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其实中医什么也治不了——评毛嘉陵《中医到底能治哪些病 》
http://www.100md.com 2008年2月13日 新语丝
     Songbie 今天在我们小区论坛看到有人转发的毛嘉陵的文章《中医到底能治哪些病 》,大致看了一下,觉得这个哥们也是思维混乱的。于是就大致答复了一下。也请大家指正。

    1. 所谓的"病"和"证"的区别:

    这是中医的一贯做法,用"证"来混淆病。

    他们一直希望告诉大家,他们和科学是两个体系;他们常说,不要用科学的方法来验证我们,我们是自成一体的。但是我们都知道科学是目前唯一正确的知识体系。中医一方面拒绝科学,一方面又想靠科学给自己贴金,比如动辄来个假新闻:WHO承认中医为主流医术啦;美国FDA承认中医中药啦。。。到后来无一不被指出是骗人。

    这点不想多说,反正是扯不清楚。我们来说点实际的。

    2. 关于非典
, 百拇医药
    中医治乙脑,我没有读到过相关的文章,没法评论。而且是解放初期的事情,什么神话都有。比如北京好多中医都吹自己的祖上曾经给毛泽东看过病,但是具有讽刺意味的是,毛泽东警卫员回忆录中说,毛自己清楚说过,自己不信中医,虽然是他把中医神化的。这种东西都是无法查证的了,中医你就他妈的瞎吹吧。

    但是对于非典,情况就不同了。我在新语丝上看过大量文章。大致说是在早期全部是西医治的,中医根本不敢碰。后来等到疫情稳定,激素疗法被验证之后,中医立马就上了,立马就功效无比,又开始包治百病了。

    我们还是回到这个帖子里面说的内容:"2003年10月8日,由世界卫生组织(WHO)和国家中医药管理局联合主办的"中医、中西医结合治疗SARS国际研讨会"。"然后是中医抗非典的一大堆好话。。。。。。。

    用google一搜,确实有这么一个会议,还有一个报告: http://www.who.int/medicinedocs/index.fcgi?sid=zNnGhaRZ9ee80ca600000000476162bf&a=d&d=Js6170e
, 百拇医药
    我down下来看了一下。

    首先介绍一下背景: In order to better understand the potential of complementary treatment for patients with SARS and to encourage robust clinical research on SARS and its treatment with traditional medicine, the Chinese Government requested the guidance of WHO and support for 13 clinical trials of integrated treatment with TCM and Western medicine for SARS patients. The Nippon Foundation provided the financial support for WHO to organize an International Expert Meeting on Review of Treatment of SARS by Traditional Chinese Medicine, and the Integration of Traditional Chinese Medicine with Western Medicine, in Beijing, China from 8 to 10 October 2003. Sixty-eight experts from seven countriesincluding Hong Kong SAR, Japan, the Netherlands, the People's Republic of China, Thailand, Viet Nam and the United States of America, attended the meeting (Annex 1: list of participants).
, http://www.100md.com
    原来是应中国政府的请求,为了potential of complementary treatment而开的一个会议,讨论的也是integrate d treatment with TCM and Western medicine for SARS patients(中西医结合),报告都是有中国政府提供的(大陆10个,香港3个,在报告后面提到的。)

    我们再来看看人家的的review意见和结论:

    Results of research based on the level of evidence First level There were sufficient data in the clinical reports to show that integrated treatment with TCM and Western medicine for patients with SARS is safe. (第一个层次上来说是安全的)
, http://www.100md.com
    Second level Of the reported trials, only two clinical trials included patients who were randomly selected for the studies, the others were prospective cohort studies or retrospective studies. The experts considered that the data were insufficient although it was concluded that there could be potential clinical benefits from integrated treatment with TCM and Western medicine for patients with SARS. (第二个层次上说,这些实验中只有两个是包含了随机选取的病例,其他的都是不严格的科学实验;专家们认为,数据是不够充分的,虽然可以认为采用中西医结合会有一些潜在的好处)
, 百拇医药
    Third level The experts noted that the data in the reports were inconclusive. An example of this is the clinical observation that the mortality rate is lower for the patients treated with integrated TCM and Western medicine than for those treated with Western medicine alone. As the diagnosis of SARS is very difficult to confirm, and some cases may be misdiagnosed, this could lead to a lower recorded mortality rate. In the prevention studies, the response rate to the questionnaires was only 40% among those subjects who had taken the prevention formula; this was too low to enable an accurate assessment of its effects. In the study on convalescence, the comparison was made between only two groups, one treated with TCM and one with exercise. There was no comparison group that received neither treatment nor exercise programmes.
, http://www.100md.com
    (专家认为报告中的数据是inconclusive的,也就是无法用来做定论用的。而且他们特别批判了中医吹的最大的一个牛皮:中西医结合的死亡率低于仅用西医治疗的。)

    总而言之,WHO专家的结论是:中西医结合治非典是安全的,可能有潜在的好处。其他的就没有了。我就根本看不出来毛嘉陵文章中鼓吹的那么牛B的中医能够治非典的描述。

    而且除了结论之外,人家还说的很清楚: Currently, the major challenges for the treatment of SARS are: the source of the SARS virus and mode of transmission are still not well understood; there are problems with diagnostic tools; there is no effective treatment; and there is no vaccine for SARS. The above-mentioned difficulties and challenges have motivated national authorities, health workers and scientists to explore the potential of complementary treatment. 最后一句话there is no vaccine for SARS 就是狠狠的抽了毛嘉陵一个嘴巴。(毛嘉陵在文章中居然敢批判现代医学针对病毒研发疫苗的策略。他根本就不知道对付这些流行性的病毒感染最有效的方法就是疫苗。)
, 百拇医药
    统观全文,人家的报告对于中医的作用的评价说的再清楚不过了,就是个potential clinical benefits (而且是在中西医结合治疗的基础上),对于中国政府提供的10份报告的评价其实再负面不过了。如果一般的博士论文要是摊上insufficient, inconclusive的字眼,应该都是毕不了业的(我自己的理解,未必正确。)但是中医的信徒们,从报告中摘出只言片语来吹牛,更是暴露了中医信徒的无耻!!

    Ps: 我还顺便看了一下香港的第3份报告的abstract,第一份说的是药方,看不懂。第二个和第三个报告都说得是在SARS病人康复阶段用中医药可能会有一些效果。

    其中第二份报告开篇第一句: It is unknown whether Traditional Chinese medicine (TCM) can affect the course of recovery of patients with severe acute respiratory syndrome (SARS). (不知道中医对于SARS病人康复是否有作用)
, 百拇医药
    其中第三份报告开篇第一句: Traditional Chinese medicine (TCM) is not the first-line treatment for severe acute respiratory syndrome (SARS) in Hong Kong Special Administrative Region (SAR). (中医从来不是SARS治疗的首要手段)

    从这个角度看,香港人说的还是相对客观些。

    大陆提供的一份都没有看,但是想必WHO专家专门批判的中医治疗SARS死亡率低于西医的观点应该出自这10份报告中。所以根本不值得细看。

    我还有一个感觉:中国政府提供这些素材,请WHO开了这个一个会,是不是有点自取其辱的味道?

    3. 关于针灸
, 百拇医药
    在WHO的网页上,对于针灸的描述如下(http://www.who.int/topics/acupuncture/en/):

    Acupuncture is a traditional Chinese system of therapy, in which long, fine needles are inserted through the skin at specific points. Acupuncture has been shown to be effective in relieving postoperative pain, nausea during pregnancy, nausea and vomiting resulting from chemotherapy, and dental pain. It can also alleviate anxiety, panic disorders and insomnia, and has very few side-effects.

    从这个描述中,根本看不出来针灸能治43种疾病。它说的只有:减轻手术后疼痛;怀孕期间恶心;化疗引起的恶心和呕吐;牙疼;焦虑;panic disorders(由惊吓引起的神经错乱?);失眠;所以一切的一切,应该说人家认可的只是针灸在辅助治疗中的作用吧 ?!

    我没有找到WHO推荐用针灸治疗43种疾病的出处,有知道的大家可以共享一下来分析分析。但是我敢打赌,WHO如果真有这个list,也肯定是用的alternative, complementary的字眼。, 百拇医药