中山大學循證醫(yī)學evidencebasedmedicine_zsu_fs(已修改)
2025-03-05 15:24 本頁面
【正文】 EvidenceBased Medicine 循證醫(yī)學 楊 學 寧 Xuening Yang, MD 廣東省人民醫(yī)院 Guangdong General Hospital 廣東省肺癌研究所 Guangdong Lung Cancer Research Institute 《 循證醫(yī)學 》 雜志 Journal of Evidencebased Medicine Background ? 1997年 – 上海醫(yī)科大學中西醫(yī)結合研究所完成的“中華靈芝寶” 動物實驗 證實：該藥物具有抑瘤作用、保護免疫功能和放化療減毒增效作用。 – 中國科學院上海藥物研究所完成“‘中華靈芝寶’對多種培養(yǎng)人癌細胞生長的作用”。課題，結論證實該藥物對 多種白血病和人體實體癌細胞 具有明顯的抑制作用，并呈現較好的量效關系。 ? 1999年 – 中國科學院上海生物研究所丁健研究員等實驗表明，中華靈芝寶（現名：雙靈固本散）能抑制拓撲異構酶 I和拓撲異構酶 II，造成癌細胞DNA單鏈或雙鏈斷裂，阻斷癌細胞的無限制繁殖，導致癌細胞破裂凋亡。 ? 2022年 – 上海預防醫(yī)學研究院以 Ames試驗和骨髓微核試驗 作了研究，結果表明中華靈芝寶具有抗突變作用。 ? 2022年 – 國家藥品監(jiān)督管理局（ SDA）批準中華靈芝寶轉為“國藥準字” B20220428，并更名為“雙靈固本散”。 Cell or animal is equal to human Background ? Traditional practice Model – Clinicians are use convenient sources – Factors that influence decision making. ? Senior doctors ? Patient request ? Pharmaceutical representatives remendation ? Local expertbased CME Outdate! Background ? Longer life ? Chronic diseases ? More studies, more articles, much more information – 20,000 RCT’s published annually， 6000 articles enter Medline monthly – 1 study report published every 189。 hour – More diasgnostic tools, more drugs, more treatment methods – “Half of what you are taught as medical students will in 10 years have been shown to be wrong. And the trouble is, non of your teachers knows which half.” ? Increasing medical costs ? The patient knows more, and questions more! Background ? Too little time – To keep up to date in Internal Medicine, I need to read 17 articles a day, 365 days a year Background ? False evidence ? Anesthesia and Analgesia – 2022 IF – 2022 Total Cites 15960 Definition ? Evidence Based Medicine – is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. – Sackett, D. L.
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