Liu Mengyu, Zhang Chi, Zha Qinglin, Yang Wei, Yuwen Ya, Zhong Linda, Bian Zhaoxiang, Han Xuejie, Lu Aiping
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Nanxiaojie, Beijing, 100700, China.
School of Chinese Medicine, Hong Kong Baptist University, Kowloon Tong, Kowloon, 999077, Hong Kong.
BMC Complement Altern Med. 2017 Sep 6;17(1):451. doi: 10.1186/s12906-017-1946-2.
Clinical practice guidelines (CPGs) for Chinese medicine (CM) are being developed to assist doctors with appropriate decisions concerning CM care. To date, there has been little investigation on the perspectives of those to whom the guidelines are directed.
A self-administered questionnaire was sent to 4503 doctors in 28 provinces of China in the latter half of 2012. Questions were organized around the topics of knowledge, application, practice changes, beliefs and outcomes of implementation. Basic classificatory data on specialties and years of qualification were also collected.
Replies were received from 4495 CM doctors (99.82%). Of these, 85.56% of CM doctors reported being familiar with CPG recommendations, but the overall adherence rate was only 50.39%. The length of time practicing CM may influence the rate of adherence, since 709 doctors (51.90%) with less than 5 years of experience reported never having followed CPGs. Doctors in nine specialties showed a modest degree of homogeneity in their attitudes towards CM diagnosis and treatment, which were generally positive. Most doctors regarded CPG-recommended therapies as safe (92%), economic (84%), and effective (76%). Approximately four-fifths of those questioned selected 'acceptable' (60.84%) and 'acceptable after revision' (19.23%) regarding their comprehensive assessment of the CPGs.
An encouraging result from this survey is that the majority of CM doctors support the concept of CPGs for the practice of CM. However, the results of this survey also suggest that improving the adherence of CM doctors to the guidelines remains a major challenge to improving the practice standards for CM.
中医临床实践指南正在制定中，以协助医生在中医护理方面做出恰当决策。迄今为止，对于指南所针对人群的观点鲜有研究。
2012年下半年，向中国28个省份的4503名医生发放了自填式问卷。问题围绕知识、应用、实践变化、实施的信念及结果等主题展开。还收集了专业和资格年限的基本分类数据。
共收到4495名中医医生的回复（99.82%）。其中，85.56%的中医医生表示熟悉临床实践指南的建议，但总体遵循率仅为50.39%。中医从业时间长短可能会影响遵循率，因为709名经验不足5年的医生（51.90%）表示从未遵循过临床实践指南。九个专业的医生在对中医诊断和治疗态度上表现出一定程度的一致性，总体呈积极态度。大多数医生认为临床实践指南推荐的疗法安全（92%）、经济（84%）且有效（76%）。约五分之四的受访者对临床实践指南的综合评估选择了“可接受”（60.84%）和“修订后可接受”（19.23%）。
本次调查的一个令人鼓舞的结果是，大多数中医医生支持中医临床实践指南的理念。然而，本次调查结果也表明，提高中医医生对指南的遵循率仍是提高中医实践标准的一项重大挑战。
