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替代医学

维基百科，自由的百科全书
（重定向自另類療法）
维基百科中的醫學内容仅供参考，並不能視作專業意見。如需獲取醫療幫助或意見，请咨询专业人士。詳見醫學聲明。
替代醫學
MeSHD000529
替代医学
总览
常见疗法和理论
阴谋论
NCCIH分類（英语：Alternative_medicine#NCCIH_classification）
传统医学

替代醫學，也称另类医学、边缘医学（英語：alternative medicine、 fringe medicine、pseudomedicine或questionable medicine，）指任何声称产生医疗效果，但并非源於科學方法及實證醫學收集证据的医疗实践[n 1][n 2][n 3]。替代医学不是實證醫學的一部分，也不會歸入作生物醫學[n 1][n 4][n 5][n 6]，由于其疗效宣稱與科學共識、醫學共識、及已確立的科學定律矛盾，所以它们通常是被证明无效的、未经证明的，或者无法证明的[7][8][9]。

由於實證醫學要求嚴格的醫學證據，不能只靠基本的科學原理推論、也不能只靠細胞實驗、動物實驗、病例報告及專家意見，還要有良好的臨床證據及雙盲隨機對照實驗研究下的綜合分析結果。

替代医学往往沒有足夠的人體實驗或臨床實證，或沒有乎合科學及生物學的醫療方式。替代醫包括各種衛生保健實踐、保健產品和療法，其在生物學角度上令人覺得貌似是合理的，但不是經過充分測試、與證據和科學矛盾，甚至是對人體有害或有毒。

部分替代有療效並聲稱沒有副作用，但實際副作用及醫療風險往往比正規醫學更多[n 4][7][9][10][11][12] 。替代醫學的例子包括順勢療法、自然療法、脊椎按摩療法、能量醫學、各種形式的針灸、中國傳統醫學、阿育吠陀醫學、柔道整復術（英语：Sekkotsu）、信仰療法、人體冷凍技術等。[13][14][15][16][17]。检测替代醫學疗效的費用龐大，美國政府曾花费高达25億美元来测试各类替代医学。然而与虛假治療（即使用安慰劑）相比，幾乎沒有一種替代疗法能表現出更佳的疗效[18][19]。

另类医学是與常規醫學治療併用的替代醫學，是一種使用它可以「補充」治療（提高療效）的「信念」，但其沒有得到科學方法證實[n 7][2][21][22]。CAM是補充和替代醫學（英語：complementary and alternative medicine）的英語縮寫[23][24]。整合医学是指替代醫學和實證醫學的結合[25]。

另類醫學診斷和治療不包括在醫學院講授的、以科學及以臨床證據為基礎的治療。替代療法缺乏科學的驗證，及其效果沒有被證明或被科學否定（英语：Scientific evidence）[n 8][7][2][3][27]。另類療法通常是建基於偽科學、古老及過時的哲學、錯誤的推理、純科學推論但沒有經過嚴格的臨床實驗、沒有經過足夠測試的醫療方法、已被推翻的醫療方式、商業宣傳和欺詐、甚至迷信，也有一些是建基於宗教、傳統、信仰、玄學、信念、超自然力量[7][8][9][2]。每一个國家對替代醫學和醫療服務提供者的監管和許可都不盡相同。

替代醫學受到科學界的批評通常為使用誤導性陳述、庸醫、胡說八道、偽科學、反科學、欺詐和使用蹩脚的科學方法。对替代醫學的推廣亦被指責为危險和不道德的[n 9][29]。对没有科学依据的替代醫學进行檢測也被指責浪費稀缺的醫療研究資源[30][31]。批評者說：「真的沒有像替代醫學一樣的東西，只是替代醫學支持者認為是可行的，但常規醫學則不同意[32]」「能否有合理的『替代』[醫學基於證據]？[33]」

定義和用語

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「替代醫學」的一個概括定義是一組產品、實踐以及理論，其使用者認為或感覺具有醫學上的治療效果[n 2][n 4]，但其有效性尚未採用科學方法確定[n 3][7][9][26][27]，其理論和實踐並不是生物醫學的一部分[n 4][n 1][n 5][n 6]，或其理論和實踐與科學證據或在生物醫學中使用的科學原理矛盾[7][8][9]。「生物醫學」是醫學的一部分，其應用生物學、生理學、分子生物學、生物物理學和其他自然科學的原理去臨床實踐，並採用科學的方法來確立實踐的有效性。替代醫學是多樣化的醫療保健系統、實踐和產品，其建立於生物醫學之外[n 1]，不被視為生物醫學的一部分[13][34]，沒有被生物醫學的專業 人員廣泛使用[35] ，並且不會在生物醫學的實踐技能中教授[35]。不同於生物醫學[n 1]，替代醫學的產品或實踐不從科學或科學方法確立，而是建基於名人證言、宗教、傳統、迷信、信仰、理念、超自然力量、偽科學、錯誤的推理、宣傳、欺詐，或其他非科學來源[n 3][7][9][2]。用語「替代醫學」是指各種各樣的相關和不相關的產品，實踐和理論，起源於不同來源、文化、理論和信念體系，實踐從生物學角度上而言是似是而非的，產品和實踐由基於一些證據至與基礎科學和明確證據矛盾，及其產品已被證明是無效的，甚至有毒有害的[n 4][10][11]。

「替代醫學」、「補充醫學」、「整體醫學」、「自然醫學」、「非正統醫學」、「邊緣醫學」、「非常規醫學」和「新時代醫學」在某些情況下可以互換使用並具有相同的含義（同義詞）[36][37][38]，但可能在其他情況下有不同的含義，例如，非正統醫學可以指不同於經常實踐的生物醫學、邊緣醫學也可能是指基於科學邊緣的生物醫學，其可能有科學根據，但不是主流。

替代醫學中的「替代」一詞的意義，並不在於它是否能實際有效地代替醫藥科學，儘管一些替代醫學的宣傳可能使用較寬鬆的術語定義去令人覺得医程有效的樣子[7]。馬希雅·安吉爾指出，「替代醫學」是「萬金油的一個新代名詞，它既可行又不可行[39]。」使用較寬鬆的用語也被用來暗指一個對立的存在(但它不是)，如「西方醫學」和「東方醫學」這倆用語暗指所不同的是亞洲東部和歐洲西部之間的文化差異，而不是實證醫學和不可行的治療之間的差異[7]。

「補充醫學」是指與常規醫學治療併用的替代醫學，有人相信它能增加建基於科学的医学的有效性[40][41][42]。“補充醫學”的一個例子是針灸的利用，再加上採用科學為基礎的醫學，相信針灸能增加或「補充」建基於科學的醫學的有效性[42]。CAM是補充和替代醫學(complementary and alternative medicine)的英語縮寫[23][24]

「整合醫學」這个用語有兩種意思，一種用法是指基於科學的醫學能與不基於科學的醫學「一體化」的一種信念；另一用法僅指一些具有科學論證其療效的替代醫學治療與常規治療的相結合，在這種情況下，它是與「補充和替代醫學」相同[25]。「整體醫學」（或整體健康）是一種替代醫學實踐，聲稱治療的是「全人」，而不僅僅是疾病本身。

「傳統醫學」和「民俗醫學」指的是各地文化社會在近代科学以前發展起來的實踐，「東方醫學」通常是指在近代科学以前發展的亞洲傳統醫學。「西方医学」指的是現代的實踐，通常是指醫學科學，而不是指西方的替代醫學（歐洲和美洲）。「西方醫學」、「生物醫學」、「主流醫學」、「醫學科學」、「基於科學的醫學」、「實證醫學」、「常規醫學」、「標準醫學」、「正統醫學」、「對抗性醫學」、「佔主導地位的衛生系統」以及「醫學」，當與替代醫學對比時可互換使用並具有相同的含義。但可能在其他情況下有不同的含義，例如，在醫學科學有些實踐沒有被嚴格的科學測試支持，所以「醫學科學」不是與「基於科學的醫學」嚴格相同、當與其他較少用或更少推薦使用的生物醫學作對比時，「標準醫療服務」可指代「最佳實踐」[n 10][1][45] 。

定義問題

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科學界[32][46]和生物醫學界[3] 中的傑出人士宣稱把傳統醫學從替代医學分開的定義是沒有意義的，及「常規醫學」、「替代醫學」、「補充醫學」、「整合医学」以及「整體醫學」這些術語並沒有意義，不能具體描述任何事物[3][32][46][47]。他們試圖批評這種虛假的定義，包括：「沒有常規醫學/替代醫學/互補醫學/綜合醫學/整體醫學這樣的事物，只有可行或不可行的醫學[3][32][46]。」；「根據定義，替代醫學要么沒有被證明其可行性，要么被證明不可行，你知道他們稱已經證明可行的替代醫學为什麼？他們就稱『可行的替代醫學』為醫學[48]。」；「不可能有兩種醫學 ——常規醫學和替代醫學，只有目前已被充分測試的醫學和沒被充分測試的醫學、可行的醫學和可能可行/不可行的醫學。一旦療法已經過嚴格測試，不管療法在當初被認為替代醫學與否也無關緊要。如果它被認为是安全和有效的，它就會被接受[3]。」、「替代醫學並不存在，只有經過科學證明及实體數據支持的實證醫學或科學證據不足並未經證實的醫學[47]。」

生物醫學以及補充和替代醫學團體中的一些人指出，「補充和替代醫學」無法準確定義，它所包括的理論和實踐多元化，而且「補充和替代醫學」和生物醫學之間的界限重疊，並且在變化[1][49]。「補充和替代醫學」這个用語不能使用簡單的定義來界定，因為它的衛生系統和實踐模糊，及其界限定義不清[10][50][n 11]。它們的歷史淵源、理論基礎、診斷技術、治療實踐和它們與主流醫學的關係可能會有所不同[52]。像中國傳統醫學和阿育吠陀般的替代療法，源於古代東亞或南亞[53]；像順勢療法、脊骨神經醫學般的替代療法則源於十八至十九世紀的歐洲或美國；一些替代療法，如冥想和祈禱，是基於身心的干預療法[54]。在一處地方被認為是替代的療法，在另一處地方可被認為是常規療法[55]。因此，脊骨神經醫學在丹麥不被認為是替代療法，同樣脊骨神經醫學不再在美國視為替代療法[55]。

不同類型的定義

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眾多替代醫學的定義的一個共通點是其定性为正規醫學以外[56]。例如由美國國立衛生研究院國家補充與替代醫學中心（英语：National Center for Complementary and Integrative Health）所制定及被廣泛引用[57]的描述性定義。稱它为「一組多樣化的醫療衛生保健系統、实践和產品未被普遍認為是常規醫學的一部分[13]。」對於常規醫學的醫務人員而言，這並不一定意味著替代醫學或它的從業者將不再被視為另類[n 12]。

一些定義從社會和政治邊緣化的角度來定義替代醫學[60]。這指的是替代療法缺乏獲得來自醫療機構和相關機構在研究經費、醫學文獻及納入標準醫學課程上的支持[60]。

分類與類型

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替代醫學包括一系列的衛生保健實踐、產品和療法。共同特徵是自稱能醫治患者，但其方法不是基於科學。替代醫學的根基和實踐方法十分多樣[13] ，並可能基於其文化淵源或信念類型而区分[7][8][13][2]。實踐方法可能包含或基於特定的文化、民間知識、迷信[61]、靈性信仰、超自然力量（反科學）、偽科學、錯誤的推理、宣傳、欺詐、關於健康與疾病的不同概念等沒通過科學方法證明的依據[7][8][9][2]。不同的民族有自己獨特的傳統或信仰，根據幾千年的發展，去不完全實踐/完整地實踐替代醫學。

不科學的體系

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替代醫學的體系可能基於不符合科學的事實，如顺势疗法[13]。

順勢療法

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順勢療法是一種疗法，基於如某物質能在健康的人身上，引起病人患某病時的病症，將此物質稀釋震盪處理後就能治療該病症的信念[n 13]。它是在人类擁有原子和分子的知識之前發展的，基礎化學表明順勢療法中的反复稀釋只会產生水，其在科學亦為不合理[63][64][65][66]。

尿療法

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尿療法是通過飲用尿液來達到治療疾病的目的，同時亦有採用尿液清洗皮膚、清洗毛髮的做法。医学专家表示尿疗法是无稽之谈。喝尿治病则无法实现临床验证，是没有任何科学根据的。尿液中主要成分是水，身体健康的人喝下自己的尿，一般不会对身体产生太大副作用，但是如果身体有严重疾病，服用药物过后，毒素可能通过尿液排出来，这种尿液就很可能对人体造成危害。虽然目前没有研究结果，但这些本已排出体外的代谢废物重新被吸收，对人体健康肯定没有益处。也有专家认为，那些自称喝尿治好病的，不排除存在心理暗示作用的可能。[67]

缺乏臨床證據支持的醫療體系

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替代醫學的體系很多都缺乏嚴謹的臨床實證，或未能通過臨床試驗，如自然醫學。

自然療法

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自然醫學把人體視為一個整體，相信人體存在生命力，有一定程度自癒的能力。它希望能利用自然界存在的物質和人的主觀能動性來預防和治療疾病，鼓勵人們或病患盡可能減少外科手術與服用化學藥物，使用自然、不具侵犯的治療方式，來改善病況、促進痊癒及保持健康。有些自然療法的學說是建基於一種與實證醫學衝突的觀點——認為身體能使用一種超自然的生命能量引導身體自癒[68][69]。許多自然療法支持者都反對接種疫苗[70]，且「科學證據並不支持自然療法支持者能治愈癌症或其他疾病的宣稱[71]。」

基於生物的療法

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一種雖然是基於生物學推理，但不是基於實證醫學的療法，或不乎合實證醫學的要求的療法。例如食療、服用膳食補充品等。[72][73]

超劑量維他命療法

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主条目：超劑量維他命療法

超劑量維他命療法，是一種以服食超過建議劑量的維他命的療法，目前沒有證據證明此療法有效，但此療法可能會引起一些副作用。[74][75][76]

民族傳統體系

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替代醫學的體系可能基於傳統醫學的做法實踐，如中國傳統醫學、印度傳統醫學或各地的文化實踐[13]。

中國傳統醫學

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現成中藥合劑

中國傳統醫學是幾千年來中國的傳統習俗和信仰的結合發展。常見的實踐包括中草藥、針灸（把針插進體內特定穴位或經絡）、推拿、氣功、祝由和食療。基是基於稱為「氣」的超自然力量的信念、占星術和命理。中國傳統亦会使用草藥等物質，並認为舌苔具备反映了身體變化的功能，其解剖模型和內臟器官的生理功能亦是不正確[7][77][78][79][80][81]。

中國共產黨創始人之一毛澤東为響應当時缺乏現代醫學從業者，復興針灸並改寫其理論，為拥护其政治、經濟及中國人口的醫療需求的必需品[82][页码请求]。在20世紀50年代，中國傳統醫學的「歷史」和理論在毛澤東的堅持下被改寫以宣傳共產主義，糾正所謂的「資產階級思想」-西医[83]。針灸在1972年美國時任總統理查德·尼克松訪問中國時受到關注，該代表團遭展示一項大手術，被施手術者在完全清醒時被施行手術並在表面看來只在接受針灸，而不是麻醉。後來人們發現，選用於外科手術的患者既具有較高的疼痛耐受性（英语：Pain tolerance），又受到強烈的思想灌輸。這些展示病例也經常暗中打點滴嗎啡而觀者只被告知注射液只含有液體和營養成分[77] 。文獻回顧發現，針灸在廣泛的情況下都不是有效的[84]。回顧眾多的系統評價，發現對於減輕疼痛而言，真針灸並沒有比假針灸的效果更佳[85]。但是，其他回顧發現，針灸能成功地減輕慢性疼痛，其中假針灸並沒有發現比安慰劑及無針刺組的效果更佳[86] 。

阿育吠陀醫學

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阿育吠陀是印度的傳統醫學。阿育吠陀相信三種能量元素（Vata、Pitta、Kapha）的存在，並相信三種能量元素的平衡会使人健康，反之疾病是三種元素失衡的結果[87]。能量元素失衡時，会使用傳統草藥、礦物質和重金屬進行調整和回復平衡。阿育吠陀強調使用以植物為基礎的藥物進行治療[88]，有時会用一些動物製品，並添加像般硫、砷、鉛、硫酸銅的礦物質[89]。

阿育吠陀已引起人們對其安全問題的關注，有兩項美國研究發現约20％印度製造的阿育吠陀專利藥物的重金屬水平(如鉛、汞和砷)能使人中毒。其他問題包括使用含有毒化合物的草藥和缺乏對阿育吠陀設備的監管。在美國，部分的重金屬中毒事件已被歸因於使用這些化合物[90][91][11][92][93][94]。

  • 印度阿育吠陀醫學包括心靈的靈性平衡會影響疾病的信念
    印度阿育吠陀醫學包括心靈的靈性平衡會影響疾病的信念

民間療法

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民間療法，大部份是一些沒有精密科學依據，但又在民間傳說中，號稱具有特定成效的治病方式。又稱偏方。民間療法的一個特色是只能問相信不相信，但不能證明真實不真實 [95]。

超自然力量和對物理上能量的誤解

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替代醫學的體系可能基於相信物理科學尚未檢測到的超自然能量的存在，如生物场。或相信的能量的性質與物理定律不符，如能量醫學[13]。

針灸以在體內插入針的方式來治療

生物场

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生物场（英语：Energy (esotericism)）治療的目的是令它所聲稱的能量場包圍及滲入身體[13]。天體物理學家和科學懷疑論倡導者卡爾·薩根(1934-1996)指出缺乏經驗證據支持療法的前提——能量場的存在[96]。

能量醫學

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磁療是一種基於生物電磁學（英语：Bioelectromagnetics）的療法，使用可檢驗的電磁場，如脈衝場、交流電或非常規的直流電[13]，磁療聲稱不主張超自然能量的存在，但認为利用磁力或磁場可以違反物理定律地治療疾病。在磁療使用的磁場強度太低，不足以實現任何生理上的變化，且所用的方法沒有科學有效性[97][98][99]。

針灸是中國傳統醫學的一個組成部分，在針灸，人們認為被稱為「氣」的超自然能量流經宇宙和身體，並有助於推動血氣，其一旦堵塞会導致疾病的發生[78]。支持者認為能通過計算星象,以確定在身體哪些部位插入針，以恢復處於阻塞狀態的血氣流動，從而治療疾病[78]。但「氣」從未被直接觀測到，並與科學中使用的能量概念毫無關係[100][101][102]。

在日本的靈氣療法，其相信科學未知且迄今無法檢測的宇宙能量（靈氣）的存在，從業者可以學習利用自己的雙手來操縱靈氣[103]，並把能量傳輸到受者使受者身體回覆平衡。跟針灸一樣，氣從未被直接觀測到[104][105]。

全人健康和心身醫學

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心身醫學（英语：Mind–body interventions）以探索的身心靈之間的聯繫來維持人的健康。它的前提是心靈會影響「身體機能和症狀」[13]。心身醫學包括用於治療的瑜伽（英语：Yoga as exercise or alternative medicine）、冥想、深呼吸运动、引導想象法（英语：Guided imagery）、催眠療法、漸進式肌肉放松法（英语：Progressive muscle relaxation）、氣功以及太極拳[13]。

瑜伽，是傳統印度教中練習方法的延伸和冥想，也可以歸類為能量醫學的一種，因其治療效果被支持者認為是由於通過呼吸吸收「生命能量」到體內治療所致，並因此被認為能治好多種疾病和主訴[106]。

90年代以來，太極班在美國的醫院、診所以及社區和老人中心變得流行。這是由於嬰兒潮那一代人口老化和太極是老年人的低強度锻練方法，令其名声逐漸為人所知[107][108]。練太極的主要目的出現一些分歧，有些人練太極的主要目的是用以自衛；有些人練太極是因為它的美感；有些則對它的身體和精神的益處更感興趣。

氣功，是以呼吸的調整、身體活動的調整和意識的調整以加强健康的一種实踐，紮根於中國的傳統醫學、哲學和武術。氣功是傳統上被視為養氣和調息(氣)(或稱為「生命能量」)的一種實踐[109]。

草藥和其他物質的使用

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基於利用在自然界中發現的物質的實踐，如草藥、食品、非補充維生素和大劑量維他命、動物和真菌的副產品以及礦物質，包括傳統醫療實踐中所使用的，也可能包括其他實踐方法[13][19][110]，例子包括宣稱帶治療效果的非維生素補充劑（魚油、Ω-3脂肪酸、葡糖胺、松果菊、亞麻子油（英语：Linseed oil）以及人參）[111]，草藥醫學或植物療法不僅包括植物產品，也可以包括動物和礦物產品[19]。它是替代醫學商業上最成功的分支之一，包括出售時被稱為「營養補充劑」的片劑、粉劑和酏劑[19]。只有非常小的百分比顯示出它們有任何療效，並且缺乏法規監管其安全性及其療效水平[19]。其中可能包括任何已知的有毒物質，如部份中藥材所含的鉛毒[111]。

  • 傳統西班牙市場出售的草藥
    傳統西班牙市場出售的草藥
  • 馬達加斯加傳統醫學
    馬達加斯加傳統醫學
  • 中國傳統醫學中使用的各種植物和動物部份
    中國傳統醫學中使用的各種植物和動物部份

手技療法

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手技療法和其他以身體為主的實踐，特點为身體部份的控制或移動，如體肌療法（英语：Bodywork (alternative medicine)）及脊椎矯正療法。

骨科手法醫學（英语：Osteopathic manipulative medicine）是一組與主流醫學區分的整骨和骨療技術[112]。

宗教、信仰療法和祈禱

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基於宗教的治療實踐，如祈禱、基督教信仰療法中的手禮以及薩滿教，依托於神或心靈能干預治療的信念。

薩滿教是世界各地許多文化的實踐，其中實踐者達到意識改變狀態（英语：Altered state of consciousness），此狀態作为一个渠道，與靈界互動或引導超自然能量为患者治療[113]。

  • 基督教信仰療法中的手禮、祈禱治療
    基督教信仰療法中的手禮、祈禱治療
  • 墨西哥索諾拉州的薩滿治療師
    墨西哥索諾拉州的薩滿治療師

無知的利用和存在缺陷的推理

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一些替代醫學實踐可能是基於偽科學、無知或存在缺陷的推理[114]。這可能會導致欺詐行為的發生[7]。

例如，基於對電和磁的治療方法的實踐者，可能故意利用病人對物理學的無知行騙[2]。

戒除非醫學認定的「不良生活習慣」

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一種聲稱戒除一些所謂不良的習慣，從而醫治疾病或獲得健康的實踐。但醫學界的共識是這些生活習慣並不會影響身體健康，也不會對身體構成傷害。

戒除自慰療法

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一種認為自慰會導致大量疾病或健康問題，而戒除自慰對身體有益的做法。不過，醫學共識是，自慰是一種性健康及心理上正常的習慣，對身體不會構成傷害或影響健康。[115][116][117][118][119][120][121]

投機與科幻推理

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一些沒有醫學實證，不合科學常理及生物醫學，靠科幻式投機的醫療方法和技術，純粹花錢買技術來寄望未來科技可以復生。

人體冷凍技術

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人體冷凍技術，以超低溫保存在臨床上已死亡的人體，並希望未來科技可以解凍及復生。目前並沒有成功個案把已冷凍的人類大腦、人體或哺乳類動物解凍後可復生，也沒有足夠科學證據證明有復生的可能。 [17][122]

參加病毒派對獲得抗體

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一種非常危險的另類醫療做法，透過參加病毒派對，希望可以藉此感染相關病毒，而獲得抗體。[123][124]

参见

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註釋

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  1. ^ 1.0 1.1 1.2 1.3 1.4 "The phrase complementary and alternative medicine is used to describe a group of diverse medical and health care systems, practices, and products that have historic origins outside mainstream medicine. Most of these practices are used together with conventional therapies and therefore have been called complementary to distinguish them from alternative practices, those used as a substitute for standard care. ... Until a decade ago or so, "complementary and alternative medicine" could be defined as practices that are neither taught in medical schools nor reimbursed, but this definition is no longer workable, since medical students increasingly seek and receive some instruction about complementary health practices, and some practices are reimbursed by third-party payers. Another definition, practices that lack an evidence base, is also not useful, since there is a growing body of research on some of these modalities, and some aspects of standard care do not have a strong evidence base."[1]
  2. ^ 2.0 2.1 "[A]lternative medicine refers to all treatments but that have not been proven effective using scientific methods."[2]
  3. ^ 3.0 3.1 3.2 "It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine – conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work... speculation, and testimonials do not substitute for evidence."[3]
  4. ^ 4.0 4.1 4.2 4.3 4.4 "Complementary and alternative medicine (CAM) is a broad domain of resources that encompasses health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the dominant health system of a particular society or culture in a given historical period. CAM includes such resources perceived by their users as associated with positive health outcomes. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed."[4]
  5. ^ 5.0 5.1 "An alternative medical system is a set of practices based on a philosophy different from Western biomedicine."[5]
  6. ^ 6.0 6.1 "CAM is a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine."[6]
  7. ^ The Final Report (2002) of the White House Commission on Complementary and Alternative Medicine Policy states: "The Commissioners believe and have repeatedly stated in this Report that our response should be to hold all systems of health and healing, including conventional and CAM, to the same rigorous standards of good science and health services research. Although the Commissioners support the provision of the most accurate information about the state of the science of all CAM modalities, they believe that it is premature to advocate the wide implementation and reimbursement of CAM modalities that are yet unproven."[20]
  8. ^ According to the Tzu Chi Institute, a Canadian centre established to evaluate complementary and alternative therapies, "alternative therapies are those lacking scientific validation that are excluded from medical school training programs and uninsured by health plans."[26]
  9. ^ "Kessler refers to a lack of efficacy but never pushes back at Hatch by enumerating the dangers that unregulated products pose to the public, the dangers that fill the pages of Offit’s book."[28]
  10. ^ The National Cancer Institute's Dictionary of Cancer Terms, states that, "Orthodox medicine [is] ... also called allopathic medicine, biomedicine, conventional medicine, mainstream medicine, and Western medicine";[43] the same source states that, "Standard medical care" is "[a]lso called best practice, standard of care, and standard therapy."[44]
  11. ^ Mary Ruggie in Chapter 2 of Marginal to Mainstream: Alternative Medicine in America said, "By the mid-1990s, the notion that some alternative therapies could be complementary to conventional medicine began to change the status of...alternative medicine. The 21st century is witnessing yet another terminological innovation, in which CAM and conventional medicine are becoming integrative."[51]
  12. ^ As David J. Hufford, Professor and Director at the Doctors Kienle Center for Humanistic Medicine at the Penn State College of Medicine,[58] has argued: "Simply because an herbal remedy comes to be used by physicians does not mean that herbalists cease to practice, or that the practice of the one becomes like that of the other."[59]
  13. ^ In his book The Homœopathic Medical Doctrine Samuel Hahnemann the creator of homeopathy wrote: "Observation, reflection, and experience have unfolded to me that the best and true method of cure is founded on the principle, similia similibus curentur. To cure in a mild, prompt, safe, and durable manner, it is necessary to choose in each case a medicine that will excite an affection similar (ὅμοιος πάθος) to that against which it is employed."[62]

参考文献

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引用

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  1. ^ 1.0 1.1 1.2 Harrison's Principles of Internal Medicine 2015，第1頁，chpt. 14-E.
  2. ^ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 National Science Board. Chapter 7: Science and Technology: Public Attitudes and Public Understanding, Section: Belief in Alternative Medicine. Science and Engineering Indicators - 2002. Arlington, Virginia: Division of Science Resources Statistics, National Science Foundation, US Government. 2002 [2016-06-22]. （原始内容存档于2009-03-12）. 
  3. ^ 3.0 3.1 3.2 3.3 3.4 3.5 Angell, M.; et al. Alternative medicine--The risks of untested and unregulated remedies. New England Journal of Medicine. 1998, 339 (12): 839–41. PMID 9738094. doi:10.1056/NEJM199809173391210. 
  4. ^ IOM Report 2005，第19頁
  5. ^ Complementary Medicine — Alternative Medical Systems. WebMD. 2014-01-14 [2015-06-04]. （原始内容存档于2015-06-01）. 
  6. ^ The Use of Complementary and Alternative Medicine in the United States. National Center for Complementary and Integrative Health. 2015-04-07 [2015-06-04]. （原始内容存档于2015-06-01）. 
  7. ^ 7.00 7.01 7.02 7.03 7.04 7.05 7.06 7.07 7.08 7.09 7.10 7.11 7.12 Sampson, W. Antiscience Trends in the Rise of the "Alternative Medicine" Movement. Annals of the New York Academy of Sciences. 1995, 775 (1): 188–197. PMID 8678416. doi:10.1111/j.1749-6632.1996.tb23138.x. 
  8. ^ 8.0 8.1 8.2 8.3 8.4 Beyerstein BL. Alternative medicine and common errors of reasoning. Academic Medicine. 2001, 76 (3): 230–237. PMID 11242572. doi:10.1097/00001888-200103000-00009. 
  9. ^ 9.0 9.1 9.2 9.3 9.4 9.5 9.6 Hines, Terence. Pseudoscience and the Paranormal 2nd. Amerst, New York: Prometheue Books. 2003. ISBN 9781573929790. ; Sampson, Walter. The Need for Educational Reform in Teaching about Alternative Therapies. Academic Medicine. March 2001, 76 (3): 248–250 [2016-06-22]. PMID 11242574. doi:10.1097/00001888-200103000-00011. （原始内容存档于2020-05-13）. ; Coulter, Ian D; Willis, Evan M. The Rise and Rise of Complementary and Alternative Medicine: a Sociological Perspective. Medical Journal of Australia. June 2004, 180 (11): 587–589 [2016-06-22]. PMID 15174992. （原始内容存档于2015-06-26）. ; Sagan 1996
  10. ^ 10.0 10.1 10.2 IOM Report 2005，第16, 175頁.
    Sointu 2012，第13–14頁.
    Nissen et al. 2013.
    Eisenberg et al. 1993.
  11. ^ 11.0 11.1 11.2 Dasgupta, Amitava; Hammett-Stabler, Catherine A. Herbal Supplements: Efficacy, Toxicity, Interactions with Western Drugs, and Effects on Clinical Laboratory Tests. Hoboken NJ: John Wiley and Sons. 2011: 202–205. ISBN 9780470433508. 
  12. ^ Complementary and Alternative Medicine Products and their Regulation by the Food and Drug Administration. Office of Policy and Planning, Office of the Commissioner, Food and Drug Administration (FDA), Dept. of Health and Human Services, US Government. 2007 [2016-06-22]. （原始内容存档于2013-09-23）.  公有领域 本文含有此來源中屬於公有领域的内容。
  13. ^ 13.00 13.01 13.02 13.03 13.04 13.05 13.06 13.07 13.08 13.09 13.10 13.11 13.12 Complementary, Alternative, or Integrative Health: What’s In a Name?. National Center for Complementary and Integrative Health. [2006-07-11]. （原始内容存档于2005-12-08）. 
  14. ^ Zollman, C.; et al. What is complementary medicine?. ABC of complementary medicine. BMJ. 1999, 319 (7211): 693–6. PMC 1116545 可免费查阅. PMID 10480829. doi:10.1136/bmj.319.7211.693. 
  15. ^ IOM Report 2005，第16–20頁.
  16. ^ Traditional Medicine: Definitions. World Health Organization. 2000 [2012-11-11]. （原始内容存档于2013-09-27）. 
  17. ^ 17.0 17.1 The False Science of Cryonics. MIT Technology Review. [2019-01-30]. （原始内容存档于2020-04-02）. 
  18. ^ $2.5 billion spent, no alternative cures found. Alternative Medicine. NBCNews.com. Associated Press. 2009-06-10. （原始内容存档于2009-06-13）. 
  19. ^ 19.0 19.1 19.2 19.3 19.4 "Science-based medicine, with its emphasis on controlled study, proof, evidence, statistical significance and safety is being rejected in favour of 'alternative medicine' - an atavistic portmanteau of anecdote, hearsay, rumour and hokum.... Probably the most commercially successful and widely used branch of alternative or complementary medicine is 'phytotherapy'. These are the tablets, powders and elixirs, otherwise known as herbal medicine, that are sold in most countries, through health shops and pharmacies as 'nutritional supplements'.... Only a tiny minority of these remedies have been shown to have mild-to moderately beneficial health effects... So why are affluent, otherwise rational, highly educated people (for this is the average user profile) so hungry for phytotherapy?... people still believe that 'natural' equals good and safe despite plenty of evidence to the contrary." ... as far as the human body is concerned, 'natural' is meaningless... Equally, what's so safe about consuming substances that need meet no standards of contents? ...", Phytotherapy - good science or big business?, Sara Abdulla, Nature - International Weekly Journal of Science, 5-13-1999 [1] （页面存档备份，存于互联网档案馆）
  20. ^ White House Commission on Complementary and Alternative Medicine Policy. Chapter 2: Overview of CAM in the United States: Recent History, Current Status, And Prospects for the Future. Final Report. NIH Pub. 03-5411. US Government Printing Office. 2002 [2016-06-22]. ISBN 0160514762. （原始内容存档于2016-08-01）.  Chapter 2 archived 2011-08-25.
  21. ^ Ernst, E. Complementary medicine: Common misconceptions. Journal of the Royal Society of Medicine. 1995, 88 (5): 244–7. PMC 1295191 可免费查阅. PMID 7636814. Complementary medicine, defined as health care which lies for the most part outside the mainstream of conventional medicine .
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  117. ^ Szasz, Thomas S. Sex. The Second Sin. London: Routledge & Kegan Paul Ltd. 1974: 10 [1973] [2011-06-30]. ISBN 0-7100-7757-2. （原始内容存档于2021-03-21）. Masturbation: the primary sexual activity of mankind. In the nineteenth century it was a disease; in the twentieth, it's a cure. 
  118. ^ Shpancer, Noah. The Masturbation Gap. The pained history of self pleasure. Psychology Today. New York City: Sussex Publishers. 29 September 2010 [2013-06-27]. （原始内容存档于2016-07-31）. The publication of Kinsey's and Masters and Johnson's research revealed that masturbation was both common and harmless. Many studies have since confirmed this basic truth, revealing in addition that masturbation is neither a substitute for "real" sex nor a facilitator of risky sex.  参数|journal=与模板{{cite web}}不匹配（建议改用{{cite journal}}或|website=） (帮助)
  119. ^ Coon, Dennis; Mitterer, John O. 11. Gender and Sexuality. Introduction to Psychology: Gateways to Mind and Behavior 14. Cengage Learning. 2015-01-01: 363 [2020-07-09]. ISBN 978-1-305-54500-7. （原始内容存档于2020-06-14）. Is there any way that masturbation can cause harm? Seventy years ago, a child might have been told that masturbation would cause insanity, acne, sterility, or other such nonsense. "Self-abuse," as it was then called, has enjoyed a long and unfortunate history of religious and medical disapproval (Caroll, 2013). The modern view is that masturbation is a normal sexual behavior (Hogarth & Ingham, 2009). Enlightened parents are well aware of this fact. Still, many children are punished or made to feel guilty for touching their genitals. This is unfortunate because masturbation itself is harmless. Typically, its only negative effects are feelings of fear, guilt, or anxiety that arise from learning to think of masturbation as "bad" or "wrong." In an age when people are urged to practice "safer sex," masturbation remains the safest sex of all. 
  120. ^ Sigel, Lisa Z. Masturbation: The History of the Great Terror by Jean Stengers; Ann Van Neck; Kathryn Hoffmann. Journal of Social History (Oxford: Oxford University Press). Summer 2004, 37 (4): 1065–1066. ISSN 0022-4529. JSTOR 3790078. doi:10.1353/jsh.2004.0065. Stengers and Van Neck follow the illness to its fairly abrupt demise; they liken the shift to finally seeing the emperor without clothes as doctors began to doubt masturbation as a cause of illness at the turn of the twentieth century. Once doubt set in, scientists began to accumulate statistics about the practice, finding that a large minority and then a large majority of people masturbated. The implications were clear: if most people masturbated and did not experience insanity, debility, and early death, then masturbation could not be held accountable to the etiology that had been assigned it. Masturbation quickly lost its hold over the medical community, and parents followed in making masturbation an ordinary part of first childhood and then human sexuality. 
  121. ^ Wood, Kate. Masturbation as a Means of Achieving Sexual Health by Walter Bockting; Eli Coleman. Culture, Health & Sexuality (London: Taylor and Francis, Ltd.). 2005-03, 7 (2): 182–184. ISSN 1369-1058. JSTOR 4005453. In the collection's introductory chapter, Eli Coleman describes how Kinsey's research half a century ago was the first in a series of studies to challenge widely prevalent cultural myths relating to the 'harmful' effects of masturbation, revealing the practice to be both common and non-pathological. Subsequent research, outlined by Coleman in this chapter, has shown masturbation to be linked to healthy sexual development, sexual well-being in relationships, self-esteem and bodily integrity (an important sexual right). As such, the promotion and de-stigmatization of the practice continue to be important strategies within sexology for the achievement of healthy sexual development and well-being.

    The collection concludes with two surveys among US college students. The first of these was based on limited quantitative questions relating to masturbation. The findings suggest that masturbation is not a substitute for sexual intercourse, as has often been posited, but is associated with increased sexual interest and greater number of partners. The second of these surveys asks whether masturbation could be useful in treating low sexual desire, by examining the relationship between masturbation, libido and sexual fantasy.     
  122. ^ Does Cold reality versus the wishful thinking of cryonics?. Science-Based Medicine（英语：Science-Based Medicine）. [2019-01-30]. （原始内容存档于2019-01-25）. 
  123. ^ Blatchford, Emily. Chicken Pox 'Parties' Are Dangerous And Unnecessary, Experts Say. March 7, 2016 [2020-06-24]. （原始内容存档于2020-06-25） –通过Huff Post. Given the highly contagious nature of chicken pox, the thinking behind such events was, seeing as the child would probably contract it at some point anyway, why not catch it early and get it over with? 
  124. ^ "英美流行的奇葩「水痘派對」，是對現代傳染病防治的巨大羞辱". March 21, 2020 [2020-06-24]. （原始内容存档于2020-06-27） –通过北京新浪網. 其實這些「水痘派對」的前提是，大多數感染水痘的人永遠不會再感染水痘。但目前沒有科學證據表明一次感染就能終身免疫。相反，它隱藏著更大的安全隱患。主動感染水痘有可能會引起嚴重的皮膚感染、腦炎和肺炎等併發症，嚴重的甚至導致死亡。 

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