Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, P.R. China.
Department of Chinese Medicine Standardization, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, P.R. China.
J Evid Based Med. 2020 May;13(2):137-152. doi: 10.1111/jebm.12386. Epub 2020 May 22.
Stroke is the leading cause of death and disability in China. Chinese medicine integrated with conventional medicine is now widely used in the prevention and treatment of stroke. A clinical practice guideline for the application of integrative medicine in stroke is urgently needed.
This guideline was developed following the methodology and procedures recommended in the World Health Organization Handbook for Guideline Development and the Guideline Development Handbook for Diagnosis and Therapy of Integrative Medicine. The quality of evidence and strength of recommendations were evaluated using the GRADE approach. The guideline followed the RIGHT statement and AGREE II was consulted to ensure its quality.
A multidisciplinary working team was established. Eleven research questions from 15 clinical questions were identified by questionnaire surveys, face-to-face meetings, and analyzed by the working team. Fourteen recommendations regarding integrative medicine for ischemic stroke, hemorrhagic stroke, and complications of stroke were formulated from systematic reviews of the benefits, harms, cost-effectiveness, quality of evidence, the values and preferences of patients and their family members, feedback on proposed recommendations from medical practitioners from a variety of disciplines, and a face-to-face consensus meeting.
This guideline focuses on clinical treatments that are specific to integrative medicine for stroke and can be used at all levels in medical institutions and rehabilitation facilities. The end-users of the guideline are most likely to be medical practitioners, including Chinese herbal medicine specialists, acupuncturists, integrative medicine practitioners, physicians, physical therapists, and clinical pharmacists.
中风是中国的首要致死和致残病因。目前，中西医结合在中风的防治中得到广泛应用。因此，急需制定中西医结合治疗中风的临床实践指南。
本指南的制定遵循世界卫生组织指南制定手册和中西医结合诊断治疗指南制定手册中推荐的方法和程序。采用 GRADE 方法评价证据质量和推荐强度。指南遵循 RIGHT 声明，并参考了 AGREE II 以确保其质量。
成立了多学科工作组。通过问卷调查、面对面会议，以及工作组分析，确定了来自 15 个临床问题的 11 个研究问题。从系统评价中综合评估了中西医结合治疗缺血性中风、出血性中风和中风并发症的获益、危害、成本效益、证据质量、患者及其家属的价值观和偏好、不同学科的医疗从业者对建议的反馈，以及面对面共识会议，制定了 14 条有关中西医结合治疗中风的建议。
本指南侧重于中风的具体中西医结合临床治疗，适用于各级医疗机构和康复机构。指南的最终使用者很可能是医疗从业者，包括中草药专家、针灸师、中西医结合从业者、内科医师、物理治疗师和临床药师。
