《中医妇科常见病诊疗指南》临床应用评价研究Clinical application evaluation of Guidelines for Diagnosis and Treatment of Common Diseases of Gynecology in Traditional Chinese Medicine
王丽颖;刘孟宇;宇文亚;赵学尧;王跃溪;韩学杰;王燕平;
WANG Li-ying;LIU Meng-yu;YUWEN Ya;ZHAO Xue-yao;WANG Yue-xi;HAN Xue-jie;WANG Yan-ping;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences;
摘要(Abstract):
为评价《中医妇科常见病诊疗指南》的临床适用性和应用性,采用调查问卷和前瞻性病例调查分析方法,在全国16家中医药标准研究推广基地(试点)建设单位,对11个病种的《中医妇科常见病诊疗指南》,开展适用性评价和应用性评价。结果显示,361位临床医生接受《指南》的适用性调查,其中87.26%比较熟悉,25.21%使用过该《指南》,辨证论治相关内容中,评价合理性较高的为组方用药(91.69%)、辨证分类(86.98%),合理性较低的为调摄预防(44.6%),75.62%临床医生认为《中医妇科常见病诊疗指南》完全适用和基本适用。前瞻性观察2 935份病例,对《指南》的应用性进行评价,《指南》与临床实际应用一致性较高的为中医疾病诊断、西医疾病诊断,分别占98.30%,94.11%;较低的为调摄预防,占59.39%。《指南》的安全性、经济性较好,分别为95.64%,94.75%。《指南》综合评价结果显示,总体疗效与技术水平、《指南》满意度、在临床实践中的适用性7~9分的分别为77.38%,74.00%,76.90%。该《指南》临床符合度较好,可作为临床治疗中医妇科常见病的规范性方案,但也存在部分内容适用性较差、不符合临床实际的情况,有待进一步修订。
To evaluate the clinical applicability and application of Guidelines for Diagnosis and Treatment of Common Diseases of Gynecology in Traditional Chinese Medicine,11 diseases from Guidelines for Diagnosis and Treatment of Common Diseases of Gynecology in Traditional Chinese Medicine were evaluated by methods of questionnaire and prospective case study at 16 construction units for traditional Chinese medicine standards research and extension. Results showed that 361 clinical doctors accepted the applicability survey of guidelines,and 87. 26% of them were more familiar to the guideline and 25. 21% of them used the guideline. In syndrome differentiation and treatment related contents,rationality of prescription medication and syndrome classification was higher,accounted for 91. 69% and 86. 98% respectively,but the rationality of recuperation prevention was lower,accounted for 44. 6%. 75. 62% clinical doctors believed that the Guidelines for Diagnosis and Treatment of Common Diseases of Gynecology in Traditional Chinese Medicine was applicable. The application of the guidelines is evaluated by prospective observation of 2 935 cases. The higher compliance between the guideline and clinical practice was present in TCM( traditional Chinese medicine) disease diagnosis and WM( western medicine) disease diagnosis,accounted for 98. 30% and 94. 11% respectively. The lower compliance was present in recuperation prevention,accounted for 59. 39%. The safety and economy of the guideline was higher,accounting for 95. 64%,94. 75%,respectively. The comprehensive evaluation results showed that the rate of the overall treatment effect with technical level,satisfaction degree or applicability in clinical practice which were 7-9 points is 77. 38%,74. 00%,76. 90% respectively. This guideline has a high clinical compliance and can be used as a standard for common diseases of gynecology,but there are also some conditions with poor applicability,which does not conform to the actual situation,and needs to be further revised.
关键词(KeyWords):
妇科常见病;诊疗指南;评价;适用性;应用性
common diseases of gynecology;guidelines for diagnosis and treatment;evaluation;applicability;application
基金项目(Foundation): 国家中医药管理局中医药标准化项目(ZYYS-2016[0013],ZYYS-2014[01]);; 北京市中医药科技发展基金项目(JJ2015-61)
作者(Author):
王丽颖;刘孟宇;宇文亚;赵学尧;王跃溪;韩学杰;王燕平;
WANG Li-ying;LIU Meng-yu;YUWEN Ya;ZHAO Xue-yao;WANG Yue-xi;HAN Xue-jie;WANG Yan-ping;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences;
Email:
DOI: 10.19540/j.cnki.cjcmm.20170623.005
参考文献(References):
- [1]刘孟宇,杨伟,赵学尧,等.中医临床诊疗指南应用评价方法研究[J].中华中医药杂志,2016,31(2):552.
- [2]靳宏光,齐锋,王义强,等.心悸中医诊疗指南临床应用评价研究[J].中华中医药杂志,2016,31(6):2213.
- [3]史楠楠,韩学杰,刘兴方,等.404名中医医师高血压病中医临床实践指南使用情况的调查研究[J].中华中医药杂志,2012,27(12):3067.
- [4]罗颂平.中医妇科学研究现状与展望[J].环球中医药,2010,3(5):321.
- [5]王丽颖,赵学尧,宇文亚,等.中医临床诊疗指南、路径与诊疗方案的比较分析[J].中医杂志,2015,56(24):2112.
- [6]Gordon H G,Andrew D O,Gunn E V.GRADE:证据质量和推荐强度分级的共识[J].中国循证医学杂志,2009,9(1):8.
- 妇科常见病
- 诊疗指南
- 评价
- 适用性
- 应用性
common diseases of gynecology - guidelines for diagnosis and treatment
- evaluation
- applicability
- application
- 王丽颖
- 刘孟宇
- 宇文亚
- 赵学尧
- 王跃溪
- 韩学杰
- 王燕平
WANG Li-ying- LIU Meng-yu
- YUWEN Ya
- ZHAO Xue-yao
- WANG Yue-xi
- HAN Xue-jie
- WANG Yan-ping
- Institute of Basic Research in Clinical Medicine
- China Academy of Chinese Medical Sciences
- 王丽颖
- 刘孟宇
- 宇文亚
- 赵学尧
- 王跃溪
- 韩学杰
- 王燕平
WANG Li-ying- LIU Meng-yu
- YUWEN Ya
- ZHAO Xue-yao
- WANG Yue-xi
- HAN Xue-jie
- WANG Yan-ping
- Institute of Basic Research in Clinical Medicine
- China Academy of Chinese Medical Sciences