Department of Integrative Oncology, Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai 200433, China.
Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
J Integr Med. 2018 Jul;16(4):236-248. doi: 10.1016/j.joim.2018.05.002. Epub 2018 May 17.
Traditional Chinese medicine (TCM) is an important part of the treatment of primary liver cancer (PLC) in China; however, the current instructions for the integrative use of traditional Chinese and Western medicine for PLC are mostly based on expert opinion. There is no evidence-based guideline for clinical practice in this field. Therefore, the Shanghai Association of Chinese Integrative Medicine has established a multidisciplinary working group to develop this guideline, which focuses on the most important questions about the use of TCM during PLC treatment. This guideline was developed following the methodological process recommended by the World Health Organization Handbook for Guideline Development. Two rounds of questionnaire survey were performed to identify clinical questions; published evidence was searched; the Grading of Recommendations Assessment, Development and Evaluation approach was used to evaluate the body of evidence; and recommendations were formulated by combining the quality of evidence, patient preferences and values, and other risk factors. The guideline was written based on the Reporting Items for Practice Guidelines in Healthcare tool. This guideline contains 10 recommendations related to 8 questions, including recommendations for early treatment by TCM after surgery, TCM combined with transcatheter arterial chemoembolization for advanced PLC, TCM drugs for external use, and acupuncture and moxibustion therapy.
中医(TCM)是中国原发性肝癌(PLC)治疗的重要组成部分;然而,目前关于中西医结合治疗 PLC 的综合使用说明大多基于专家意见。在这一领域没有基于证据的临床实践指南。因此,上海中医药学会成立了一个多学科工作组来制定本指南,该指南重点关注 TCM 在 PLC 治疗过程中使用的最重要问题。本指南是按照世界卫生组织指南制定手册推荐的方法流程制定的。进行了两轮问卷调查以确定临床问题;搜索了已发表的证据;使用推荐评估、制定与评价分级方法评估证据体;并结合证据质量、患者偏好和价值观以及其他风险因素制定建议。该指南是根据医疗保健实践指南报告项目工具编写的。本指南包含与 8 个问题相关的 10 条建议,包括手术后 TCM 的早期治疗、TCM 联合经导管动脉化疗栓塞治疗晚期 PLC、TCM 外用药物以及针灸治疗。