Liu Quan-Hui, Rong Ping, Wang Meng, Zhang Bo-Li, Xie Yan-Ming, Zhang Jun-Hua, Yan Hai-Hong, Li Rui-Ben, Li Li, Zhang Xi-Lian, Ma Rong
First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China.
Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China.
Zhongguo Zhong Yao Za Zhi. 2018 Dec;43(24):4753-4758. doi: 10.19540/j.cnki.cjcmm.20180925.006.
Questionnaires and case investigation methods were taken in this paper, taking the clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for upper respiratory tract infection in children published by the Chinese Medicine Association as the research object. Doctors from 187 hospitals in 29 regions across the country were invited to evaluate the applicability of the Guideline and clinical application effects, so as to collect the opinions on revising the Guideline. Clinicians about 508 accepted the applicability survey of the Guideline, and considered that the structure and content of the Guideline were reasonable, with the proportions being as high as 98.23% and 98.03%, respectively. In the content of syndrome differentiation-based treatment, the factors with higher rationality included therapeutic principle and method (99.41%), diagnosis elements (98.82%), and syndrome differentiation classification (98.03%); while the factors with lower rationality included the rehabilitation and health preserving (97.05%) and complication prevention (97.24%). 98.03% of the clinicians considered theat the Guideline was to be fully applicable and basically applicable, and 1.97% of the clinicians considered it to be applicable after revision. By observing 491 cases, the Guide was applied for evaluation and analysis. The factors with higher compliance included diagnosis of Western medicine disease (100%) and the diagnosis of TCM disease (99.18%); while the factors with lower compliance included the treatment measures, with a compliance rate of 77.18% and 83.05% respectively for simple preparations and other treatment method. The safety and economy of the Guideline were good, 97.35%, 93.89%, respectively. The comprehensive evaluation was good, and 99.41% of the respondents were willing to follow the treatment schemes recommended in the Guideline, suitable for clinical application. The opinions on revision were mainly focused on dialectical treatment, complication prevention and rehabilitation. It indicates that only by actively and extensively soliciting opinions to revise the Guideline, can we improve the quality of the Guideline for clinical practice, so as to raise the level of clinical efficacy.
本文采用问卷调查和病例调查方法，以中华中医药学会发布的《中医治疗小儿上呼吸道感染单用或联用抗生素的临床实践指南》为研究对象。邀请全国29个地区187家医院的医生对该指南的适用性及临床应用效果进行评价，以收集修订该指南的意见。约508名临床医生接受了该指南的适用性调查，认为该指南的结构和内容合理的比例分别高达98.23%和98.03%。在辨证论治内容方面，合理性较高的因素包括治疗原则与方法（99.41%）、诊断要素（98.82%）、辨证分类（98.03%）；合理性较低的因素包括康复养生（97.05%）和并发症防治（97.24%）。98.03%的临床医生认为该指南完全适用或基本适用，1.97%的临床医生认为修订后适用。通过观察491例病例，对该指南进行应用评价分析。依从性较高的因素包括西医疾病诊断（100%）和中医疾病诊断（99.18%）；依从性较低的因素包括治疗措施，单方制剂和其他治疗方法的依从率分别为77.18%和83.05%。该指南的安全性和经济性良好，分别为97.35%、93.89%。综合评价良好，99.41%的受访者愿意遵循该指南推荐的治疗方案，适用于临床应用。修订意见主要集中在辨证论治、并发症防治和康复方面。这表明只有积极广泛征求意见修订该指南，才能提高临床实践指南质量，从而提升临床疗效水平。
