中醫藥隨機對照試驗與我國疾病負擔的關系_《華西醫學》

作者：

樊濤 ¹ ,  張宇 ² , 蔣洪麗 ¹ , 閔婕 ¹ , 王科 ¹ , 周維 ¹

1四川大學華西醫院中西醫結合科（成都，610041）;2成都市中西醫結合醫院;

關鍵詞：

中醫藥隨機對照試驗疾病負擔死亡率傷殘調整壽命年

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目的　評估中醫藥臨床研究是否與我國主要疾病負擔相關。方法　首先從1999年－2004年出版的13種中醫、中西醫結合雜志中手工檢索出隨機對照試驗（RCT），并提取出雜志名稱、出版年限、治療的疾病類別及樣本含量等數據。然后采用死亡率和傷殘調整壽命年（DALY）作為衡量標準，統計2002年我國疾病負擔前30位病因的RCT數量，采用秩相關分析這些疾病負擔與發表的中醫藥RCT及其受試者數量的關系。結果　最終確認7 422個RCT，約38%的RCT來自于3種國家級雜志。這些RCT覆蓋了我國疾病負擔中的主要病種，其中4 280個RCT（57.7%）研究前30位病因合并產生的42個病種，只有3個病種（7%）沒有任何RCT研究。采用DALY得到的相關系數分別是0.108（P=0.569）、0.092（P=0.628），通過死亡率產生的相關系數分別是0.453（P=0.012）、0.536（P=0.002）。結論　中醫藥RCT與采用死亡率衡量的疾病負擔明顯相關，但采用DALY分析卻未發現二者存在相關性。中醫藥臨床研究可能更注重死亡率高的病種，一定程度上忽略了DALY衡量的疾病負擔。

引用本文： 樊濤,張宇,蔣洪麗,閔婕,王科,周維. 中醫藥隨機對照試驗與我國疾病負擔的關系. 華西醫學, 2012, 27(4): 538-541. doi: 復制

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15.	李廷謙, 毛兵, 常靜, 等. 中西醫、中醫核心雜志臨床研究文獻評價[J]. 華西醫學, 2000, 15(3): 266-269.
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1. 　Gensus UT. World population profile: 1998[M]. Washington: US Government Printing Office, 1999: 31.
2. 　Fraser DW. Overlooked opportunities for investing in health research and development[J]. Bull World Health Organ, 2000, 78(8): 1054-1061.
3. 　Gross CP, Anderson GF, Powe NR. The relation between funding by the National Institutes of Health and the burden of disease[J]. N Engl J Med, 1999, 340(24): 1881-1887.
4. 　Rochon PA, Mashari A, Cohen A, et al. Relation between randomized controlled trials published in leading general medical journals and the global burden of disease[J]. CMAJ, 2004, 170(11): 1673-1677.
5. 　Perel P, Miranda JJ, Ortiz Z, et al. Relation between the global burden of disease and randomized clinical trials conducted in Latin America published in the five leading medical journals[J]. PLoS One, 2008, 3(2): e1696.
6. 　Davey S. The 10/90 report on health research 2001-2002[M]. Geneva: Global Forum for Health Research, 2002.
7. 　Sumathipala A, Siribaddana S, Patel V. Under-representation of developing countries in the research literature: ethical issues arising from a survey of five leading medical journals[J]. BMC Med Ethics, 2004, 5: E5.
8. 　Miranda JJ, Zaman MJ. Exporting ’failure’: why research from rich countries may not benefit the developing world[J]. Rev Saude Publica, 2010, 44(1): 185-189.
9. 　Stevens D, Siegel K, Smith R. Global interest in addressing non-communicable disease[J]. Lancet, 2007, 370(9603): 1901-1902.
10. 　Wang G, Mao B, Xiong ZY, et al. The quality of reporting of randomized controlled trials of traditional Chinese medicine: a survey of 13 randomly selected journals from mainland China[J]. Clin Ther, 2007, 29(7): 1456-1467.
11. 　毛兵, 王剛, 樊濤, 等. 中醫藥隨機對照試驗疾病譜的變化及趨勢[J]. 中國中西醫結合雜志, 2007, 27(5): 404-408.
12. 　Isaakidis P, Swingler GH, Pienaar E, et al. Relation between burden of disease and randomised evidence in sub-Saharan Africa: survey of research[J]. BMJ, 2002, 324(7339): 702.
13. 　World Health Organization. Global Burden of Disease (GBD) 2002 estimates: incidence, prevalence, mortality, YLL, YLD and DALYs by sex, cause and region, estimates for 2002 as reported in the World Health Reports 2003 and 2004. Available from: http://www.who.int/ healthinfo/bodgbd2002/en/index.html.
14. 　Tang JL. Research priorities in traditional Chinese medicine[J]. BMJ, 2006, 333(7564): 391-394.
15. 　李廷謙, 毛兵, 常靜, 等. 中西醫、中醫核心雜志臨床研究文獻評價[J]. 華西醫學, 2000, 15(3): 266-269.
16. 　Murray C, Lopez AD. The global burden of disease:a comprehensive assessment of mortality and disability from diseases,injuries,and risk factors in 1990 and projected to 2020[R]. Cambridge: Harvard School of Public Health, 1996: 43.
17. 　王家良. 臨床流行病學[M]. 第2版. 上海:上海科技出版社, 2011: 11-18.

《華西醫學》

中醫藥隨機對照試驗與我國疾病負擔的關系

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《華西醫學》

中醫藥隨機對照試驗與我國疾病負擔的關系

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