Zhang Chen, Yu Ming-Kun, Tang Jin-Ping, Huo Yu-Qing, Fei Yu-Tong, Wang Zhi-Fei, Xu Qiang, Xie Yan-Ming
Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine Tianjin 300150, China.
Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine Beijing 100029, China.
Zhongguo Zhong Yao Za Zhi. 2021 Apr;46(8):1999-2003. doi: 10.19540/j.cnki.cjcmm.20210203.501.
Traditional Chinese medicines(TCMs) have certain limitations in the clinical research design in their post-marketing evaluation, so that randomized controlled programs cannot be strictly implemented in some studies, while the objective performance criteria is a reasonable external controlled research method that has been gradually recognized at home and abroad in recent years in addition to randomized controlled trial(RCT) method. It is more mature in medical devices, surgery and other research fields, but there is no relevant report in the field of post-marketing evaluation of Chinese patent medicines. In this paper, the application prospect of the objective performance criteria and the problems were discussed in the field of post-marketing evaluation of TCM. The characteristics of as TCM are more consistent with the scope of the objective performance criteria, the application of the objective performance criteria in post-marketing evaluation of Chinese patent medicines, especially in single arm research, can break through the limitations of existing conventional clinical research methods, and improve the level of evidence, with good feasibility and advantages. However, in the application process, we should pay attention to the key issues such as the selection of index, research population, follow-up period and the reference selection, to ensure the quality of research. This research group has carried out some exploration and practice in the field of post-marketing evaluation of TCM injections by using single arm combined with the objective performance criteria, hoping to establish the key technology in this field, and provide certain research and design reference for the secondary development of Chinese patent medicines.
中药在上市后评价的临床研究设计方面存在一定局限性,致使一些研究无法严格实施随机对照方案,而客观性能标准是近年来除随机对照试验(RCT)方法外,在国内外逐渐得到认可的一种合理的外部对照研究方法。其在医疗器械、手术等研究领域较为成熟,但在中成药上市后评价领域尚无相关报道。本文探讨了客观性能标准在中药上市后评价领域的应用前景及存在的问题。由于中药的特点与客观性能标准的适用范围较为契合,客观性能标准在中成药上市后评价中,尤其是在单臂研究中应用,能够突破现有传统临床研究方法的局限,提高证据水平,具有良好的可行性和优势。然而,在应用过程中,应注意指标选择、研究人群、随访期及对照选择等关键问题,以确保研究质量。本研究团队在中药注射剂上市后评价领域运用单臂结合客观性能标准开展了一些探索与实践,希望建立该领域的关键技术,并为中成药二次开发提供一定的研究设计参考。