[Problems in establishing clinical guideline for integrated traditional Chinese and Western medicine].

A good clinical guideline for integrated traditional Chinese and Western medicine (ITCWM) should be established by multi-subject specialists, including clinical expert of ITCWM, traditional Chinese medicine and Western medicine, and medical staff from different levels of health care organization, clinical and preclinical medicine researcher, statistician, clinical epidemiologist and economist, medical decision-maker and administrative expert. Establishment of guideline should be abided by the following scientific procedure: association of ITCWM (AITCWM) or the branch of AITCWM decides the subject of clinical guideline, set up a team of special subject of clinical guideline (or decided by research project), evaluate literature systematically, prepare a draft manuscript, consult and appraise it in the same occupation, announce the content in the academic circle, collect feedback opinions and proposals and then make analysis, modify the clinical guideline, publish the clinical guideline, apply the clinical guideline, collect and appraise feedback opinions and proposals, modify and consummate the clinical guideline. In order to supply and consummate original guideline, scientific and renewed evidence should be emphasized on the basis of evidence-based medicine. The author also suggested insistence on the combination of disease and syndrome, syndrome being governed by disease, standardization of syndrome type, establishment of reasonable amount of syndrome types, standard and method of modifying the treatment. The user of guideline should pay attention to both the principle and flexibility, and the author stressed that guideline was just a diagnosis and treatment reference to clinician, which should be used flexibly and not be imitated mechanically in practical application. The practicability of guideline should be pay attention to so that the clinician can apply and manipulate the guideline easily. Meanwhile, the group of guideline establishment has an obligation to train medical staff and to promote the practice of clinical guideline. Only in this way, the authority, standardization and applicability of clinical guideline on ITCWM can be ensured, and then the expected purpose of clinical guideline establishment can be attained.