Ma Kun, Li Min, Wang Kai-Li, Xie Yan-Ming, Zhang Jun-Hua, Zhang Bo-Li
China Academy of Chinese Medical Sciences, Beijing 100700, China.
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.
Zhongguo Zhong Yao Za Zhi. 2018 Dec;43(24):4741-4745. doi: 10.19540/j.cnki.cjcmm.20181009.002.
To evaluate the clinical application of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for pelvic inflammatory disease and provide reference for the revision of the Guideline. Questionnaire research was conducted from applicability and application evaluation. A total of 1 311 copies of valid questionnaires were obtained, including 717 questionnaires on applicability evaluation and 594 questionnaires on application evaluation. There were 83 items from 4 aspects in the applicability questionnaire. In statistical agreement rates of those items to reflect the application status of the Guideline, the rates of 8 items were all more than 95% except for rates of "content integrity", "comparison with the diagnosis and treatment scheme of his/her unit (individual)" and "economy of clinical application", 94.70%, 93.86% and 93.17% respectively. In statistical agreement rates of those items to reflect the quality of the Guideline, the rates of 3 items were all more than 97%, except the rate of "whether syndrome classification is reasonable" item was 95.26%. Among the items that reflect the local purchase difficulty and price evaluation of Chinese patent medicine recommended in the Guideline, most clinicians thought the prices were modest. There were 56 items from 6 aspects in the application evaluation questionnaire. In statistical agreement rates of those items to reflect the application rationality of the Guideline, the rates of 3 items were all more than 96%, except rate of "whether syndrome classification is reasonable" item was 91.58%. In statistical agreement rates of those items to reflect the clinical application effect of the recommended regimen in the Guideline, the traditional application of traditional Chinese medicine decoction had generally better application effect, whereas Chinese patent medicines were less effective. In statistical agreement rates of those items to reflect the overall evaluation of clinical application, the rates of "overall effect" and "overall safety" were all more than 96%, except the rates of "overall economy" item was 92.42%. It indicates that the overall effect of this Guideline is relatively well. It is suggested to improve the classification of syndrome differentiation and increase the species of Chinese medicine decoction and Chinese patent medicines, and to standardize the duration and course of medication. The next revised work should not only uptake the experiences of prominent TCM doctors and all kinds of research achievements, but also regularly update and strengthen the publicity of the Guideline.
评价盆腔炎性疾病中医诊疗指南单独或联合抗生素的临床应用情况，为指南修订提供参考。从适用性和应用评价两方面进行问卷调查研究。共获得有效问卷1311份，其中适用性评价问卷717份，应用评价问卷594份。适用性问卷从4个方面设置了83个条目。在反映指南应用状况的条目统计一致率中，除“内容完整性”“与本单位（个人）诊疗方案比较”“临床应用经济性”的一致率分别为94.70%、93.86%、93.17%外，8个条目的一致率均超过95%。在反映指南质量的条目统计一致率中，3个条目的一致率均超过97%，除“证候分类是否合理”条目的一致率为95.26%。在反映指南推荐中成药的当地购买难度及价格评价的条目中，多数临床医生认为价格适中。应用评价问卷从6个方面设置了56个条目。在反映指南应用合理性的条目统计一致率中，3个条目的一致率均超过96%，除“证候分类是否合理”条目的一致率为91.58%。在反映指南推荐方案临床应用效果的条目统计一致率中，传统中药汤剂应用效果总体较好，而中成药效果较差。在反映临床应用总体评价的条目统计一致率中，“总体疗效”和“总体安全性”的一致率均超过96%，除“总体经济性”条目的一致率为92.42%。表明本指南总体效果较好。建议完善辨证分类，增加中药汤剂及中成药品种，规范用药疗程和时间。下次修订工作既要吸纳名老中医经验及各类研究成果，又要定期更新并加强指南宣传。
