中医药学循证医学文献阅读

1、中医药学循证医学文献阅读中医药学循证医学文献阅读Systematic Review系统评价系统评价Ginkgo 银杏银杏 2记忆医学术语方法之一记忆医学术语方法之一No Chineseas simple as one word复杂学名记住中文即可复杂学名记住中文即可3GlossaryGinkgo Biloba 5iNkEu 银杏树银杏树maidenhair 5meIdEnheE 掌叶铁线蕨掌叶铁线蕨intention-to-treat analysis 意向治疗分析意向治疗分析neurotransmitter 7njuErEtrAns5mitE 神经递质神经递质bias baiEs preju

2、dice 偏见偏见depression di5preFEn sadness 沮丧沮丧 抑郁抑郁tinnitus ti5naitEs ringing in the ears 耳鸣耳鸣viscosity vis5kCsiti state of being thick 粘性粘性4Ginkgo 5iNkEu5maidenhair 掌叶铁线蕨掌叶铁线蕨 (少女秀发蕨少女秀发蕨)6意向治疗分析意向治疗分析7neurotransmitter 7njuErEtrAns5mitE神经递质神经递质8Prejudice 偏见偏见 BiasbaiEs9Sadness 抑郁抑郁 Depressiondi5preFEn1

3、0Ringing in the ears耳鸣耳鸣Tinnitusti5naitEs11State of being thick粘性粘性 viscosityvis5kCsiti12记忆公共英语单词方法之一记忆公共英语单词方法之一No Chineseas simple as one wordPlain English （简朴英语）（简朴英语）13Glossaryrobust rE5bQst strong 精力充沛的精力充沛的substantive 5sQbstEntiv large 大量的大量的cognitive 5kCnitiv get to know 认知的认知的 modification 7

4、mCdifi5keiFEn make change 修正修正Unconfounded kEn5faundid not confuse 不糊涂不糊涂的的inconsistent7inkEn5sistEnt contradictory 不一不一致致14Strong 精力充沛的精力充沛的 RobustrE5bQst15Not confuse不糊涂的不糊涂的 UnconfoundedkEn5faundid糊涂的糊涂的 confoundedkEn5faundid16Contradictory 不一致不一致 inconsistent shape7inkEn5sistEnt17GlossaryGinkgo

5、Biloba 白果白果 (中文即可中文即可)Maidenhair 掌叶铁线蕨掌叶铁线蕨 (中文即可中文即可)Cognitive get to know Substantive large Amendment improveDepression sadness Tinnitus ringing in the ears Viscosity state of being thick医学英语新教程医学英语新教程第第30章章 - p234 阅读阅读16句子句子Ginkgo 银杏银杏医学英语新教程医学英语新教程第第30章章 - p234 阅读阅读16句子句子Cochrane Library系统综述文摘系统

6、综述文摘20Learning Objectives of Systematic ReviewTo masterTitleAuthorStructure of SRResult ConclusionTo know aboutIntroductionBackgroundObjectiveSearch strategyGinkgo Biloba for cognitive impairment and dementia白果治疗认知损害与痴呆症白果治疗认知损害与痴呆症（Cochrane系统综述）系统综述）Ginkgo Biloba for cognitive impairment and dement

7、ia白果白果治疗治疗认知损害与痴呆症认知损害与痴呆症（Cochrane系统综述）系统综述）23标题固定句式标题固定句式:中心词中心词 for 短语短语 24当代当代(科技科技)医学英语特点医学英语特点Controlled language1.Birks J2.Grimley Evans JCochrane ReviewSystematic Review Abstract27Structure of Cochrane Reveiw1.Introduction2.Background3.Objective4.Search strategy5.Selection criteria6.Data col

8、lection and analysis7.Main results8.Reviews conclusion28Structure of Cochrane Reveiw1.Introduction 引言引言2.Background3.Objective4.Search strategy 检索策略检索策略5.Selection criteria 选择标准选择标准6.Data collection and analysis 数据收集与分析数据收集与分析7.Main results 主要结果主要结果8.Reviews conclusion 综述者结论综述者结论A substantive amendm

9、ent to this systematic review was last made on 26 August 2002.此系统综述的实质性修改截止此系统综述的实质性修改截止2002年年8月月26日。日。 origin 起源起源 current status 现况现况 mechanism 机制机制 originExtracts of the leaves of the maidenhair tree, Ginkgo biloba, have long been used in China as a traditional medicine for various disorders of h

10、ealth.在中国，从掌叶铁钱蕨白果树叶精华作在中国，从掌叶铁钱蕨白果树叶精华作为传统药物，长期用于治疗各种疾病。为传统药物，长期用于治疗各种疾病。 status A standardized extract is widely prescribed in Germany and France for the treatment of a range of conditions including memory and concentration problems, confusion, depression, anxiety, dizziness, tinnitus and headache

11、. 2. 背景背景 现况现况一种广泛用于德国与法国的标一种广泛用于德国与法国的标准萃取物可治疗多种疾病，包准萃取物可治疗多种疾病，包括记忆与思想集中病症、意识括记忆与思想集中病症、意识模糊、抑郁、焦虑、头晕、耳模糊、抑郁、焦虑、头晕、耳鸣与头痛。鸣与头痛。 mechanismThe mechanisms of action are thought to reflect the action of several components of the extract and include increasing blood supply by dilating blood vessels, red

12、ucing blood viscosity, modification of neurotransmitter systems, and reducing the density of oxygen free radicals. 2. 背景背景 机制机制有人认为，若干成分的作用机有人认为，若干成分的作用机制是扩张血管、降低血液粘滞制是扩张血管、降低血液粘滞度、改善神经递质系统，以及度、改善神经递质系统，以及减少氧游离基密度而增加血供减少氧游离基密度而增加血供 - explicit 鲜明鲜明 The aim of the review is to assess the efficacy and

13、safety of Ginkgo biloba for the treatment of patients with dementia or cognitive decline.本综述目标本综述目标是评估是评估白白果果治疗痴呆症或治疗痴呆症或认知功能减退的认知功能减退的有效性有效性与与安全性安全性。 4. Search strategy 3T TimeTypesTerms4. Strategy Time & Types Trial were identified on 26 June 2002 through a search of the CDCIG39synonym 同义词同义词

14、& asterisk * The search terms used wereginkgo*,tanakan,EGB-761,EGB761 andEGB 761.所用检索术语为所用检索术语为ginkgo*、tanakan、EGB-761、EGB761与与“EGB 761”。5.Selection criteria - phrase+All relevant, unconfounded, randomized, double-blind controlled studies, in which extracts of Ginkgo biloba at any strength and o

15、ver any period were compared with placebo for their effects on people with acquired cognitive impairment, including dementia, of any degree of severity.5. 收录标准收录标准收录所有与白果萃取物（任何收录所有与白果萃取物（任何浓度与任何疗程）治疗获得性浓度与任何疗程）治疗获得性认知损害（包括任何类型的痴认知损害（包括任何类型的痴呆症）呆症）相关的相关的正规正规随机双盲安随机双盲安慰剂对照慰剂对照研究文献。研究文献。 6.collection &

16、amp; analysis - metaData for the meta-analyses are based on reported summary statistics for each study.供荟粹分析分析的资料取自每供荟粹分析分析的资料取自每个研究的发表总结性统计。个研究的发表总结性统计。 7. Main results 先总后分先总后分1. General: 1-42. Division (benefit): 5-7 (the same sentence pattern)3. Summary (adverse): 8-97. Main results 先总先总 概括概括Ove

17、rall, there are no significant differences between Ginkgo and placebo in the proportion of participants experiencing adverse events. 在总体上，接受白果与安慰剂受试者的在总体上，接受白果与安慰剂受试者的不良反应事件无显著差异。不良反应事件无显著差异。 7. Main results 先总先总 - metaThere are benefits (主语主语) associated with Ginkgo (dose less than 200mg/day) compa

18、red with placebo at less than 12 weeks (54/63 showed improvement compared with 20/63, OR 15.32, 95% CI 5.90 to 39.80, P= P 0.01显著意义显著意义 0.001极显著意义极显著意义7. Main results -先总先总 - meta与安慰剂对照组相比，至少在与安慰剂对照组相比，至少在12周以内显示白果（剂量周以内显示白果（剂量200mg/日）相关效益（日）相关效益（56/43 比比20/63，优势优势比比15.32，95%可信区间可信区间5.90至至39.80，P=0.

19、0001）。）。 7. Main results 3 divisionCognition shows (different data.)Activities show / .Measures of mood show / .Division 后分(疗效)7.Main results division -metaThere are benefits (主语主语) associated with Ginkgo (dose less than 200mg/day) compared with placebo at less than 12 weeks (54/63 showed improvemen

20、t compared with 20/63, OR 15.32, 95% CI 5.90 to 39.80, P=0.0001). 7.same pattern with different subjects and dataCognition shows benefit for Ginkgo (dose less than 200mg/day) compared with placebo at 12 weeks (SMD -0.57, 95% CI -1.09, -0.05, P=0.03, random effects model). 7.same pattern with differe

21、nt subjects and dataActivities shows benefit for Ginkgo (dose less than 200mg/day) compared with placebo at 12 weeks (SMD -0.57, 95% CI -1.09, -0.05, P=0.03, random effects model). 7.same pattern with different subjects and dataMeasures of mood shows benefit for Ginkgo (dose less than 200mg/day) com

22、pared with placebo at 12 weeks (SMD -0.57, 95% CI -1.09, -0.05, P=0.03, random effects model). 53当代当代(科技科技)医学英语特点医学英语特点Controlled language8.Reviewers conclusions Merits Imperfect Prospect8.Reviewers conclusions 优点优点Ginkgo biloba appears to be safe in use with no excess side effects compared with pla

23、cebo.应用白果相对安慰剂应用白果相对安慰剂无无过度副作过度副作用，用，显得显得(似乎似乎)安全。安全。8.Reviewers conclusions 说明说明Many of the early trials used unsatisfactory methods, were small, and we cannot exclude publication bias.许多早期试验应用效果不满意者多为许多早期试验应用效果不满意者多为小型研究小型研究,综述者综述者不能排除不能排除论文论文偏倚。偏倚。8.Reviewers conclusions -优点优点Overall there is pro

24、mising evidence of improvement in cognition and function associated with Ginkgo.总体上讲，白果改善认知与功能总体上讲，白果改善认知与功能依据前景良好依据前景良好。8.Reviewers conclusions 不足不足However, the three more modern trials show inconsistent results.然而，有个以上当代临床试然而，有个以上当代临床试验的结果不一致。验的结果不一致。8.Reviewers conclusions 展望展望There is need for a

25、 large trial using modern methodology and permitting an intention-to-treat analysis to provide robust estimates of the size and mechanism of any treatment effects.尚需应用现代的方法学与尚需应用现代的方法学与“意向治疗分析意向治疗分析”大型临床试验，以提供任何治疗效应大小的大型临床试验，以提供任何治疗效应大小的有力依据与机制。有力依据与机制。60Summary key pointsTitle: 干预干预 + for + 病症病症Author : 2, independently Structure of SR: 8 sectionsCon