循证医学在针灸领域的发展.pdfVIP

World J．Acu—moxi．Vo1．17，No．4，December，2007 Acu 1)uncture Outlook EVIDENCE．BASED MEDICINE IN ACUPUNCTURE 循证医学在针灸领域的发展 LAO Lixing(劳力行) Center for Integrative Medicine．University ofMaryland School ofMedicine，Baltimore 21207，USA(马里 兰大学医学院结合医学中心，巴尔的摩，马里兰州21207，美国) 1 BACKGRoUND Since the 1970s．acupuncture has become popular in the West for many conditions，and particularly for treating chronic illnesses．With the increasing use of acupuncture and other complementary and alternative medicine (CAM)interventions。the demand for scientific evaluation of these modalities has grown．In the United States， this exDansion is exemplified by the 1991 establishment of the National Institutes of Health(NIH)Office of A1一 ternative Medicine．authorized by the US Congress，and by 3 1994 FDA workshop that led to 3 reclassification of the acupuncture needle 3s 3 medical device and the 1997 NIH consensus conference on acupuncture．Since the latter 1990s，clinical trials on acupuncture have dramatically increased，along with increased research funding in the US and other Western countries．For example，in the US，the budget of the National Center for Comple— mentary and A1ternative Medicine(NC(1AM)in the National Institutes of Health(NIH)for CAM research，in— cluding acupuncture research．increased from 2 million in 1992 to 123 million in 2006．Moreover，based on the results of 3 database search．over 500 randomized clinical trials(R( s)have been published during the past 10 years，1997 to 2007，compared to only 125 between 1987 and 1997．In recent years，acupuncture research has become part of evidence—based medicine．and clinical trials in particular have been rigorously and scientifically e— valuated 2 EVIDENCE BASED MEDICINE AND ACUPUNC 兀JRE The concept of evidence—based medicine(EBM)emerged in the 1990s．Sackett et 3l(1996)stated in their arti— cle Evidence based medicine：what it is and what it isn t，“Evidence—based medicine is the conscientious，ex— plicit and iu