为什么无效的药物治疗会被认为有效?
祖述宪①
摘要: 把无效的治疗误认为有效，不仅在大众中非常普遍，而且很多医生也常如此。造成这种疗效假象有许多原因，主要由于疾病的自愈或自发缓解、药物和治疗的安慰效应、缺乏严格的评价疗效标准以及诊断不确实，以及把良性疾病误诊为严重或恶性疾病所造成的。对传统医疗的信仰也是原因之一。因此，对任何药物或医疗的效果必须进行严格的随机对照临床试验，并且得到同行的检验和公认。
关键词：疗效评价，临床试验，疾病自限性，安慰效应，中医药
Why an Ineffective Treatment Is Misunderstood as Being Effective?
ZU Shuxian, Anhui Medical University, Hefei 230032, China
Abstract：An ineffective drug or treatment to be confused as effective one is very common not only in lay patients, but also in our medical professionals. Many reasons contribute to this false impression, such as the self-limiting or spontaneous remission of diseases, placebo effect, inappropriate evaluative criteria and the misdiagnosis of benign illnesses as severe diseases or malignancies. In addition, the belief in our traditional medicine is also an influential factor. Therefore, any drug or treatment should be evaluated by randomized, controlled and double blinded clinical trial, whether new or ancient treatment. The results of the clinical trial also need to be evaluated critically by international academic circles.
Keywords: efficacy evaluation, clinical trial, self-limiting, placebo effect, TCM
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作者简介：祖述宪，安徽医科大学流行病学与社会医学教授，已退休。
语言的批评并不能立即改变现实，但一定是撬动现实成本最低、影响最深的方法。
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