his colleagues first selected 29 randomized studies of acupuncture that they determined to be of high quality. Then they contacted the authors to obtain their raw data, which they scrutinized and pooled for further analysis. This helped them correct for statistical and methodological problems with the previous studies, allowing them to reach more precise and reliable conclusions about whether acupuncture actually works.
All told, the painstaking process took the team about six years. "Replicating pretty much every single number reported in dozens of papers is no quick or easy task," Dr. Vickers said.
The meta-analysis included studies that compared acupuncture with usual care, like over-the-counter pain relievers and other standard medicines. It also included studies that used sham acupuncture treatments, in which needles were inserted only superficially, for example, or in which patients in control groups were treated with needles that covertly retracted into handles.
Ultimately, Dr. Vickers and his colleagues found that at the end of treatment, about half of the patients treated with true acupuncture reported improvements, compared with about 30 percent of patients who did not undergo it.
"There were 30 or 40 people from all over the world involved in this research, and as a whole the sense was that this was a clinically important effect size," Dr. Vickers said. That is especially the case, he added, given that acupuncture "is relatively noninvasive and relatively safe."
Dr. Vickers said the results of the study suggest that people undergoing the treatment are getting more than just a psychological boost. "They're not just getting some placebo effect," he said. "It's not some sort of strange healing ritual."
In an accompanying editorial, Dr. Andrew L. Avins, a research scientist at Kaiser Permanente who focuses on musculoskeletal pain and preventive medicine, wrote that the relationship between conventional medical care "and the world of complementary and alternative medicine remains ambiguous." But at least in the case of acupuncture, he wrote, the new study provides "robust evidence" that it provides "modest benefits over usual care for patients with diverse sources of chronic pain."
凯萨医疗机构(Kaiser Permanente)专事研究肌肉骨骼疼痛和预防医学的研究科学家安德鲁·L·埃文斯博士(Dr. Andrew L. Avins)在文后的编者按中,把传统医疗保健与“补充和替代医学世界” 之间的关系描述为“含糊不清”,但他写道,至少就针灸而言,新的研究提供了“强有力的证据”,“相比常规治疗,针灸对于不同原因慢性疼痛的患者都有一定程度的益处。”