以认识论思想促进循证医学的不断发展

循证医学（evidence-based medicine，EBM）正式出现至今已历经30年，30年来EBM对医学，包括医学以外的一些领域带来了巨大的改变，可谓有力推进了整个医学的进步。本文结合人类认识进步带来的改变与特殊作用，从关于证据、进一步认识医学、颠覆式的决策思维：医患共同决策、促进EBM不断发展四个方面展开阐释和讨论。显示了认识论思想在EBM与时俱进过程中所具有的指导性与重要性，并力图以认识论的思想丰富和促进EBM的不断发展。

Development Promotion of Evidence-based Medicine with the Thought of Epistemology

It has been 30 years since the formal emergence of evidence-based medicine (EBM). In the past 30 years, EBM has brought enormous changes to both medicine and fields besides it, and has vigorously promoted the progress of medicine as a whole. Combined with the changes and special roles brought by the progress of human cognition, this article explains and discusses four aspects: evidence, further understanding of medicine, subversive decision-making thinking: shared decision making, and promoting the continuous development of EBM. It shows the guidance and importance of the epistemological thought in the process of EBM advancing with the times, and attempts to enrich and promote the continuous development of EBM with the epistemological thought.