Lian Fengmei, Ni Qing, Shen Yuandong, Yang Shuyu, Piao Chunli, Wang Jia, Wei Junping, Duan Junguo, Fang Zhaohui, Lu Hao, Yang Guanhu, Zhao Linhua, Song Juexian, Li Qingwei, Zheng Yujiao, Lyu Yi, Tong Xiaolin
Clinical Evaluation Center, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Ann Palliat Med. 2020 Jul;9(4):2237-2250. doi: 10.21037/apm-19-271. Epub 2020 Jul 10.
Diabetes mellitus (DM) was one of the most severe public health problems that affected nearly 463 million adults around the world. In addition to insulin and oral hypoglycemic agents, traditional Chinese medicine (TCM) was an effective alternative therapy for diabetes and its complications, and it had been widely used in the Pan-Pacific region, especially in Southeast Asia, however, TCM lacked specialized standards of care for DM in the past, which limited the TCM clinical efficacy of diabetes. Since March 2017, the Endocrinology Committee of World Federation of Chinese Medicine Societies (WFCMS) had invited experts in diabetes, TCM, and international standard setting to work with TCM endocrinologists from the Guideline Development Committee to review the TCM clinical research evidence related to the prevention and treatment of diabetes over the previous 14 years. Over an 8-months careful revision, the international TCM guideline was finally developed under the guidance of review experts, physicians and surveyed patients, to provide standardized diagnosis and treatment advice of diabetes for global TCM doctors. This guideline clarified the TCM classification, staging, and syndromes of diabetes, gave the instructions that how to identified different stages and syndromes clearly, and accordingly recommended different TCM therapies based on the level of evidence. It's worth noting that when the guideline was being made, fewer high-quality clinical research evidence could be found, and very few researches were so outdated that need to be updated. More high-quality research evidence would be included in the updated version of guideline to continuously improve the overall level of global TCM in preventing and treating diabetes, and long-term clinical researches were advocated.
糖尿病(DM)是最严重的公共卫生问题之一,影响着全球近4.63亿成年人。除胰岛素和口服降糖药外,传统中医(TCM)是治疗糖尿病及其并发症的一种有效替代疗法,在泛太平洋地区,尤其是东南亚地区已被广泛应用。然而,过去中医缺乏针对糖尿病的专门护理标准,这限制了中医治疗糖尿病的临床疗效。自2017年3月起,世界中医药学会联合会(WFCMS)内分泌委员会邀请糖尿病、中医及国际标准制定方面的专家,与指南制定委员会的中医内分泌专家共同回顾过去14年里与糖尿病防治相关的中医临床研究证据。经过8个月的精心修订,在评审专家、医生及受调查患者的指导下,最终制定出国际中医指南,为全球中医医生提供糖尿病的标准化诊断和治疗建议。该指南明确了糖尿病的中医分类、分期及证候,给出了如何清晰辨别不同阶段和证候的指导,并根据证据水平推荐了不同的中医疗法。值得注意的是,在制定该指南时,高质量的临床研究证据较少,且极少有研究过时到需要更新的程度。更新版指南将纳入更多高质量研究证据,以不断提高全球中医防治糖尿病的整体水平,并提倡开展长期临床研究。