Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China.
Evidence-Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China.
J Evid Based Med. 2021 Dec;14(4):313-332. doi: 10.1111/jebm.12444. Epub 2021 Oct 11.
The coronavirus disease 2019 (COVID-19) has turned into a pandemic and resulted in huge death tolls and burdens. Integrating Chinese and western medicine has played an important role in the fight against the COVID-19 pandemic.
We aimed to develop a living evidence-based guideline of integrating Chinese and western medicine for COVID-19.
Living evidence-based guideline.
This living guideline was developed using internationally recognized and accepted guideline standards, dynamically monitoring the release of new clinical evidence, and quickly updating the linked living systematic review, evidence summary tables, and recommendations. Modified Delphi method was used to reach consensus for all recommendations. The certainty of the evidence, resources, and other factors were fully considered, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to rate the certainty of evidence and the strength of recommendations.
The first version of this living guidance focuses on patients who are mild or moderate COVID-19. A multidisciplinary guideline development panel was established. Ten clinical questions were identified based on the status of evidence and a face-to-face experts' consensus. Finally, nine recommendations were reached consensus, and were formulated from systematic reviews of the benefits and harms, certainty of evidence, public accessibility, policy supports, feedback on proposed recommendations from multidisciplinary experts, and consensus meetings.
This guideline panel made nine recommendations, which covered five traditional Chinese medicine (TCM) prescription granules/decoction (MXXFJD, QFPD, XFBD, TJQW, and JWDY), three Chinese patent medicines (LHQW granules/capsule, JHQG granules, and LHQK granules), and one Chinese herbal injection (XBJ injection). Of them, two were strongly recommended (LHQW granules/capsule and QFPD decoction), and five were weakly recommended (MXXFJD decoction, XFBD decoction, JHQG granules, TJQW granules, and JWDY decoction) for the treatment of mild and moderate COVID-19; two were weakly recommended against (XBJ injection and LHQK granules) the treatment of mild and moderate COVID-19. The users of this living guideline are most likely to be clinicians, patients, governments, ministries, and health administrators.
2019 年冠状病毒病(COVID-19)已成为大流行,导致大量死亡和负担。中西医结合在抗击 COVID-19 大流行中发挥了重要作用。
我们旨在制定中西医结合治疗 COVID-19 的循证指南。
循证指南。
本循证指南采用国际认可和接受的指南标准制定,动态监测新临床证据的发布,并快速更新相关的循证综述、证据总结表和建议。采用改良 Delphi 法对所有建议达成共识。充分考虑证据、资源和其他因素的确定性,并采用推荐评估、制定和评价(GRADE)方法对证据确定性和建议强度进行分级。
本循证指南的第一版主要针对轻度或中度 COVID-19 患者。成立了一个多学科指南制定小组。根据证据现状和面对面专家共识,确定了 10 个临床问题。最终,有 9 项建议达成共识,这些建议来自于系统评价的获益和危害、证据确定性、公众可及性、政策支持、多学科专家对建议的反馈以及共识会议。
本指南小组提出了 9 项建议,涵盖了 5 种中药配方颗粒/汤剂(MXXFJD、QFPD、XFBD、TJQW 和 JWDY)、3 种中药成药(LHQW 颗粒/胶囊、JHQG 颗粒和 LHQK 颗粒)和 1 种中药注射剂(XBJ 注射液)。其中,2 项强烈推荐(LHQW 颗粒/胶囊和 QFPD 汤剂),5 项弱推荐(MXXFJD 汤剂、XFBD 汤剂、JHQG 颗粒、TJQW 颗粒和 JWDY 汤剂)用于治疗轻度和中度 COVID-19;2 项弱推荐(XBJ 注射液和 LHQK 颗粒)用于治疗轻度和中度 COVID-19。本循证指南的使用者很可能是临床医生、患者、政府、部委和卫生管理人员。