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英国医生发公开信质疑"另类疗法" (zt) [复制链接]

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发表于 2006-5-28 04:49

英国一些著名西医现在联名发表公开信要求当局停止采用这些"另类疗法"(alternative treatment)并把资源集中在一些他们所称的"已经得到确实证明有效"的疗法。

签署这封信函的包括了13位科学家,发起人是英国伦敦大学学院(University College, London)的教授迈克尔·鲍姆(Michael Baum)。

签署的科学家之中包括诺贝尔奖得奖人詹姆斯·布莱克爵士(Sir James Black)和英国医疗科学会主席(president of the Academy of Medical Science)基斯·彼得斯爵士(Sir Keith Peters)。

这封公开信在英国《泰晤士报》发表,并且发送给英国476家医疗保健基金会。

公开信说,发件人相信,虽然英国保健系统目前面临重大的压力,但是,有关方面仍然在缺乏证据的情况下大力推动"另类疗法"。

在这信函公布之际,英国王储查尔斯王子正准备在同一天在瑞士日内瓦的一个世界卫生大会上发言。预料他将支持"另类疗法"。(查尔斯懂个P! 瞎掺和)

批评要点

由13位科学家联名发出的公开信在两个方面作出了批评。

首先,公开信签署人批评了政府拨款支持的有关"顺势疗法"(homeopathy)的指引。另外,公开信也批评了由查尔斯王子委托撰写的斯莫尔伍德报告(Smallwood Report)。

斯莫尔伍德报告建议病人可以在英国全国医疗系统中更方便得到"另类疗法"。

公开信批评"顺势疗法"是一种"难以置信"的疗法,虽然经过10多次的检讨研究,但是都没有得到证据显示它是真正有效的。

发件人同时说,如果使用现有资金提供一些已经得到确实证据证明有效的疗法,这将可以为英国公众以及保健系统提供最大的益处。

所谓的"另类疗法"之中还包括不少其他的疗病保健方法,例如:足部反射区健康法(reflexology)以及芳香疗法(aromatherapy)等。

英国王储查尔斯王子在20多年前开始表示支持发展"另类疗法"。

他也成立了一个基金会,鼓励传统西医以外的医疗保健办法的发展。

英国卫生部表示,究竟对病人来说什么是最佳疗法,一切由医护人员决定。

不过,发言人同时指出,他们也知道,随着更多的人使用这些"另类疗法",有关方面需要找到确实的支持证据。

另类疗法流行

在英国,所谓的"另类疗法"越来越流行。大街小巷都可以看到不少例如芳香疗法所(aromatherapy practice)、中草药店、针灸治疗所等店铺。


英国的大街小巷都能看到中医诊所
除了中药以外,来自其他地区的一些非西方主流疗法也逐渐受到注意和重视,这包括印度式草药疗法(ayurvedic medicine)以及一些来自非洲和加勒比海地区国家的疗法。

这些"另类疗法"大多采用草药,以及集中调理人体功能,以此疗疾或者改善病人健康状况。

在英国,由于多种原因,越来越多人倾向尝试这些有别于西方医疗方法的治病保健做法。这些原因包括西医疗法对不少疾病没有功效,以及保健系统安排病人接受治疗的等候时间太长等。

"另类疗法"的支持者之中包括了一些知名人士,英国王储查尔斯王子是其中的表表者。他多次表示支持开发传统西医以外的保健医疗方法。

英国一些高等学府也开始设立讲授"另类疗法"的课程,其中包括英国埃克塞特大学(University of Exeter)。

BBC

From Professor Michael Baum and others

Re Use of ‘alternative’ medicine in the NHS (National Health Service in the UK)

We are a group of physicians and scientists who are concerned about ways in which unproven or disproved treatments are being encouraged for general use in the NHS. We would ask you to review practices in your own trust, and to join us in representing our concerns to the Department of Health because we want patients to benefit from the best treatments available.

There are two particular developments to which we would like to draw your attention. First, there is now overt promotion of homeopathy in parts of the NHS (including the NHS Direct website). It is an implausible treatment for which over a dozen systematic reviews have failed to produce convincing evidence of effectiveness. Despite this, a recently-published patient guide, promoting use of homeopathy without making the lack of proven efficacy clear to patients, is being made available through government funding. Further suggestions about benefits of homeopathy in the treatment of asthma have been made in the ‘Smallwood Report’ and in another publication by the Department of Health designed to give primary care groups “a basic source of reference on complementary and alternative therapies.” A Cochrane review of all relevant studies, however, failed to confirm any benefits for asthma treatment.

Secondly, as you may know, there has been a concerted campaign to promote complementary and alternative medicine as a component of healthcare provision. Treatments covered by this definition include some which have not been tested as pharmaceutical products, but which are known to cause adverse effects, and others that have no demonstrable benefits. While medical practice must remain open to new discoveries for which there is convincing evidence, including any branded as ‘alternative’, it would be highly irresponsible to embrace any medicine as though it were a matter of principle.

At a time when the NHS is under intense pressure, patients, the public and the NHS are best served by using the available funds for treatments that are based on solid evidence. Furthermore, as someone in a position of accountability for resource distribution, you will be familiar with just how publicly emotive the decisions concerning which therapies to provide under the NHS can be; our ability to explain and justify to patients the selection of treatments, and to account for expenditure on them more widely, is compromised if we abandon our reference to evidence. We are sensitive to the needs of patients for complementary care to enhance well-being and for spiritual support to deal with the fear of death at a time of critical illness, all of which can be supported through services already available within the NHS without resorting to false claims.

These are not trivial matters. We urge you to take an early opportunity to review practice in your own trust with a view to ensuring that patients do not receive misleading information about the effectiveness of alternative medicines. We would also ask you to write to the Department of Health requesting evidence-based information for trusts and for patients with respect to alternative medicine.

Yours sincerely

Professor Michael Baum
Emeritus Professor of Surgery, University College London

And
Professor Frances Ashcroft FRS
University Laboratory of Physiology, Oxford

Professor Sir Colin Berry
Emeritus Professor of Pathology, Queen Mary, London

Professor Gustav Born FRS
Emeritus Professor of Pharmacology, Kings College London

Professor Sir James Black FRS
Kings College London

Professor David Colquhoun FRS
University College London

Professor Peter Dawson
Clinical Director of Imaging, University College London

Professor Edzard Ernst
Peninsula Medical School, Exeter

Professor John Garrow
Emeritus Professor of Human Nutrition, London

Professor Sir Keith Peters FRS
President, The Academy of Medical Sciences

Mr Leslie Rose
Consultant Clinical Scientist

Professor Raymond Tallis
Emeritus Professor of Geriatric Medicine, University of Manchester

Professor Lewis Wolpert CBE FRS
University College London

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