Yu Guo-Yong, Xie Yan-Ming, Gao Ning, Sun Yue, Miao Run-Pei, Han Shuai-Jie, Yang Han-Wen, Xiong Min, Liu Heng, Liao Xing, Wang Yao-Xian, Su Xiao-Nan, Xu Xiao-Fang, Wang Li-Fei, Li Yan-Li, Zhang Jun-Hua, Zhang Bo-Li
Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, 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):4746-4752. doi: 10.19540/j.cnki.cjcmm.2018.0126.
A questionnaire survey of 1 000 clinicians having experience in treating uncomplicated lower urinary tract infections from different levels of hospitals was conducted to mainly evaluate the applicability and effectiveness of clinical application of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for uncomplicated lower urinary tract infection(hereinafter referred to as Guideline). The research was conducted with the three-level quality control strictly throughout the process, and the data was real and reliable. The survey's results showed that: most clinicians considered that the Guideline had good clinical applicability. The availability and price of the recommended medicine were moderate. Traditional Chinese medicine had obvious features and advantages in treating lower urinary tract infection for it could reduce the usage of antibiotics and shorten the course of antibiotic application. In the recommendation section, clinicians proposed increasing medication guidance, updating the Guideline timely, as well as increasing treating methods and techniques, strengthen propaganda and promotion, and improve the use of evidence-based methods. In the evaluation of effectiveness, the majority of clinicians agreed that the definition in both traditional Chinese medicine (TCM) and Western medicine and differential diagnosis in the Guideline were accurately described and the basic principle of treatment as well as the treating method of TCM were recommended appropriately. The TCM formulas and Chinese patent medicine had good effect. Some clinicians suggested refining the syndrome differentiation of stranguria. Some clinicians considered that the formulas and herbs recommended in Guideline didn't have obvious effect and some had doubts about the manipulation of fumigation and washing in the part of other methods recommended in Guideline. Moreover, specification and procedure of manipulation of fumigation and washing using herbs and the acupuncture included in characteristic TCM therapy treating uncomplicated lower urinary tract infection remained to be developed.
对1000名来自不同级别医院、有治疗单纯性下尿路感染经验的临床医生进行了问卷调查，主要评估单纯使用中医治疗或联合抗生素治疗单纯性下尿路感染的临床实践指南（以下简称《指南》）临床应用的适用性和有效性。研究全过程严格进行三级质量控制，数据真实可靠。调查结果显示：多数临床医生认为《指南》临床适用性良好。推荐药物的可及性和价格适中。中医在治疗下尿路感染方面具有明显特点和优势，可减少抗生素使用，缩短抗生素应用疗程。在建议部分，临床医生提出增加用药指导、及时更新《指南》，以及增加治疗方法和技术、加强宣传推广、提高循证方法运用等。在有效性评价方面，多数临床医生认为《指南》中中医和西医的定义及鉴别诊断描述准确，中医治疗基本原则及治法推荐恰当。中药方剂和中成药疗效良好。部分临床医生建议细化淋证的辨证。部分临床医生认为《指南》推荐的方剂和药物效果不明显，对《指南》中推荐的其他方法中熏洗操作存在疑问。此外，单纯性下尿路感染中医特色疗法中中药熏洗及针灸操作的规范和流程尚待制定。
