中医临床疗效评价研究的现状与展望.pdf中医临床疗效评价研究的现状与展望.pdf

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G21G21G22G2BG27G21G21G23G21G24G21G25G21G26G21G27G21G28G22G25G26G25G36G22学科进展与展望G22中医临床疗效评价研究的现状与展望G22G21G21G22G24G2BG75GB1G27GACG6DG85G42G46G42G48G24G2AG28G23G29G2BG42G48G26GCAGCCG24G51G3FG24G22G25G25G2BG2EG53G21G25G2CG2BG25G26G26G24G33G34G35G22G25G26G25G36G21G37G22G28G38G39G3AG24刘保延G21中国中医科学院G22北京G26G25G25G23G25G25G23G24摘G21要G25G21现代临床流行病学的设计G28测量与评价方法在中医药临床评价研究中得到了广泛的应用G22但并没有完全解决中医在G25真实世界G26研究的方法学问题G27在中医临床诊疗实际条件下开展临床研究G22给临床流行病学提出了挑战G22也给中医临床疗效评价方法的创新带来了机遇G27本文在对中医临床疗效评价现状回顾的基础上G22提出了充分利用临床流行病学和循证医学研究成果G22以人为核心G22以建立临床G25实际条件下G26疗效评价的方法和评价指标G22构建临床科研信息一体化技术体系G22形成G25阶梯递进G26的G25证据链G26G22并与高质量的G25理想条件下G26验证研究相结合G22两条腿走路G22解决中医临床疗效评价的瓶颈问题G22提出国内外G25公认G26与G25认可G26的高质量的临床证据的建议G27G24关键词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疗效评价是古代中医辨证论治的重要环节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中医临床疗效评价的发展现状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临床流行病学G2C循证医学在中医药领域广泛传播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非随机对照研究是中医药临床研究采取的主要方法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随机对照研究的数量逐年增加G21但高质量的研究还比较少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