Chapter 274 Evidence-Based
“What I want is to use rational, quantifiable, standard, and evidence-based methods to optimize medicine.
Ling medical skills, from experience to rationality.
is evidence-based. "
Li Ang said: "Traditional dialectical treatment is based on personal experience, so there will be chaos such as rampant quack doctors, good doctors are difficult to drive out quack doctors, and the industry is difficult to purify itself.
The public says that the public is right, and the mother-in-law says that the mother-in-law is right.
Some effective treatments are shelved because they are not known to the public.
Some ineffective or even harmful treatments, such as cutting stock and feeding relatives,
is widely spread and used for a long time, which will have a bad and long-term impact.
With evidence-based medicine, it's different.
Follow, follow. Evidence, evidence.
Take malaria as an example. It is said that malaria is caused by external evils. So what is exogenous evil?
Which one of wind, cold, heat, dampness, dryness, and fire?
If you throw people into a windy day, will you get malaria?
Will you get malaria if you dry people out in the summer?
Will you get malaria if you take off your clothes and throw them on the ice?
The answer is obviously no. "
Li Ang shook his head, "Doctor Qiu Jing, it should have been mentioned in the Imperial Medical Office, the experience of Chang'an's malaria prevention at that time.
They didn't take my advice from the start,
Instead, according to my method, I found a lot of evidence.
For example, we asked people from door to door, and found that people living in low-lying areas with dense mosquitoes have a higher overall probability of suffering from malaria than people living in highlands.
People who hang mosquito nets at home have a lower probability of suffering from malaria;
Such evidence has been found one after another,
After that, stagnant water was cleaned up, canals were closed, fish were raised in canals, larvae were actively eliminated, and mosquito nets were hung in every household.
After some targeted measures were implemented, the incidence of malaria in Chang'an that year dropped significantly.
Therefore, it can be said that malaria is related to mosquito bites.
Mosquito bites are the culprit of malaria, not factors such as wind, cold and heat.
Now, with microscopes and filament detection, we can go one step further and find more evidence.
For example, the cause of malaria is further locked into the malaria parasite in mosquitoes.
Layer by layer, constantly looking for evidence, classifying all evidence according to their strength and reliability,
Like doing a math problem, narrow down the range of the final answer.
This is evidence-based.
Who can say that this lack of the eight principles of syndrome differentiation is not rational and does not conform to medical theory? "
“.”
Qiu Feng frowned, faintly feeling that something was wrong, but he didn't know where to refute.
Li Ang smiled slightly when he saw this, not worried that Qiu Feng would not understand. The charm of evidence-based medicine lies in rationality, and she is also a disciple of the academy.
"Moreover, evidence-based medicine can also be falsified and self-clearing."
Leon added: "If someone suspects that malaria is not caused by mosquitoes, he can conduct reasonable experiments,
For example, put people together with a group of mosquitoes whose mouthparts have been pulled out, and observe whether the subjects respond.
Give people the sound of mosquitoes flying, but not be bitten by mosquitoes.
Or to test the efficacy of artesunate,
Give three groups of people with roughly similar physical conditions and take three kinds of medicines,
Artesunate, antimony potassium tartrate, and saline as a placebo,
Neither the physician nor the patient knows what drug the patient is taking,
Finally, long-term observation of the patient's survival rate, quality of life, etc.,
In this way, it can be concluded whether artesunate is useful or invalid.
And so on, after long-term and extensive verification, a complete set of data evidence can be obtained.
Physicians can use the most effective treatment method in theory based on past medical records, combined with their own experience and specific conditions of patients.
Some are evidence-based and can be repeated, generalized, and tested.
I am confident that the effect of evidence-based medicine based on anatomy and pathology is no less than that of medicine based on syndrome differentiation and treatment. "
Li Ang put his hand on the book of physical diagnostics and said seriously.
Qiu Feng frowned deeply: "Even if it goes against the existing medical theory?"
Li Ang said: "The doctor added a hundred poisons, and the fumigation did not stop.
The moxibustion master applies moxa cones, which is as cool as hunting fire.
If you hold a wormwood candle and pretend to be a ghost, you can cure malaria 100%, or at least with a high probability,
Then no matter how confused I am, I will think that there is something I don't understand yet, and try to analyze and understand it until I understand what's going on.
Instead of talking a lot about malaria like before, I still couldn’t find the cause and explain the process. "
“.”
Qiu Feng finally understood Li Ang's purpose, took a deep breath, and said in shock, "Risheng, you want to rebuild medicine?"
"Should say, push."
Li Ang corrected: "Evidence-based is more rational dialectics.
It is established under a set of quantifiable standards, and it is the product of the development of Neo Confucianism and society to a certain stage.
Without microscopy, without statistics, without a general acceptance of rationality, evidence-based in any case would not have been possible.
Like a person, can it be said that the eighteen-year-old him is not the same as the eight-year-old him? "
"You are sophistry."
Both are disciples of Neo Confucianism, Qiu Feng immediately reacted, "After distributing this set of textbooks, will there be medical students in the Imperial Medical Office who understand the eight principles of syndrome differentiation after decades?"
"After decades of effort, the world should be able to see the general picture of a thing."
Li Ang smiled and said: "Do you still remember our practice in the ward? A large number of cases were accumulated, and the patient's identity information, disease history, medication process, etc.
All records are on paper documents, with evidence to follow.
We can test it with practice.
In long-term practice, accumulate data, test the efficiency and practicability of the two methods, and compare the advantages and disadvantages of the two methods.
Medical students, those who are willing to learn the original textbooks should learn, and those who are willing to learn evidence-based studies should learn evidence-based.
The more the truth is debated, the clearer it becomes, and the more it is practiced, the clearer it becomes.
And I have enough patience and time to see the results appear.
Finally remove the chaff and keep the essence of medicine, and eliminate the turbid and clear. "
"Do an experiment for decades."
Qiu Feng was shocked by Li Ang's ambition and grand plan,
The expansion of wards in various places can be said to have laid the foundation for practice and data collection.
Seven or eight hundred states and counties, with a population of 40 million, are all part of Li Ang's plan.
Did he think about such a day when he took out allicin?
She stared at the familiar yet unfamiliar young man in front of her again, and slowly said: "Risheng, have you ever thought that with your current fame and status, you have already agreed with the Imperial Medical Office.
After decades, who can compete with you? "
"You."
Li Ang smiled and said: "You and I invented the Niansi surgery together, and you and I witnessed the whole story of Suzhou water poisoning together.
The debate between you and me today is all about how to better cure diseases and save lives. Opinion from the portal only accounts for a small part of it.
I believe in your medical skills, medical ethics, and your recognition of reason and truth.
The world is yours and mine,
But in the end, it is still the people of the future, our children and grandchildren. "
"!"
Qiu Feng's face quickly flushed red at a speed visible to the naked eye, and he stammered: "What nonsense are you talking about, what about future generations."
"Uh, I mean the descendants of all mankind, not you and me"
Li Ang also realized that his words were inappropriate the moment he finished speaking, his expression froze, and he quickly waved his hands to make up for it: "Sorry, I didn't turn the corner for a while, mine, mine."
"snort."
Seeing him like this, Qiu Feng was even more ashamed and annoyed, picked up the physical diagnostics on the table, and said with a stern face: "I'll go back first, I haven't finished reading your book yet.
After a while, the Tai Medical Department will expand its enrollment, and you must show up.
If you want to promote some evidence-based medicine, you can’t do it without being present. "
"must."
Li Ang breathed a sigh of relief, glanced at Qiu Feng's reddish face, "Shall I see you off?"
"Um."
Under Chai Chai's puzzled and curious eyes, the two pushed open the study door and walked through the courtyard dully.
Li Ang stood by the door, thinking about what to say as a farewell. Qiu Feng also held the book and slowed down.
"See you at the academy tomorrow"
Before the words fell, the courtyard door was knocked heavily, and anxious Chang'an official dialect with a slight Turkic accent came from outside the door.
"Is it Mr. Li Xiaolang? I'm Astor Tumen."
(end of this chapter)