Chapter 1402 Large sample double-blind controlled experiment method
"Fifth uncle, what do you want to tell your nephew?" Yunxi asked.
"Guan Jia, Guan Jia passed by Kaifeng in the winter of the sixth year and told me to study more carefully what parts of certain medicinal materials can cure diseases and why they can cure diseases. I think what Guan Jia said is right.
The medicinal properties of different parts of the same medicinal material may be completely different, but many quack doctors do not know this, or although they know this truth, they do not know that the medicinal properties of different parts of those medicinal materials are different due to lack of experience. The medical skills passed down by ancient doctors, even those called
There are many fallacies in the medical books of miracle doctors. It happened that there were omissions in the "Puji Fang" I compiled before, so I took this opportunity to fill it in, so I followed the official's instructions and started studying it."
"But after such research, I found that there was no way to start. Originally, the whole medicinal material was in the prescription, so how could we find out which part of it could actually cure the disease?"
"The simplest way, of course, is to have another patient with this disease come to see a doctor. Originally, the medicinal material was prescribed as a whole, but this time only a small part of the medicinal material was prescribed and the patient drank the medicine.
Let's see if it can be cured. Of course, it can be done. There is no need to mention the waste of medicinal materials because the fried medicine is useless. However, if the medicine is useless, the patient will be delayed a day or even a few days before he can drink the right medicine. In the end, he will not be able to drink the right medicine.
What should I do if it can be cured? You can’t disregard human life like this.”
"Even if we ruthlessly treat these patients as drug trials so that all future patients can use the right medicine, there are still problems that are difficult to solve. Some diseases can be cured without treatment, but some people can be cured without treatment.
People will die if they are not treated; sometimes only a small part of a medicinal material in a prescription is used. Some people cannot be cured after drinking such medicine, but some people are cured. What if the person who is cured is originally from the disease?
The fact that people can get well without treatment means that this part of the medicinal material has no medicinal properties; but if the person who recovers would have died without treatment, it means that although the medicinal properties of this part of the medicinal material are lower, it still has. This is a dilemma.
Place."
"What's even more difficult is that the bodies of young and strong men, women and children are different from those of the old and young. Young and strong men have strong bodies, so doctors often increase the dosage of medicines to help them get better as soon as possible; while old, young, women and children have weak bodies and in order to prevent
If they can't bear it, they have to reduce the dose. If a young man takes the medicine prepared by decoction according to the original prescription, he will be cured; if a woman or child takes the medicine prepared by decoction with some missing medicinal materials, it will not be cured. What is the reason?
Are the medicinal materials ineffective, or is it because the dosage of all the medicines in the prescription has been reduced?" Zhu Ru said.
He once compiled the medical book "Puji Prescriptions", which was just a collection of various prescriptions spread across the country. He used them on local patients in Henan. After curing the disease, he included them in it. After collecting enough prescriptions, he compiled it into a medical book. However,
I haven't done such research according to Yunxi's words. After doing this research, I found that it is so difficult to verify which part of a medicinal material in a prescription works and what role it plays.
When he was talking, Yunxi listened quietly without interrupting. After Zhu Ru finished speaking, Yunxi said warmly: "Uncle Wu worked really hard to verify the prescription and the medicinal materials."
"I don't think it's hard work. It's the doctors who were recruited by me to study this matter who worked hard, and I gave them very generous rewards for this. And doctors are parents, so it's okay to work hard. But if the research is useless, the hard work will be in vain.
One scene would be very bad." Zhu Ju said.
"Dare you ask the officials to teach me how to solve these problems?"
"Fifth uncle, are you 100% sure that your nephew can solve these problems?" Yunhe said with a smile.
Seeing his smile, Zhu Xi felt at ease and smiled: "I wasn't sure at first, but now that I see the official's smile, I am sure."
"If the officials don't have a way to solve these problems, they will definitely not laugh at me at this time; since the officials are laughing, then there is a way."
Although Zhu Xi originally asked Yunxi these questions, he really didn't know whether he could solve them. Zhu Xi's idea was actually to ask Yunxi to summon the people in Gezhijian and tell them to think of ways to solve these problems. After all, one person is short of two.
The Chief Accountant and those who served as officials in Gezhi Prison were the most fond of studying Gezhi's studies in the entire Ming Dynasty, and they were also the smartest people. Compared with the doctors in Henan Province in Kaifeng, they were more likely to come up with it.
But he didn't expect Yunxi to come up with solutions to these problems on his own, which made Zhu Zhu respond to his words with a smile.
"Fifth uncle, my nephew has been figured out by you." Yunxi said again with a smile, "Actually, the way to solve this problem is simple and difficult. That is to use a large sample to double-blind
Controlled Experimental Method.”
"Guan Jia, what is the large-sample double-blind controlled experimental method?" Zhu Ru asked.
"Let my nephew explain it in detail."
Yunxi said slowly: "In fact, some people in the Gezhi Prison in the capital have encountered similar problems during research. Although dead objects such as rocks, minerals, and trees are not as varied as medicinal materials, they want to study
It is not easy to know what it can be used for and which formula is most useful. One of them came up with a method. Taking the ratio of gunpowder as an example, prepare two identical doses of saltpeter and sulfur, only the doses of charcoal are different.
, after mixing gunpowder, test its power. The more powerful is the better charcoal ratio; through repeated trials, you can get the best gunpowder ratio. This person calls this method a comparison."
"But then someone discovered the problem. Taking the ratio of gunpowder as an example, sometimes small changes in dosage will produce almost the same power after the experiment, making it extremely difficult to distinguish; if the experimenter has a bias in his mind, even if it is just
There is a slight bias, thinking that a higher dose of charcoal should be more powerful. When the power is almost the same and it is difficult to distinguish, he will think that the formula with a larger dose of charcoal is better, so he adopts this formula. So he
It is believed that the person checking the results should not know the ratio of the two gunpowders, obtain the test results, and then tell the person doing the test, in order to get the most accurate results. This method is called single-blind."
"Gunpowder can be tested very clearly. As long as an impartial person looks at the test results, the best ratio will be obtained in the end. It's just a waste of sulfur, saltpeter and charcoal in the middle. It can be like a prescription.
There is no way to test medicinal materials like gunpowder. If a doctor has a slight bias in his mind, he will definitely come to the wrong conclusion in the end, but it is difficult to find out. Not only is the test done in vain, but he will get the wrong prescription, which is harmful.
It is unprofitable. Therefore, the single-blind method must be used to verify the prescription and medicinal materials."
"As for what a large sample is, it is to verify a prescription. A large number of patients must be cured by this prescription. After all, people's bodies are different. Uncle Wu also said just now, 'Some diseases, some
Many people can get well without treatment, but some people will die without treatment. Too few people have been cured by using medicine, and it is hard to say whether the medicine is effective or not. Therefore, a large sample size method must be used. Of course, treating the disease
No more than others, patients are hard to come by, so sometimes this method cannot be too demanding."
"Guan Jia, you just explained single-blindness, but what does double-blindness mean?" After Yunxi said this, he stopped and picked up the cup and took a drink of water. Zhu Zhu thought he had finished speaking and hurriedly asked.
"This is what my nephew has figured out by himself." Yunxi put down the water glass and continued: "Just like the formula of gunpowder, saltpeter, sulfur and charcoal are dead things. They can't speak, let alone have any ideas; but people are different.
If a person knows that the medicine he takes is not necessarily a medicine that can cure him, he will have random thoughts, which will also affect the effect of the medicine, so the patient cannot be informed of the change in the medicine. Because as I said before, it is best
The person who checked the test results did not know the change in the prescription, nor did the patient, so it is called double-blind."
"The combination of these methods is a large-sample double-blind controlled experimental method."
"That's right, that's right!" After hearing Yunxi's words, Zhu Xi immediately praised: "The official said it is good. These methods combined together will definitely be able to confirm whether a certain prescription or medicine is useful."
But he then added: "But it is not easy to do this. Needless to say about the large sample, it is very difficult to blind the doctor. The doctor prescribes the medicine, and finally checks the condition and finds someone else. This
That is to say, at least two doctors treat a patient, and the one who examines the condition is more skilled than the one who prescribes the medicine. In the entire Ming Dynasty, except for those who are almost beggars and have extremely poor medical skills, there are not many doctors;
If we do this, even fewer people will be able to receive treatment."
"What's more, although I have summoned many famous doctors to study this matter in Kaifeng, many of the prescriptions are handed over to ordinary doctors for verification. I cannot afford to add doctors to every medical clinic. If this is done throughout the world, the imperial court will
I can’t afford it either.”
Although Zhu Rui immediately heard that this large-sample double-blind controlled experimental method was very good, he immediately realized that if this method was used, the investment of manpower and material resources would be greatly increased, and the time would be greatly extended. He may not be able to do it in his lifetime.
All the prescriptions in "Puji Fang" have been verified.
"My nephew also knows this, so he picks up the prescriptions that are used the most and have the most people sick. Use this method to test the medicinal materials. For the others, use the old method first, or just use the comparison method, and don't use the others."
Yunxi replied. Not only now, but also in future generations, the cost of strictly using large-sample double-blind controlled experimental methods is also scary. It costs hundreds of millions to test each drug in China, and more than one billion U.S. dollars in the United States.
Even billions of dollars. Therefore, even if the technological development of later generations has reached a level unimaginable by the people of the Ming Dynasty, countless funds have poured into the medical industry, and the number of doctors is hundreds or a thousand times that of the Ming Dynasty, and they are all formal doctors who have been trained by medical schools for at least seven or eight years.
Doctors, there are only hundreds of drugs that go through three clinical phases and are officially put on the market every year.
But it doesn't seem right to leave a good method unused. So we can only pick up the prescriptions that are more useful first, test the drugs in this way, and do the other things slowly.' As long as this method is promoted and known to all doctors, sooner or later one day
All the prescriptions will be tested,' Yunxi thought. (To be continued)