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常殺銀 發表於 2007-8-3 19:41 | 只看該作者 回帖獎勵 |倒序瀏覽 |閱讀模式
中醫,爭議中的文化

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轉貼自:《自然》雜誌

中醫:爭議中的文化----系統生物學能把有著幾乎不可調和差異的中醫和西方科學結合起來嗎?

劉文龍(音譯,Liu Wen-long)在北京不起眼的營業與其他的小診所沒有什麼不同,但他不是一個一般的大夫。劉從不用實驗室檢查,也不用高科技顯像診斷。他靠的就是望,問,聞,切。劉現在69歲,已從事中醫43年。他對中醫的療效堅信不移,他說他的「回頭客不少,因為中醫能治好他們的病,活得更好」。

的確找劉看病的人整個上午絡繹不絕,從過敏到肺癌患者都有。其中有些是想試一試的初次病人,有些則是相信中醫的常客。黃女士是來自北京郊區的一位會計師。她對三副葯就治好了困擾她多年的偏頭痛十分滿意。她說她「過去就靠去痛片,一天到晚疲憊不堪,(服中藥后)現在變了一個人」。

在(中國)這樣一個迅速現代化的國家,劉這樣幾千年來亘古不變的診所好象過時,難以生存。人們對中醫的態度確實也各有不同。去年湖南中南工業大學的張功耀(音譯,Zhang Gong-yao)在中醫雜誌上發表了一篇文章,稱中醫是偽科學,應從醫療體制和科研退出。這引來一片責難聲。今年初中國政府就宣布了一個雄心勃勃的中醫現代化計劃。

但是(現代醫學與中醫間的)巨大差異應當整合起來嗎?現代醫學通常是根據病因,對某種疾病提出治療方案。而中醫則注重癥狀,用動植物成分,礦物和針灸治療。這些療法是否有效,機理如何還是一個被人不以為然的把柄。二者最大的不同點是檢測:在西方國家,研究人員用隨機,對照試驗來檢測藥物的安全性和有效性;而中醫治療則是基於病人的癥狀,特徵和世代相傳的醫療理論的整合。

無論在中國在還是外國,主流醫學都十分重視基礎理論。中醫的理論是「氣」不通則致病;「陰」「陽」需平衡;人體五臟和狀態則分為「金」,「木」,「水」,「火」,「土」。

在過去的十多年中製藥公司對中醫越來越感興趣。但其方式卻是典型西方式的:先分離活性成分,再一個一個檢測。這種還原方法得到了某些批准上市的藥物。比如治療瘧疾的青蒿素,(其原植物)中醫用來治療發燒。還有三氧化二砷也是從中醫借鑒來的,現被用來治療急性早幼粒細胞白血病。

然而(從中藥)找到活性成分卻非易事。原來中醫治病通常都是用復方。有些復方包括多達50種草藥,含上千種化合物。要真正了解中醫的治療,科學家認為需要了解這些複雜的成分是怎樣聯合起作用的。

至少在美國批准草藥作為藥物的標準已開始降低。2004年6月,美國食品與藥品管理局(FDA)出台了新的規定。草藥只要證明安全有效即可,不必強求成分清楚。去年十月,FDA按新規定批准了第一個有知識產權的草藥,由德國MediGene公司開發的用來治療尖銳濕疣,取名為Veregen的綠茶提取物。這些新規定燃起了(製藥)工業對復方的興趣。無孔不入的西方製藥業可能會願意花錢探索中醫的秘密。一種稱為系統生物學(Systems biology)的學科通過研究生物體各部分之間的相互作用來了解生物體的功能和行為。系統生物學更強調整體觀念,有人認為與中醫很相似。

系統生物學可以通過對大量基因,蛋白質,代謝物同時進行測定,了解完整機體對複雜草藥的整體反應。荷蘭萊頓大學生藥學系主任Robert Verpoorte說:「如果有一種技術可以使中醫藥有所突破,那就是系統生物學」。但並不是所有人都同意系統生物學好得可以破解古老中醫。

上海交通大學系統生物學中心的藥理學家賈偉(音譯,Jia Wei)和中國科學院武漢數理研究所的唐輝如(音譯,Tang Hui-ru)想要更全面地了解草藥提取物怎樣作用於機體。他們與倫敦帝國學院(Imperial College London)生物分子醫學部主任Jeremy Nicholson合作,用核磁共振波譜分析和質譜分析等技術來測定人血,尿中代謝物譜,稱之為代謝組學。賈及其同事發現,在用二甲基肼誘導結腸腫瘤的大鼠,其尿代謝物譜與正常對照是不一樣的。如果給這些大鼠喂與黃連和吳茱萸兩者提取物,其代謝物譜變化可以逆轉。

他們還沒有發表這些研究結果。但他們表示通過對代謝物的詳細分析,已經確定了這些草藥影響的代謝通路。

荷蘭SU Biomedicine的Jan van der Greef及其同事王梅(音譯,Wang Mei)也正在用類似的方法進行研究。用具有胰島素抵抗和高血壓等症侯群的小鼠模型,他們的研究小組觀察了一種未公開的中醫復方對於脂質譜的影響。當給小鼠喂以高脂飼料后小鼠便顯示出對胰島素的抗性,脂質譜也與喂正常飼料小鼠的明顯不同。但如果給高脂飼料小鼠喂這種中藥,脂質譜就會趨於正常化。

他們注意到這種中藥復方引起的脂質譜與作用於CB-1內生性大麻素受體的減肥藥利莫那班(Rimonabant)的效能十分相似。據van der Greef說,未發表的細胞培養實驗結果提示這些中藥提取物也是通過同一受體影響脂代謝。該研究小組目前正在進行該中藥的臨床試驗。

雖然某個活性成分可以象西藥一樣發揮作用,但作用不明的其他成分已及活性成分的易於變動還是使西方那些謹慎者感到困惑。Nicholson說,(中藥成分的)易變性「使人們感到不安」。同一品種中藥生長在不同區域或在不同季節收穫都可能有不同的化學組成。這一直是一個困擾草藥研究者的問題。

在Nicholson 的實驗室,唐及其同事分析來自埃及,斯洛伐克和匈牙利的洋甘菊分子成分,很容易將它們鑒別出來。但武漢數理研究所的研究小組卻發現不同公司生產的同一草藥產品(成分)相差懸殊,甚至同一公司不同批的草藥產品也是這樣。唐指出「中國草藥要想在國際市場上取勝,這是一個必須解決的問題」。

對許多姑且稱之為系統生物學家的人來說,要描繪出生物體(如何工作)的完整圖象和了解中醫如何作用需要從幾種途徑進行研究。但系統生物學顯然是一個還難以明確定義的學科。許多人並不是在嚴格地使用(系統生物學)這一術語。這一領域的先驅者們也承認技術上還沒有發展到他們可以應用這些途徑的地步。位於華盛頓州西雅圖的系統生物學研究所所長Leroy Hood說:「可以預見系統生物學可以在搞清中草藥成分方面發揮作用,但目前還不成熟。在這個問題上現在還困難重重」。

據Hood 介紹,系統生物學在常用實驗生物體上應用非常成功。但用在人體上則遠非成功。別說做,就是規劃如何處理在諸如中醫這樣的複雜系統也有許多障礙需要克服。比如要精確測定血液中的代謝物,特別是蛋白質就需要更好的檢測系統。更有力的計算和統計工具對處理大量的複雜數據也是必要的。Hood說「這些技術都還不成熟」。

在中醫現代化方面,提倡者和懷疑者都有更多方面的考慮。有些對把中藥研究開發與中醫行醫的基礎理論割裂開來感到疑慮。位於北京的中國中醫研究院已退休研究人員,現中國古籍出版社社長付京華(音譯,Fu Jing-hua)說「中醫不僅僅是一種醫療系統,也是一種哲學和治療藝術。這些都是中華文化的重要組成部分。去掉了它的文化內涵,(中藥)就成了無本之木」。

但張和在美國訓練過的生化學者方是民(音譯,Fang Shi-min)認為就是要廢除那些中醫理論。他們認為「陰陽五行」,「氣」等都是近於憑空想象的對人體的不準確描述。方是民也管理一個反偽科學和學術不端的新語絲網站。

在彌合中西方差異的過程中,文化因素不可避免地成為一個障礙。中國醫學科學院哲學研究員阮重(音譯,Yuan Zhong)說:「中醫領域對批評向來是反感的,如果人們不能發表不同意見,任何學科都不能前進」。

雖然關於中醫前途的辯論進行得熱火朝天,劉的生意還是向往常一樣。他歡迎中,西醫結合,但也抱著一個務實的態度。他表示「中醫西醫都是為了人們健康,只要能治好病就行」。劉對中西醫結合的真正進展還在觀望。在此之前,他的直覺和經驗,以及那似乎神秘的中醫理論與治療,對他和他的病人還是很有用。
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瘋瘋顛顛 發表於 2007-8-5 11:49 | 只看該作者
本文可認為是一篇比較真實的新聞報道.
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新鮮人 發表於 2007-8-6 07:35 | 只看該作者

回復 #2 瘋瘋顛顛 的帖子

一個外國人,  能作出如此比較客觀的報道比某些偏激的中國人高明多了. 難能可貴.
知之為知之,不知為不知,是知也

海納百川,  有容乃大
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goodoctor 發表於 2007-8-6 12:46 | 只看該作者
懂英文的,希望您看看英文原文。是不是有些不一樣?是無心之過,還是有心之做?
也許是我的英文有待提高?

News Feature

Nature 448, 126-128 (12 July 2007) | doi:10.1038/448126a; Published
online 11 July 2007

Traditional medicine: A culture in the balance

Jane Qiu1

   1. Jane Qiu writes for Nature from Beijing.

Traditional Chinese medicine and Western science face almost
irreconcilable differences. Can systems biology bring them together?
Jane Qiu reports.

Liu Wen-long's modest Beijing practice looks no different from most
clinics. But he is no ordinary doctor. Liu never orders lab tests, nor
does he prescribe high-tech imaging diagnostics. He relies on simple
observations, checking a patient's pulse, complexion and odour, and
asking about habits and medical history. At 69 years old, he has been
practising traditional Chinese medicine for 43 years and he is
resolute about its benefits. "People keep coming back because it cures
them and improves their well-being," he says.

Indeed, patients trickle in to see Liu all morning for conditions
ranging from allergies to lung cancer. Some are nervous first-timers,
others are regulars, confident in what traditional Chinese medicine
has to offer. Ms Huang, an accountant from the outskirts of Beijing,
is delighted that her migraines, which haunted her for years,
disappeared after three herbal regimens. "I used to live on
painkillers and felt tired all the time," she says. "I am now a
totally different person."

In a country that is fiercely embracing modernity, clinics such as
Liu's, which have been operating the same way for thousands of years,
seem vulnerable and out of place. Indeed, attitudes on traditional
Chinese medicine have divided the country. Last year, Zhang Gong-yao,
from the Central South University in Changsha, Hunan, published an
article in a Chinese journal calling traditional Chinese medicine a
pseudoscience that should be banished from public healthcare and
research1. The article caused uproar in the country, and earlier this
year the government announced an ambitious plan to modernize the
millennia-old practice2.

But should such a formidable gap be bridged? Modern Western medicine
generally prescribes treatments for specific diseases, often on the
basis of their physiological cause. Traditional Chinese medicine,
however, focuses on symptoms, and uses plant and animal products,
minerals, acupuncture and moxibustion — the burning of the mugwort
herb (Artemisia vulgaris) on or near the skin. But whether these
methods are effective and, if they are, how they work remain a source
of some derision. The greatest divide is in the testing. In the West,
researchers test a drug's safety and efficacy in randomized,
controlled trials. Traditional Chinese treatments are mixtures of
ingredients, concocted on the spot on the basis of a patient's
symptoms and characteristics and using theories passed down through
generations.

The mainstream medical community, in China and abroad, has been highly
critical of the underlying theories. Traditional Chinese medicine is
based on ideas such as qi (meridian), in which illness is caused by
blocked energy channels; yin and yang, which emphasizes the balance of
energy; and wuxing (five elements), in which people's organs and
health status are categorized according to their 'elemental
characteristics': fire, wood, water, earth and metal.


Pharmaceutical companies have become more interested in traditional
Chinese medicines over the past decade. But their approach has been
characteristically Western: isolate the active ingredients and test
them one at a time. This reductionist approach has led to the approval
of drugs such as artemisinin for malaria, which is used to treat fever
in traditional Chinese medicine, and arsenic trioxide, which has been
carried over from Chinese medicine for treatment of acute
promyelocytic leukaemia.

But identifying the active ingredients isn't easy. Most remedies in
traditional Chinese medicine, as it turns out, are compound formulae
— or fufang — that contain as many as 50 species of herbs, and
thousands of chemicals therein (see 'Knowledge mining'). To tap into
the deeper well of traditional Chinese treatments, researchers think
they may need to look at how the mixtures of ingredients act in concert.
Relaxed regulation

The criteria for approval of herbal mixtures as medicines are now
starting to relax, at least in the United States. In June 2004, the US
Food and Drug Administration (FDA) issued new guidelines that permit
the approval of herbal mixtures if they can be shown to be safe and
effective, even if the active constituents are not known. Last October,
the FDA approved the first such botanical drug under the new rules, a
proprietary mixture of green-tea extracts called Veregen developed by
the German company MediGene for treating genital warts.

These new regulations have helped to renew industry's interest in the
complex formulae. And a buzzing new Western field could be poised to
capitalize on the deeper secrets of traditional Chinese medicine.
Systems biology attempts to understand the function and behaviour of
an organism by studying the interactions between its components. It
has been called a more holistic approach to biology and is seen by
some as a perfect match for traditional Chinese medicine.

By measuring many genes, proteins and metabolites at the same time,
systems biology may provide a measure of the entire body's response to
a complex mixture of herbs. "If there is any technology that could
lead to a breakthrough in traditional Chinese medicine, it will be
systems biology," says Robert Verpoorte, head of the pharmacognosy
department at the University of Leiden in the Netherlands. But not
everyone agrees that the new technology is equipped to test old ideas.

Jia Wei, a pharmacologist at the Shanghai Centre for Systems
Biomedicine at Jiao Tong University, and Tang Hui-ru at the Wuhan
Institute of Physics and Mathematics, part of the Chinese Academy of
Sciences, want to understand more fully how herbal extracts affect the
whole body. They are collaborating with Jeremy Nicholson, head of the
department of biomolecular medicine at Imperial College London, and
using technologies such as nuclear magnetic resonance spectroscopy and
mass spectrometry to profile the metabolites in a person's urine or
blood — a discipline they call metabonomics.

Jia and his colleagues found that rats given the compound
1,2-dimethylhydrazine to induce tumours in their colons had different
metabolic profiles in their urine from those in the control group. And
by feeding the rats a combination of two herbal extracts — Coptidis
rhizoma and Evodia rutaecarpa, which are widely used in traditional
Chinese medicine to treat gastric conditions — the researchers were
able to reverse these changes in metabolism. Their results have not
yet been published, but the researchers say that by looking at the
changes in metabolites in detail, they have pinpointed the metabolic
pathways that the herbs affect.
Culture shift

Jan van der Greef from SU Biomedicine in Zeist, the Netherlands, and
his colleague Wang Mei are using a similar approach. In a mouse model
of metabolic syndrome — a cluster of conditions such as insulin
resistance and high blood pressure that often occur together — they
and their team looked at the effect of an undisclosed formula used in
traditional Chinese medicine on lipid profiles. When these mice are
fed a high-fat diet, they become more resistant to insulin. The lipid
profiles of these mice were clearly distinguishable from those of mice
fed a normal diet, and they shifted towards the healthy state when the
mice were given traditional Chinese medicine3.

The researchers noticed that the profile shift resembled that caused
by the Western obesity drug Rimonabant, which acts on proteins called
CB-1 endocannabinoid receptors. And their unpublished work with cell
culture suggests that herbal extracts can affect lipid metabolism
through the same receptor, says van der Greef. The team is now testing
the formula in clinical trials.

Although one active ingredient may act as the Western drug, the
uncertain role of additional ingredients and the variability of active
ingredients confounds Western sensibilities. "Variations worry
people," Nicholson says. The same plant species grown in different
regions and harvested in different seasons could have distinct
chemical compositions. This has always been a vexing issue for
herbal-medicine researchers.

While at Nicholson's lab, Tang and his colleagues analysed the
molecular components in chamomile plants from Egypt, Slovakia, and
Hungary, and could classify them easily4. Using similar approaches,
the team from the Wuhan Institute of Physics and Mathematics found
significant variations in the same herbal medicines produced by
different companies and even between different batches produced by the
same company. "This is an issue China must tackle for its herbal
medicines to raise their game in the world market," says Tang.

To many self-purported systems biologists, several approaches are
needed to build a complete picture of a living organism and to
understand the effect of traditional Chinese medicine. Nevertheless,
systems biology has been a conspicuously hard field to define. Many
have used the term loosely, and pioneers in the field contend that the
technologies haven't been honed to the point that they could be used
for these approaches.

"It's conceivable that systems biology could find applications in
trying to sort out components in Chinese herbal medicine, but it's
very early days," says Leroy Hood, president of the Institute for
Systems Biology in Seattle, Washington, and regarded as the field's
founding father. "It would be an enormous challenge at this point and
time."

Systems biology has been successful in model organisms, according to
Hood, but is much less so in human studies. Many hurdles need to be
overcome before researchers could even begin to contemplate how to
deal with subjects as complex as traditional Chinese medicine. For
example, better detection systems are needed to measure metabolites,
especially proteins, accurately in the blood, and more powerful
computational and statistical tools are crucial for dealing with large
and complex data sets. "Those technologies are at early stages of
maturation," Hood says.

There are also broader concerns about the modernization of traditional
Chinese medicine, from both advocates and sceptics of the practice.
Some are uncomfortable with separating the study and development of
Chinese herbal medicines from the theories that underlie its normal
practice. "Traditional Chinese medicine is not just a medical system,
but a branch of philosophy and healing art that is an important part
of Chinese culture," says Fu Jing-hua, a retired researcher at the
Chinese Academy of Chinese Medicine Sciences in Beijing and president
of the Chinese Ancient Books Publishing House in Beijing. "Devoid of
that cultural context, it would become a tree without roots."
Lofty ideals

But Zhang and Fang Shi-min, a US-trained biochemist who now runs a
society called New Threads that is known for fighting pseudoscience
and research misconduct in China say that it is exactly those
traditional Chinese medicine theories that should be abolished.
Conceits such as yin and yang, wuxing and qi "are inaccurate
descriptions of the human body that verge on imagination", he says.

Inevitably, cultural factors may be the biggest obstacle in bridging
the East–West gap. "The field of traditional Chinese medicine is
notorious for being averse to criticism," says Yuan Zhong, a
philosopher of medicine at the Chinese Academy of Medical Sciences.
"If people are not allowed to disagree or voice their opinions, there
would be no hope of progress for any discipline."

But although heated exchanges are boiling over in debates on the
future of traditional Chinese medicine, it's business as usual in
Liu's practice. He is sanguine about the convergence between
traditional Chinese medicine and Western medicine, but has a pragmatic
attitude towards it. "Whether from the East or the West, we share the
same goal of improving human health. As long as it works, anything
goes," he remarks. But Liu says that he is yet to see any real
progress in the merging of the two philosophies and, until then, his
intuition and experience — as well as traditional Chinese medicine's
seemingly arcane theory and practice — will serve him and his
patients just fine.

See Editorial, page 106.

References

   1. Zhang, G.-Y. Med. Phil. 27, 14–17 (2006).
   2. Qiu, J. Nature 446, 590–591 (2007). | Article |
   3. Wang, M. et al. Phytother. Res. 19, 173–182 (2005). | Article |
PubMed | ChemPort |
   4. Wang, Y. et al. Planta Med. 70, 250–255 (2004).

以下的《自然》社論和上文登在同一期雜誌上,不知是譯者有選擇的刪掉了, 還是
版主忘了帖上?


Editorial

Nature 448, 105-106 (12 July 2007) | doi:10.1038/448106a; Published
online 11 July 2007

Hard to swallow
Is it possible to gauge the true potential of traditional Chinese
medicine?

Researchers, practitioners and drug companies around the world are
engaged in a complex, tentative dance over the best way to tap into
the unknown potential of traditional Chinese medicine. The scientific
community and the drug industry both tend to be sniffy about
'traditional' cures; yet there is a strong sense that millennia of
practice in China — much of it barely documented — is likely to have
yielded at least some treatments that work.

Pharmaceutical companies are understandably eager to enter a Chinese
domestic market that was estimated by the Boston Consulting Group to
be worth US$13 billion last year, and growing fast. But they are
tantalized by one opportunity above all: the prospect that the
nation's traditional medicine might contain a number of potentially
profitable compounds hidden somewhere in its arcane array of potions
and herbal mixtures.

The task of finding these elusive gems has been approached in a
typically reductionist manner, with researchers seeking single
compounds that might have a role in treating specific diseases.
Sometimes this has been successful: artemisinin, for example, which is
currently the most effective treatment for malaria, was fished out of
a herbal treatment for fevers. But such success stories have been few
and far between.

So if traditional Chinese medicine is so great, why hasn't the
qualitative study of its outcomes opened the door to a flood of cures?
The most obvious answer is that it actually has little to offer: it is
largely just pseudoscience, with no rational mechanism of action for
most of its therapies. Advocates respond by claiming that researchers
are missing aspects of the art, notably the interactions between
different ingredients in traditional therapies.

Nevertheless, the drug industry is not exactly awash with promising
new medicines at the moment. Perhaps as a result, the global
regulatory process has become increasingly receptive to traditional
approaches. In 2004, for example, the US Food and Drug Administration
issued new guidelines on botanical drugs that made it much easier to
get extracts into clinical trials if there was some history of prior
use, and that obviated the need to characterize all compounds in an
extract.

Some researchers in China and elsewhere, meanwhile, are advocating
systems biology — the study of the interactions between proteins,
genes, metabolites and components of cells or organisms — as a way to
assess the usefulness of traditional medicines (see page 126).
Constructive approaches to divining the potential usefulness of
traditional therapies are to be welcomed. But it seems problematic to
apply a brand new technique, largely untested in the clinic, to test
the veracity of traditional Chinese medicine, when the field is so
fraught with pseudoscience. In the meantime, claims made on behalf of
an uncharted body of knowledge should be treated with the customary
scepticism that is the bedrock of both science and medicine.


[ 本帖最後由 goodoctor 於 2007-8-6 00:10 編輯 ]
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goodoctor 發表於 2007-8-6 12:49 | 只看該作者
譯文:
「無論在中國在還是外國,主流醫學都十分重視基礎理論。中醫的理論是「氣」不通
則致病;「陰」「陽」需平衡;人體五臟和狀態則分為「金」,「木」,「水」,
「火」,「土」。」


原文:
The mainstream medical community, in China and abroad, has been highly
critical of the underlying theories. Traditional Chinese medicine is
based on ideas such as qi (meridian), in which illness is caused by
blocked energy channels; yin and yang, which emphasizes the balance of
energy; and wuxing (five elements), in which people's organs and
health status are categorized according to their 'elemental
characteristics': fire, wood, water, earth and metal.


這原文和翻譯有些差距吧?

[ 本帖最後由 goodoctor 於 2007-8-5 20:51 編輯 ]
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goodoctor 發表於 2007-8-6 13:05 | 只看該作者
原帖由 新鮮人 於 2007-8-5 15:35 發表
一個外國人,  能作出如此比較客觀的報道比某些偏激的中國人高明多了. 難能可貴.



「專科醫生」您難道不應該看看英文原文嗎?您的水平有限, 馬甲再多也沒用嘛!

[ 本帖最後由 goodoctor 於 2007-8-6 00:26 編輯 ]
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goodoctor 發表於 2007-8-6 16:04 | 只看該作者
原帖由 瘋瘋顛顛 於 2007-8-4 19:49 發表
本文可認為是一篇比較真實的新聞報道.



「本文可認為是一篇比較真實的新聞報道.」

您老醒醒吧! 《自然》雜誌上的文章是「新聞報道」?現在搞明白了中醫什麼事總
往新聞媒體上捅,原來是搞不清什麼是專業期刊,什麼是大眾媒體!

可笑, 這樣的人支持中醫,中醫不亡,難啊!
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goodoctor 發表於 2007-8-6 16:19 | 只看該作者
以下的《自然》社論和上文登在同一期雜誌上,不知是譯者有選擇的刪掉了, 還是
版主忘了帖上? 請看中文翻譯和英文原文:


《自然》社論:   

難以下咽:

有沒有可能評判中藥的真實潛力?   

全世界的研究者、從業者和醫藥公司在翩翩起舞,想要找到挖掘中藥的未知 潛力的
最佳方式。科學界和醫藥業界都傾向於對「傳統」療法嗤之以鼻;但是有 一種強烈
的感覺認為,在中國延續千年的醫療實踐──它的大部分缺乏記錄── 有可能至少
產生某些有效的療法。   

可以理解,醫藥公司渴望進入中國市場,波士頓顧問集團估計這個市場去年 價值130億
美元,並正在快速增長。但是最刺激他們的是這樣一種可能前景:該 國的傳統醫藥
中也許含有許多可能贏利的化合物,隱藏在一堆神秘的藥劑和草藥 混合物之中的某
處。

要發現這些隱藏的寶物,通常採用的是還原論的方法,即研究者去尋找也許 會對治
療特定的疾病起作用的單個化合物。這種方法有時能獲得成功:例如,目 前用來治
療瘧疾最有效的藥物青蒿素就是從一種用來治療發燒的草藥中提取出來 的。但是這
種成功的故事非常稀少。
  

那麼,如果中醫藥是那麼偉大的話,為什麼對其結果的定性研究沒有為眾多 治療打
開方便之門呢?最明顯的答案是,它實際上沒有多少可提供的:它基本上 不過是偽
科學,它的大多數療法沒有合理的機制
中醫擁護者反駁說,研究者沒 有掌握其奧
妙,特別是傳統療法中不同成分之間的相互作用。   

不過,醫藥產業在現在並沒有充斥著有希望的新葯。也許由於這個原因,全 世界的
管理機構對傳統的方法越來越接受。例如,在2004年,美國食品藥品管理 局發布有
關草藥的新規章,如果一種草藥以前被用過的話,就很容易讓其提取物 進入臨床試
驗,而且無需鑒定提取物中的所有成分。   

同時,中國和其他地方的一些研究者正在提倡系統生物學──研究蛋白質、 基因、
代謝物和細胞或有機體其他組分的相互關係的學科──做為評定傳統醫藥 的用途的
一種方法。我們歡迎那些建設性的方法用以預測傳統傳統療法的可能用 途。但是,
要把一種基本上還未經過臨床檢驗的全新技術,用來檢驗充斥著偽科 學的中醫藥的
準確性,看來是很成問題的。而且,對那些依據一個模糊不清的知 識體系所做出的
宣稱,應該按慣例抱著懷疑態度,這對科學和醫學來說都是基本 原則。

(方舟子譯)

Editorial

Nature 448, 105-106 (12 July 2007) | doi:10.1038/448106a; Published
online 11 July 2007

Hard to swallow
Is it possible to gauge the true potential of traditional Chinese
medicine?

Researchers, practitioners and drug companies around the world are
engaged in a complex, tentative dance over the best way to tap into
the unknown potential of traditional Chinese medicine. The scientific
community and the drug industry both tend to be sniffy about
'traditional' cures; yet there is a strong sense that millennia of
practice in China ─ much of it barely documented ─ is likely to have 
yielded at least some treatments that work.

Pharmaceutical companies are understandably eager to enter a Chinese
domestic market that was estimated by the Boston Consulting Group to
be worth US$13 billion last year, and growing fast. But they are
tantalized by one opportunity above all: the prospect that the
nation's traditional medicine might contain a number of potentially
profitable compounds hidden somewhere in its arcane array of potions
and herbal mixtures.

The task of finding these elusive gems has been approached in a
typically reductionist manner, with researchers seeking single
compounds that might have a role in treating specific diseases.
Sometimes this has been successful: artemisinin, for example, which is
currently the most effective treatment for malaria, was fished out of
a herbal treatment for fevers. But such success stories have been few
and far between.

So if traditional Chinese medicine is so great, why hasn't the
qualitative study of its outcomes opened the door to a flood of cures?
The most obvious answer is that it actually has little to offer: it is
largely just pseudoscience, with no rational mechanism of action for
most of its therapies.
Advocates respond by claiming that researchers
are missing aspects of the art, notably the interactions between
different ingredients in traditional therapies.

Nevertheless, the drug industry is not exactly awash with promising
new medicines at the moment. Perhaps as a result, the global
regulatory process has become increasingly receptive to traditional
approaches. In 2004, for example, the US Food and Drug Administration
issued new guidelines on botanical drugs that made it much easier to
get extracts into clinical trials if there was some history of prior
use, and that obviated the need to characterize all compounds in an
extract.

Some researchers in China and elsewhere, meanwhile, are advocating
systems biology ─ the study of the interactions between proteins,
genes, metabolites and components of cells or organisms ─ as a way to
assess the usefulness of traditional medicines (see page 126).
Constructive approaches to divining the potential usefulness of
traditional therapies are to be welcomed. But it seems problematic to
apply a brand new technique, largely untested in the clinic, to test
the veracity of traditional Chinese medicine, when the field is so
fraught with pseudoscience. In the meantime, claims made on behalf of
an uncharted body of knowledge should be treated with the customary
scepticism that is the bedrock of both science and medicine
.

[ 本帖最後由 goodoctor 於 2007-8-6 00:20 編輯 ]
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goodoctor 發表於 2007-8-7 01:59 | 只看該作者
"對那些依據一個模糊不清的知識體系所做出的宣稱,應該按慣例抱著懷疑態度,這對科學和醫學來說都是基本原則。"
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goodoctor 發表於 2007-8-7 02:12 | 只看該作者
對世界上最著名的科學期刊上的文章作如此的刪改,原因是什麼?是英語水平的
問題還是道德問題?靠這種騙術,救的了中醫嗎?
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新鮮人 發表於 2007-8-7 05:33 | 只看該作者
原帖由 goodoctor 於 2007-8-6 16:04 發表

「本文可認為是一篇比較真實的新聞報道.」

您老醒醒吧! 《自然》雜誌上的文章是「新聞報道」?現在搞明白了中醫什麼事總
往新聞媒體上捅,原來是搞不清什麼是專業期刊,什麼是大眾媒體!

可笑, 這 ...


請看Nature本期目錄   http://www.nature.com/nature/index.html
Volume 448 Number 7153 pp511-622
In this issue (2 August 2007)
Editorials
Research Highlights
News
Column
Business
News Features
Correspondence
Books and ArtsVolume 448 Number 7153 pp511-622
News and Views
News and Views Q&A
Articles
Letters
Naturejobs
Futures

goodoctor..你不感到造謠可恥也可鄙嗎?

[ 本帖最後由 新鮮人 於 2007-8-7 06:04 編輯 ]
知之為知之,不知為不知,是知也

海納百川,  有容乃大
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小辣辣 發表於 2007-8-7 07:01 | 只看該作者
原帖由 新鮮人 於 2007-8-7 05:33 發表


請看Nature本期目錄   http://www.nature.com/nature/index.html
Volume 448 Number 7153 pp511-622
In this issue (2 August 2007)
Editorials
Research Highlights
News
Column
Business
News Fe ...


同一篇文章,   請看方舟子是如何篹改本文的.  
他利用專欄作家珍尼.Qiu1女士在專題報道《Traditional medicine: A culture in the balance》引用方的觀點(一段話),再由方自己「翻譯」成與原文出入不小的文章。這種目的性特別明顯的炒作,決不是一個「學者」的嚴謹作風!要看原文(中英文), 請進下網址.
http://club.backchina.com/main/v ... &extra=page%3D1

不知是他的英文不好呢還是別有用心?

[ 本帖最後由 小辣辣 於 2007-8-7 08:52 編輯 ]
精衛銜微木,將以填滄海
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goodoctor 發表於 2007-8-7 08:58 | 只看該作者

回復 #11 新鮮人 的帖子

這裡的News是「新聞報道"的意思嗎?

[ 本帖最後由 goodoctor 於 2007-8-6 17:01 編輯 ]
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新鮮人 發表於 2007-8-7 09:01 | 只看該作者
原帖由 goodoctor 於 2007-8-7 08:58 發表
這裡的News是「新聞報道"的意思嗎?


你說是什麼意思?
知之為知之,不知為不知,是知也

海納百川,  有容乃大
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goodoctor 發表於 2007-8-7 09:05 | 只看該作者
原帖由 小辣辣 於 2007-8-6 15:01 發表


同一篇文章,   請看方舟子是如何篹改本文的.  
他利用專欄作家珍尼.Qiu1女士在專題報道《Traditional medicine: A culture in the balance》引用方的觀點(一段話),再由方自己「翻譯」成與原文出入不小的 ...



Agree, please read complete original articles! Also, it will be better to read all relevant articles, not just the one you like.
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