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台湾地区 COPD 治疗指南的更新:基于证据和 GRADE 系统的推荐。

Update on guidelines for the treatment of COPD in Taiwan using evidence and GRADE system-based recommendations.

机构信息

Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan; Department of Chemical Engineering and Materials Science, Yuan Ze University, Zhongli City, Taoyuan County, Taiwan.

Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan; Department of Respiratory Care, College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan.

出版信息

J Formos Med Assoc. 2021 Oct;120(10):1821-1844. doi: 10.1016/j.jfma.2021.06.007. Epub 2021 Jun 29.

Abstract

Chronic obstructive pulmonary disease (COPD) has significant contributions to morbidity and mortality world-wide. Early symptoms of COPD are not readily distinguishable, resulting in a low rate of diagnosis and intervention. Different guidelines and recommendatations for the diagnosis and treatment of COPD exist globally. The first edition of clinical practice guidelines for COPD was published in 2016 by the Ministry of Health and Welfare in Taiwan in collaboration with the Taiwan evidence-based medicine association and Cochrane Taiwan, and was revised in 2019 in order to update recent diagnostic and therapeutic modalities for COPD and its acute exacerbation. This revised guideline covered a range of topics highlighted in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) report, including strategies for the diagnosis, assessment, monitoring, and management of stable COPD and exacerbations, with particular focus on evidence from Taiwan. The recommendations included in the revised guideline were formed based on a comprehensive systematic review or meta-analysis of specific clinical issues identified by an expert panel that surveyed relevant scientific evidence in the literature and guidelines published by the clinical communities and organizations nationally and internationally. The guidelines and recommendations are applicable to the clinical settings in Taiwan. We expect this revised guideline to facilitate the diagnosis, treatment and management of patients with COPD by physicians and health care professionals in Taiwan. Adaptations of the materials included herein for educational and training purposes is encouraged.

摘要

慢性阻塞性肺疾病(COPD)在全球范围内对发病率和死亡率有重大影响。COPD 的早期症状不易察觉,导致诊断和干预率较低。全球存在不同的 COPD 诊断和治疗指南和建议。2016 年,台湾卫生福利部与台湾实证医学协会和 Cochrane Taiwan 合作发布了 COPD 临床实践指南的第一版,并于 2019 年进行了修订,以更新 COPD 及其急性加重的最新诊断和治疗方法。本修订指南涵盖了全球倡议慢性阻塞性肺疾病(GOLD)报告中强调的一系列主题,包括 COPD 稳定期和加重期的诊断、评估、监测和管理策略,特别关注来自台湾的证据。修订指南中的建议是基于专家小组对特定临床问题进行全面系统审查或荟萃分析形成的,该小组调查了文献和国内外临床社区和组织发布的相关科学证据以及指南。该指南和建议适用于台湾的临床环境。我们希望本修订指南能够为台湾的医生和医疗保健专业人员提供 COPD 患者的诊断、治疗和管理方面的便利。鼓励为教育和培训目的改编本文包含的材料。

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