绉瀛伴诲褰濞变伴荤锛

诲绌惰藉涔锛

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锛d锛锛绉瀛伴诲浠ュ濞变伴荤

濡杩℃伴昏诲绌讹ｄх╂d锛锛ｄㄦュ涓绉璋ュ悍锛杩藉ｄ诲ㄤ富娴濯浣涓锛扮璁烘绉瀛伴伙姣濡璇磋卞芥涓㈤浠涔涓瑗垮跨哄板奖浜锛浠ぇ姒浠ョ锛浣瀹灏卞浠ョ存瀹蹇浜

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璇磋璇浜哄 John P.A. Ioannidis锛浠骞村琚换戒负ぇ瀛插诲绌朵腑蹇涓讳换Ioannidis 璇达ignore them all. 浠诲荤涓浠浠ュ诲锛翠釜诲绌躲2005骞达Ioannidis 琛ㄤ袱绡璁烘锛璇ぇㄥ诲绌堕芥杩涓ょ璁烘ㄥ诲琚ㄥソ炬锛浣病浜鸿浠杩涓浼兼姣缁璁烘虫病浜鸿〃绀烘璁躲诲绌剁绉瀛界ラ杩涓瀵锛诲绌舵规璋便

浣浠朵涓村2010骞村寮璧峰虫敞棣瑰板ぇ琛ㄥ婊℃ゆ挎锛棰ㄨ卞介稿椹娓╁寮璋锛璇ユ璋锛诲绌垛朵唬ㄥ绔宠杩锛骞舵缁璁鸿涓姝ョ簿绠涓衡90%诲绌堕芥锛朵唬ㄥ杩绡ラ璇达ㄥ凡缁浜哄濮姝ｈ伴板瑙翠釜诲绉锛涓绔冲浜涓浠ヨ瀹ㄧ稿缁璁猴姣濡璇达

- 娌′胯繁妫ヤ钩匡涓浣涓浼浣钩跨姝讳骸锛娌″杩锛

- 跺绉瀛骞舵病瓒冲璇娉ㄥ娴瀵归叉不娴

Ioannidis 涓ょ璁烘寮杩哄诲村ㄤㄨ琛涔涓浠骞翠伴诲ㄥラ锛杩涓や釜诲甯歌琚共浜锛

- 涓浠浠ぇ锛濡汉娌℃蹇璇锛灏辫ｄ涓ㄧ浣洪跺芥病浠涔浣

- 琛ラ瑕D绾贰 浠涔釜浜洪藉凡缁瓒冲澶缁寸绱D锛规瑕浠绾寰扮ュ璇达涓汉浠ヤ冲涓戒汉姣ぉョ5锛蹭汉绉1520锛寰缁寸绱D锛灏伴ユ濂崇浜轰璁搁瑕杩浠╀腑琛ュ涓广

浠ユ伴诲ㄥ辨杩绡ラ棰瀹涓衡涓轰涔涔浣诲

绉瀛伴诲父甯告叉浠ㄧ浠ｅ诲甯歌椹虫村癸ㄧ瀛璁烘椹虫浜虹甯歌锛ㄦ缇瀛璁烘椹充腑界瀛璁烘惰 Ioannidis 璇存缇瀛璁烘跺涔涓涓璇90%锛姘村规病杩姣杩涓ソ广浠ヤ互涓杩绡ラ澶ф涔规棰锛浠椤荤 Ioannidis 板璇翠浠涔

浠涓绡琛ㄥ PLoS Medicine 涓绔璇达ㄥ诲绌朵腑琚箍娉浣跨ㄧ缁璁℃规锛跺釜甯歌寮辩浣绯汇濡浣涓椤圭绌舵瀵绉╁浜虹ュ悍ソ澶锛浣甯借濂藉璇锛浣灏寰瀹规拌涓广棣锛ㄥぇㄥ诲绉绌剁搴跺芥杈寰急锛涓轰寰急搴汉╁氨绌跺浜舵锛浠涔瀵瑰ュ悍濂藉锛涔璁镐涓浜虹骞舵病浠涔惧ソ杞浣涓轰甯杩涓╂锛浣涔璁镐瀹ㄦ绘句濂借浆璇浣戒ユ病浠涔濂借浆浜哄濂借浆浜恒杩灏辨Ioannidis 杩绡璁烘跺ㄦ板锛浠浜涓绠锛璇村杩涓井寮辨搴10%锛浣30%璇锛浣瀹楠寰版纭璁虹姒20%

绉瀛浠藉涓烘夸昏璧╄甯璇涓╃锛浠村戒负浜藉ㄥ琛ㄦ杞板ㄦ搴璁烘杩芥浜虹缁翠10%搴30%宸澶灏辨琛瀛绌剁姘村钩锛浠ぇ姒浠ヨ80%娴琛瀛绌堕芥规风璁＄锛灏妯￠鸿楠淇℃т23%Ioannidis 杩绡绔灏辨ㄦ板规璇绉澶

板褰朵琛锛硅瀹寰瀹璇杩姝ｆIoannidis涓绡璁烘骞茬浜锛琛ㄥㄦ濞 JAMA涓娌℃浜鸿芥诲璁烘界绌朵锛浠ヤ娉稿锋фэ浠19902003骞撮村琛ㄥㄩ《绾т复搴诲涓椤剁骇璁烘锛ラ寮ㄨ杩1000娆°绗杩涓璁烘涓辨49绡锛朵腑45绡澹扮О浜绉╂娉

浠界ラ绉瀛蹇椤婚芥澶锛浠ラ澶灏绉瀛琚汉澶杩杩45绡璁烘界堕借寮ㄤ娆′互涓锛朵腑34绡琚澶妫楠杩

汉妫楠缁朵腑7绡缁璁洪璇姣濡涓绡璁烘璇寸淮绱E瀵归浣峰蹇椋╂濂藉锛涓绡璁烘璇寸淮绱E瀵归浣コ瀛蹇椋╂濂藉锛ョ澶ц妯￠哄楠璇淮绱E瀵归浣蹇椋╂规病濂藉7绡璁烘琚じ澶тс涔灏辨34绡缁妫楠璁烘涓14绡锛41%锛锛琚缁璁烘杩45绡濞璁烘涓20绡浜骞舵杩浜堕寸楠

椤剁骇璁烘灏涓濡姝わ涓芥峰90%戒涔锛浠 Ioannidis 璇磋90%诲绌堕介浜杩璇锛朵唬ㄥラ纭棰

Ioannidis 璇寸涓90%锛432涔431娌℃浜鸿藉交ユ诲璁烘锛浠 Ioannidis 娉╀涓ㄩ锛褰绘ヨ涓璁烘杩涓绌剁峰コｅ绉剧椋╀锛涓哄哄褰卞2007骞 JAMA 涓绡璁烘涓Ioannidis 涓浣惧拌涓77绡璁烘锛跺绡杩浜璁烘澶版规冻澶涓ヨ皑杩浜璁烘涓辨轰432涓朵腑60涓浠ョО寰涓规涓ヨ皑杩60涓跨烘璁烘腑锛剧跺绌惰冲澶楠璇浜涓ゆ锛涓涓

濡浠姝ｇ‘绉瀛瑕姹规涓ヨ皑锛缁冲缁涓ゆ妫楠锛ｄ杩涓肩1/432濡浠惧瑕姹锛瑕涓绡璁烘涓琚锛灏辩瀹ソ璁烘锛ｄ琛ㄥㄦ濞涓琚ㄦ版澶诲璁烘涓7/45

杩涓绡涓涓ょ璇寸淮绱E浠ラ浣蹇椋╋浜瀹涓锛2000骞存拌辨煎板诲蹇涓灏辨绔ㄨ杩9000浜虹涓ユ奸哄楠璇淮绱E规介浣蹇椋╋杩涓缁璁轰涔涔娌¤缈昏ｄ板澶灏绉瀛ラ杩浠朵垮Ioannidis 绛浜烘剧ㄨヤ板澶灏璁烘杩ㄤ娇ㄢ缁寸绱E浣蹇椋┾杩涓璇ヨ锛缁璁烘村2005骞达浠50%板璁烘杩ㄥㄥ㈤ｄ袱绡璇椤剁骇璁烘锛骞朵浠ヤ负瀹浠

濡浣ㄩ究句釜涓藉荤缁寸绱E蹇濂藉锛㈡璧浠璇存濂藉Googleㄤ腑绱⑩缁寸绱E 蹇锛绗椤电缁ㄦ濂藉锛瀹冲凡缁涓哄父璇杩ュ绉诲缃绔

浜哄涓虹浜2000骞翠伴绘ラ澶у缁寸绱Eラ浣蹇椋┿浜鸿ㄥ澶ц洪浜鸿ㄨˉD

瀛缁璁烘骞垮扮瀹涓锛跺甯稿遍╃浜涓轰瑙ｇ瀛绌剁缁存瑰瀵艰村ぇ澶颁汉瀵圭瀛涓や釜澶ц瑙ｏ绗锛璁や负绉瀛绌剁瀵圭锛绗锛璁や负姣椤圭芥ㄧ浜ф浠ュ父崇绛妗瀹绉瀛绌跺跺涓涓婊℃叉锛虫跺杩虹杩绋

撮瑕绉瀛跺姣璁炬崇灏版版涓鸿涓锛绉瀛杩涔寮哄ぇ寰澶璁烘涓涓ヨ皑锛冲澶芥锛杩骞朵琛ㄦ瀛腑娌℃姝ｇ‘绛妗锛瀹〃板ゆ纭妗骞朵绠

绉瀛ラ芥ㄤ汉绫讳缁璇锛绉瀛绌朵娇ㄧ翠汉绫讳缁璇璋绉瀛规锛跺涓濂寰涓涓风缁存瑰浠澶╁诲绌剁插跺苟涓瑙寰灏辫瀛规涓琛崇ㄦ涓ョ绡灏锛浠缁涓涓绉瀛规锛杩绉瓒瓒浜浜虹被界缁存瑰涓涓浠涔镐俊缁寸绱E涓介浣蹇椋┾杩涓璁哄氨锛涓烘浜绉瀛规姣涓浜绉瀛规村淇°浠璇存负浠涔伴讳濡璁烘锛涓轰涔涓绡璁烘涓濡澶绡璁烘缁煎ㄤ璧风锛绉颁负 meta-analysis锛锛浠ュ涓轰涔杩涔杩琛

绉瀛骞翠汉涓瑗裤璁や负辩璋缁浠版绉瀛釜璇搴姝ｇ‘瑙瑙璇ュ妫涓凤刊瑙

㈢绂ㄩㄧ绉瀛氨╃瀛堕エ褰跺㈢绂釜╃瀛锛涓浠ｆ浜瀛浼间ㄨ瓒舵璁哄浣锛浠璋╃瀛璋绉瀛瀵规浠撮瑕锛涓虹澶у版ュ父绉瀛芥涓洪甯稿琚瑙ｃ

娉朵诲绌惰骞舵病瀵 Ioannidis 绀虹舵ㄤ》涓涓绔浜1993骞寸 Cochrane Collaboration 介缁缁锛灏辨ㄤㄤ弗煎瑙绉诲绌讹骞朵轰寰澶ュ锛涓浠浠绾充 Ioannidis 虹瀹℃ユ规杩涓缁瑰己璋缁垂ヨ垮锛澶у绉浜烘娆撅涓垮昏便