Hāngai ana Taunakitanga-rongoā. Center mō te Medicine Evidence-I. Ngaahi Tefito'i Mo'oni o rongoā e hāngai ana taunakitanga-

EBM tohu tino pai tohenga kōmitimiti pūtaiao me te wheako haumanu ki ngā hiahia o te manawanui. Ko te whakamahi āmiki me te kouma o te pai whakatutukitanga hou i roto i te tukanga o te whakatau kaupapa i roto i te maimoatanga o te tūroro. Ka whakamahia e te reira i anake aua tohenga e kua ahu mai i ngā arotake nahanaha. Ko hauora rongoā e hāngai ana Taunakitanga-rangahau e hāngai ana, tango ki pūkete nga ngākau nuitanga o te manawanui. Ko te putanga o te taunakitanga ko te tika, me te tika o ngā whakamātautau tātaritanga, me arowhai, te faufaa o matapae mahi, kakama, me te haumaru o te therapy, whakanohonoho me te ārai.

Ko te kōrero o

I roto i te tau 1940, i te randomized (tohatoha tupurangi) tuatahi Rangahau te whakamahi o moni "streptomycin" i roto i te maimoatanga o te mate kohi i kawea i roto i. I roto i 1962, te Komiti US, e whakahaere te kounga o pharmaceuticals me hua kai kua whakaurua ture e hāngai ana i te tūhura momo hou o taero. E iwa nga tau i muri i tenei kili ko kōkiritanga a Araki Kokran e pā ana ki te kore o te taunakitanga pūtaiao. E toru nga tau i muri mai kitea e matou i te rerekētanga i waenganui i te ariā me te mahi. I roto i te mutunga o te 80 o - i unu aro wawe a 90 ki te hiahia mo te arotake pūnahanaha i roto i te ako haumanu. Hoki te wā tuatahi e whakaarohia ana te wā "rongoā e hāngai ana taunakitanga-" i roto i te 1988 e epidemiologists me matahauroa e kua mahi i te Canadian McMaster University. hoatu Araki Kokran te whakamārama o te āhua o ki te tapaea te rangahau ki te tohunga. I tua atu, whai wāhi ai ki te meka e paearu mō te kōrero me te tātari tika ratou hua i. Cochran ko ana hoa, e te hunga i roto i te British Medical Kaunihera Research, kua hanga tautooraa tahi mau tautooraa nui mo te whanaketanga o te rongoā e hāngai ana taunakitanga-hou. Ko ia te tangata e i roto i te 1979 ka haere ki te whakaaro e kore he pūtaiao kitenga tino nui o randomized tamataraa te mana. whakaturia Cochran i te Center tuatahi mō Taunakitanga-Based Medicine, e kiia nei ko i muri ia ia. ka anga ia mahi i roto i Oxford 10 matahiti i teie nei. I tēnei wā 15 taua pokapū ao. whakatika ratou te mahi o te rōpū te ao o kairangahau.

wāhanga

E rima ngā taumata o te rongoā e hāngai ana taunakitanga-:

1. A ani i te pātai ki i reira he he taea ki te tiki i te whakahoki.
2. Kimihia te whakaū pai.
3. Te arotake arohaehae i te raraunga.
4. A feruri i taunakitanga hāngai tohungatanga haumanu me ngā ngākau nuitanga o te manawanui.
5. Arotake i pēhea te taea te whakamahi o hangarau tautoko.

Ngaahi Tefito'i Mo'oni o rongoā e hāngai ana taunakitanga-. Te kimi i te taunakitanga pai

Tohunga titiro hoki taunakitanga, e hāngai ana i runga i kupumatua: manawanui, te wawaotanga, whakarite, ngā putanga. Tuatahi, e hiahia ana koe ki te puta ki arotake nahanaha, me te randomized tamataraa mana no te mea he ratou ake pono. Ki te kahore e tūtohutia te taunakitanga ki te tīmata ki te rapu hoki taunakitanga o te taumata o raro. Ko ētahi o ēnei ko te ropu ako, "take-mana" me etahi atu.

aromatawai Critical o taunakitanga

Ki tenei aromatawai, ka taea e koe te whakatau me pehea pono te taunakitanga kitea me nga hua o te ako. Hei tirohia te tika o tohaina matapōkeretia akoranga mana, me whakahoki koe i te pātai e whai ake nei:

1. Kaua kawea Tupurangitanga o tūroro i roto i?
2. oti e tūroro katoa tango wahi i roto i te ako i te reira?
3. Kua reira kua he tātaritanga o tūroro i roto i te rōpū ki te i randomized ai ratou?
4. Ko te maimoatanga o "matapo" mō kairangahau me ngā tūroro?
5. Mahi i te ōritenga kitea i roto i te rōpū i mua i te tīmatanga o te ako?
6. Kaua i tono te maimoatanga taua, ki te kahore hoki te pairati?

I roto i te take o te rangahau kounga taea puta ki te aro mātai o ngā hua.

tātari o ngā mahi

haere tahi ana tēnei aromatawai e te mau uiraa i muri:

1. He aha ahau te mahi ahau?
2. Hoki te mea kei te mahia e te reira, he aha ngā hua e whakaritea ki te riro?
3. He aha e nga taurangi o miramira me te haumaru o tenei mahi?
4. He reira he ara pai, tikanga atu e tika ana ki te whakatutuki i tenei whāinga?

whai wāhitanga ako

Hei rapu mō tautohetohe me te tātari arohaehae ko te kounga teitei, kia whai i te arotmatawai te tohungatanga e tika ana, me te wā. I tua atu, ka taea e ia te whakamahi i te mau ve'aa te i runga i te tuhinga pūtaiao kaupapa, me te tahi atu. He mea pai ki te kōrero ki te whakarāpopototanga o te rongoā e hāngai ana taunakitanga-, haaputuhia e te tahi atu tohunga. pea he pātengi raraunga Cochrane, te pukapuka M. Enkin, atu mau papai i roto i tenei rohe tenei. Ka tūtohu hoki mātou i te kawa rite-hanga, e kua rite i runga i te pūtake o te rongoā e hāngai ana taunakitanga-.

arotake Periodic o tuhinga

te whakaaro nui tikanga ta taua taunakitanga pūtaiao nui ko noa he wahi iti o wawaotanga tiaki hauora. Ko reira e pā ana ki te 15%. Katoa ra, e hiahiatia ana kaimahi o rongoā i roto i te ao kei te ki te whiwhi nui taunaki hou e tika ana mo te tōtika me te maimoatanga tika o tūroro. Ki te mahi i tenei, Me tākuta ki te rapu kōrero motuhake i roto i tenei kōtaha. E tūtohu ana ki te whakamahi i te tuhinga hauora, i te mea i tēnei wā nui atu. Kua tuaruatia Ko tōna nui i roto i te 1970. Ano, Kei te tipu haere te reira i nga ra katoa. Ia tau, whakaputaina te poari ētita e pā ana ki 6000 tuhinga i roto i taua wāhi rite gynecology me obstetrics. I roto i te tikanga ki te ōrite te taumata o te matauranga o nga wa hou, hiahiatia te tākuta kei te ki te pānui i 20 tuhinga he ra. Ko tētahi atu pātai ko ahakoa i reira he i tenei wa, te kaimahi hauora? Me te reira ki te tango ki pūkete te meka e tokomaha o nga oko e kore e whakatau noa nga paerewa mōkito o te kounga.

mahi tika

mohio wāhanga o te matauranga hauora te hape tawhitotia ranei i muri i rima nga tau i muri i te ākonga tu'ite i te institution mātauranga teitei. Pono, he reira unknown rite te nui. Ka taea te whakaritea Pukapuka i runga i rongoa ki te uru raau no, rite faarahi te reira rawa tere, i reira e maha "rakau mate", "pūngāwerewere" me "nakahi", engari vahi i roto i nga taonga huna katoa.

mōhiohio taketake

rongoā e hāngai ana Taunakitanga-ko he huarahi ki-whakatau kaupapa. I roto i tenei take, whakamahi te arotmatawai nga tautohetohe pai e te hunga e wātea ana, me te wheako ngaio. tangohia te whakatau kei ki te manawanui, tango ki pūkete ona ngākau nuitanga. Katoa ra, kaimahi mahi i roto i te mara hauora rapu rerekē momo o puna ki te kitea e tali ki ngā pātai auau. Hei tauira, Me ngā ākonga e ako ana i roto i tenei rohe mōhiohio taketake, faatahoêraa i te take o te mate, me tona pathogenesis, āhuatanga māori, me te tahi atu taipitopito. no raraunga Basic ki pūtaiao rerekē. Tenei, i roto i ngā, whaiaroaro, pathogenesis, anatomy, etiology. Ko auhia eu mōhiohio Basic, he reira i roto i tu'utu'uni, pukapuka, me ētahi atu kai whānui hauora. Heoi, Me ki te whakahoki kupu i te pātai e pā ana tika ki te tiaki o te manawanui, me tona maimoatanga te nuinga o taote. Here te tahi mau hi'oraa o ngā take e pā ana ki te mate huru ranei, engari e kore e tirohia āta ki te mahi haumanu:

• E te tikanga ...?
• He aha te mea otitis pāpāho?
• He aha microorganisms wāhi ki te pāpāho otitis?

Pahonoraa ki ngā pātai o tenei momo e taea te kitea i roto i pukapuka, ngā pukapuka tohutoro me ētahi atu puna.

Mōhiohio i runga i te whakahaere o te mate

Haunga te matauranga taketake, Me mōhiohio o te hāngaitanga tika ki te whakahaere o te manawanui, tikanga tātaritanga, maimoatanga me te waitohunga te tākuta. E tuatapaparaa te reira ki te take taua rongoa e hāngai ana taunakitanga-. Ko nga kupu matua konei e "te tātaritanga, maimoatanga, waitohunga." Ki te tiki i nga hua pai, a he tika te whakautu pai ki te hanga tika i te pātai.

tauira haumanu

Ka taea e kite koe i te fariiraa "diethylstilbestrol" tarukino ki te ārai whakatahe i roto i nga wahine. Ko te take i te whakamahi o tenei taputapu mahi te arumanga auau o te hapūtanga. I roto i tenei whakaaro, whakaaro te wāhi o estrogen i roto i te tarukino ki te ārai materoto te arorau. Tūroro tango tenei rongoā, hapūtanga, te nuinga ka ora taua. I roto i te 50 o rite ki te hua o te rangahau kore-randomized ono kua whakapumautia e whakaiti i te maha o mâtutuhia i roto i te whakahaere o te tarukino "diethylstilbestrol." Hoki whakahaere reira rima rangahau, i roto i nei i wehea nga tūroro ki e rua ngā rōpū i te tīpako matapōkere. ka mau te tuatahi te tarukino "diethylstilbestrol", te tuarua - te placebo. E ai ki nga hua o te whakamātautau i roto i nga wahine te whakamahi i tenei taputapu, puta whakatahe i 7% o te wā. Whakamutunga o hapūtanga i roto i te rōpū tuarua ko 5%. Nā ki enei hua i whiwhi taunakitanga mārama e kore he pai te tarukino. Ko, ahakoa tenei, kei te haere tonu i runga i tona whakamahi. I mua 1970, i tukinotia e ratou e milioni o te wahine. hāngai ana Taunakitanga-rongoā titau te rauemi pānui hiahiatia e kore noa i te tetahi wa. Tino huri koutou ake me ētahi atu 'mahi i runga i ngā mōhiohio hou. rongoā e hāngai ana Taunakitanga-whakarato te hiahiatanga mo te aromatawai whāinga o te whai huatanga o wawaotanga hauora, me te pai kia rite ki te mau hopearaa o tona tono i roto i te mahi haumanu. O te akoranga, e kore te mea ohie, no te mea i roto i te rapu mo te taunakitanga, me i roto i to ratou tohatoha me te whakataki o huringa, e taea te kitea tauārai e puta puta noa i te tukanga.

te hanganga o ngā whakaaro

Kei te whakawhanake rongoā e hāngai ana Taunakitanga-mo te katoa i roto i te ao i roto i te haereraa āhuahanga. Tīmata ki te '90, te wā o tona hanganga, me tenei ra tata te maha o ngā pukapuka, Ngā Huinga me pokapū o tenei rohe e i roto i tekau, me te maha o tānga - i te rau. I roto i 1997, kua riro mai 12 taua pokapū karaati mo 5 tau i te US Agency kaupapa here, te pūtaiao me te hauora. i whakapumautia ēnei rōpū i ārahi whare wānanga me ngā pūtahi rangahau i roto i āhua rerekē. Nui haere te maha o ngā pokapū o ngā take tino motuhake pērā i o tamariki, me te hauora hinengaro, te āwhina tuatahi, me te tahi atu wāhi. tohutoro General ki a ratou, ko ki te tono i te parau tumu o te taunakitanga i nga taumata o te whakatau-hanga i te āhua tūmatanui o te hōtaka, me te mutu ki te whakarite o te maimoatanga takitahi. I roto i Russia, e kei te ngä tino rongonui i roto i te St Petersburg me Moscow. i roto i hoki nga āwangawanga runga, me te rongoā e hāngai ana-taunakitanga whare hauora, Nizhnevartovsk. Faanahoraa motuhake i roto i te tātaritanga, Neurology, Fale- me te mimi, andrology me gynecology, gastroenterology me Ent mate.

hoa

rongoā e hāngai ana Taunakitanga-ko te hoki whakawhanake i te Russian Federation tere. I roto i Russia reira condominiums hapori Interregional. Kua riro te reira i te rēhitatanga i te 2003. Society o rongoā e hāngai ana taunakitanga-ko te rōpū pai-kore noa. Mahi i te reira i raro i te Tūtohinga. Ko te mahi matua o condominiums:

1. Te haapiiraa i te mahi e pā ana ki te raruraru huarahi o ngā rangahau tātari tahumaero me te haumanu mōhiohio systematics i te parae o ngā tānga pūtaiao me te aro mātai o te tātaritanga raraunga tatauranga.
2. Ko te publicity o nga hua o ngā pūtaiao taketake.
3. Ko te whakataki o te nama i roto i te mahi hauora.
4. Examination o te kounga o ngā tānga pūtaiao, ngā tikanga e hoki tūroro me ētahi atu.
5. Sotsioepidemiologicheskie me rangahau biomedical.

Ko te mau parau tumu o te mau melo o condominiums:

- te whakahörapatanga o ngā mōhiohio e hāngai ana rangahau-e pā ana ki te wawaotanga hauora me ngā kōwhiringa mo te rironga o taua raraunga;

- faka'ehi'ehi i te fanongonongo o ngā mōhiohio mahi, e kore nei kua pūtaiao kï;

- whakapuakitanga o te ngā ngākau nuitanga maioro.

Kaimahi o te whakahaere ko te tākuta e piri ki teie mau parau tumu, a te whakatinana ratou i roto i te mahi. Ki te rā, i roto i nga rohe United 17 me te neke atu i te 300 ngā mema. Head o te tari ā-rohe e tino tohu tiaki hauora, me te hauora.

Center mō te Taunakitanga-Based Medicine (Mātauranga, 14, St Petersburg)

mahi te reira i wāhi ki waru i roto i te ata tae noa ki whitu i te po, me te kua he putanga kotahi, e hinga ki runga ki te Rātapu. Ko te Center Northwest mō Medicine Taunakitanga-I whakarato te whānuitanga o ngā ratonga mō te taupori whānui. Hea e taea te tiki e koe tohutohu me te maimoatanga i taote o whāiti kuiti, haere tātaritanga taiwhanga, colposcopy, ultrasound, mirimiri akoranga. mahi hoki Taunakitanga-Based Medicine Center aroturuki ia o ECG + pēhanga toto. ngā kaimahi katoa e mahi i roto i te whare, he kaiwhakaako tino tohu. Northwest Center mō te Medicine Taunakitanga-I tohunga ana i roto i te mate pērā i:

- osteochondrosis, hë vertebral Cervicalgia, radiculitis discogenic me lumbodynia;

- kōpeketanga neuropathy, rere pūroto, i te mea he tohumate o te kōpā i te maihao;

- deforming osteoarthrosis i ngā wāhanga rerekē (rite te maimoatanga whakamahia medikametoznye pā tono waikawa hyaluronic);

- disorders pathological o nga uaua me tuhonohono (tendovaginitah, enthesopathies me ētahi atu);

- māuiuitanga o capsules tahi, "Spurs" i runga i nga rekereke.

He tuarua pūtahi o St Petersburg pai-mohiotia

Center mō te Medicine Taunakitanga-I (Lenin 88) rere i waru i roto i te ata tae noa ki te waru i te po. tū ana whakatūnga te i roto i te whare noho i runga i te papa tuatahi. taputapu Modern, taumata tiketike o te mahi, tikanga matatau o te tātaritanga - e kore te mea he rārangi tino o painga tenei e te Center mō te Taunakitanga-Based Medicine. tohu Reviews o tūroro maha e konei ka ia manuhiri e hoatu aro mōrahi. i whakahuatia mauruuru no te kounga o ngā ratonga. Ka taea e koe te rapu i te āwhina o taua tohunga rite te rata mātai me te gastroenterologist, he toketā neave me internist, mafatu me ophthalmologist, tafe'anga, roma mimi, a na i runga i. tuku te whare hauora rongoā e hāngai ana taunakitanga-me tātaritanga i roto i te taiwhanga, e pupuri ana ultrasound, echocardiography, kalposkopii, mirimiri, electrocardiography. Ko te tino tākuta o te whare i whakaritea matepukupuku rānei Beynusov Dmitriy Sergeevich. Ka taea te kitea hua whakamātautau mā te karanga ranei te fariiraa ratou i roto i te mēra. I tua atu ki te pokapū hauora, pā hoki te mahi o ngā tohunga ki te hōhipera pa. utu kōrero Medical 1200 moni.