樊濤 1 , 張宇 2 , 蔣洪麗 1 , 閔婕 1 , 王科 1 , 周維 1
  • 1四川大學(xué)華西醫(yī)院中西醫(yī)結(jié)合科（成都，610041）;2成都市中西醫(yī)結(jié)合醫(yī)院;

目的 　評估中醫(yī)藥臨床研究是否與我國主要疾病負擔相關(guān)。 方法 　首先從1999年－2004年出版的13種中醫(yī)、中西醫(yī)結(jié)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(shù)據(jù)。然后采用死亡率和傷殘調(diào)整壽命年（DALY）作為衡量標準，統(tǒng)計2002年我國疾病負擔前30位病因的RCT數(shù)量，采用秩相關(guān)分析這些疾病負擔與發(fā)表的中醫(yī)藥RCT及其受試者數(shù)量的關(guān)系。 結(jié)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(chǎn)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(guān)系數(shù)分別是0.108（P=0.569）、0.092（P=0.628），通過死亡率產(chǎn)生的相關(guān)系數(shù)分別是0.453（P=0.012）、0.536（P=0.002）。 結(jié)論 　中醫(yī)藥RCT與采用死亡率衡量的疾病負擔明顯相關(guān)，但采用DALY分析卻未發(fā)現(xiàn)二者存在相關(guān)性。中醫(yī)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(yī)藥隨機對照試驗與我國疾病負擔的關(guān)系. 華西醫(yī)學(xué), 2012, 27(4): 538-541. doi: 復(fù)制

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11. 　毛兵, 王剛, 樊濤, 等. 中醫(yī)藥隨機對照試驗疾病譜的變化及趨勢[J]. 中國中西醫(yī)結(jié)合雜志, 2007, 27(5): 404-408.
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15. 　李廷謙, 毛兵, 常靜, 等. 中西醫(yī)、中醫(yī)核心雜志臨床研究文獻評價[J]. 華西醫(yī)學(xué), 2000, 15(3): 266-269.
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17. 　王家良. 臨床流行病學(xué)[M]. 第2版. 上海:上?？萍汲霭嫔? 2011: 11-18.
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  2. 2. 　Fraser DW. Overlooked opportunities for investing in health research and development[J]. Bull World Health Organ, 2000, 78(8): 1054-1061.
  3. 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. 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. 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. 6. 　Davey S. The 10/90 report on health research 2001-2002[M]. Geneva: Global Forum for Health Research, 2002.
  7. 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. 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. 9. 　Stevens D, Siegel K, Smith R. Global interest in addressing non-communicable disease[J]. Lancet, 2007, 370(9603): 1901-1902.
  10. 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. 11. 　毛兵, 王剛, 樊濤, 等. 中醫(yī)藥隨機對照試驗疾病譜的變化及趨勢[J]. 中國中西醫(yī)結(jié)合雜志, 2007, 27(5): 404-408.
  12. 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. 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. 14. 　Tang JL. Research priorities in traditional Chinese medicine[J]. BMJ, 2006, 333(7564): 391-394.
  15. 15. 　李廷謙, 毛兵, 常靜, 等. 中西醫(yī)、中醫(yī)核心雜志臨床研究文獻評價[J]. 華西醫(yī)學(xué), 2000, 15(3): 266-269.
  16. 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. 17. 　王家良. 臨床流行病學(xué)[M]. 第2版. 上海:上?？萍汲霭嫔? 2011: 11-18.