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Is traditional Chinese medicine recommended in Western medicine clinical practice guidelines in China? A systematic analysis

机译:中医是否推荐中西医临床实践指南?系统分析

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摘要

BackgroundEvidence-based medicine promotes and relies on the use of evidence in developing clinical practice guidelines (CPGs). The Chinese healthcare system includes both traditional Chinese medicine (TCM) and Western medicine, which are expected to be equally reflected in Chinese CPGs.ObjectiveTo evaluate the inclusion of TCM-related information in Western medicine CPGs developed in China and the adoption of high level evidence.MethodsAll CPGs were identified from the China Guideline Clearinghouse (CGC), which is the main Chinese organisation maintaining the guidelines issued by the Ministry of Health of China, the Chinese Medical Association and the Chinese Medical Doctors’ Association.TCM-related contents were extracted from all the CPGs identified. Extracted information comprised the institution issuing the guideline, date of issue, disease, recommendations relating to TCM, evidence level of the recommended content and references supporting the recommendations.ResultsA total of 604 CPGs were identified, only a small number of which (74/604; 12%) recommended TCM therapy and only five guidelines (7%) had applied evidence grading. The 74 CPGs involved 13 disease systems according to the International Classification of Diseases 10th edition. TCM was mainly recommended in the treatment part of the guidelines (73/74, 99%), and more than half of the recommendations (43/74, 58%) were related to Chinese herbal medicine (single herbs or herbal treatment based on syndrome differentiation).ConclusionsFew Chinese Western medicine CPGs recommend TCM therapies and very few provide evidence grading for the TCM recommendation. We suggest that future guideline development should be based on systematic searches for evidence to support CPG recommendations and involve a multidisciplinary approach including TCM expertise.
机译:背景循证医学在制定临床实践指南(CPG)的过程中促进并依靠证据的使用。中国的医疗保健体系包括中药和西药,有望在中国的CPG中得到同样的体现。目的评估在中国研发的西药CPG中是否包含中医相关信息以及采用的高水平证据方法从中国指南交换所(CGC)中识别所有CPG,CGC是维护中国卫生部,中华医学会和中华医学会发布的指南的主要中国组织,并提取了与TCM有关的内容来自所有已确定的CPG。提取的信息包括发布指南,发布日期,疾病,与中医相关的推荐,推荐内容的证据水平以及支持推荐的参考文献的机构。结果总共确定了604个CPG,其中只有少量(74/604 ; 12%)建议采用中医治疗,只有五项指南(7%)采用了证据分级。根据《国际疾病分类》第10版,74个CPG涉及13个疾病系统。指南的治疗部分主要推荐中医治疗(73/74,99%),超过一半的建议(43/74,58%)与中草药有关(单一草药或基于证候的草药治疗)结论几乎没有中西药CPG推荐中医治疗方法,几乎​​没有为中医推荐提供证据分级。我们建议,未来的指南制定应基于系统地寻找证据以支持CPG建议,并涉及包括中医专业知识在内的多学科方法。

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