Zheng Qingyong, Gao Ya, Xiong Lu, Huang Hengyi, Li Junfen, OuYang Guoyuan, Saimire Wulayin, Yang Jingjing, Zhang Yu, Wang Xiaopeng, Luo Xiaofeng
School of Public Health, Lanzhou University, Lanzhou, China.
School of Nursing, Evidence-based Nursing Center, Lanzhou University, Lanzhou, China.
Acupunct Herb Med. 2022 Sep;2(3):152-161. doi: 10.1097/HM9.0000000000000043. Epub 2022 Dec 8.
To systematically review the clinical practice guidelines (CPGs) for the treatment of patients with coronavirus disease 2019 (COVID-19) using Chinese herbal medicine (CHM), assess the methodological quality as well as clinical credibility and implementability of specific recommendations, and summarize key recommendations.
As of April 2022, we conducted a comprehensive search on major electronic databases, guideline websites, academic society websites, and government websites to assess the methodological quality and clinical applicability of the included CPGs using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool and Evaluation-Recommendations EXcellence (AGREE-REX) instructions, respectively.
The search yielded 61 CPGs, which were mostly published in 2020; moreover, 98.4% of the CPGs were published in China. Only five CPGs achieved a high-quality AGREE II rating; further, six CPGs could be directly recommended, with most of the CPGs still showing much room for improvement. CPGs had a low overall score in the AGREE-REX evaluation, with the domains of clinical applicability, values and preferences, and implementability being standardized in 21.80% ± 12.56%, 16.00% ± 11.81%, and 31.33% ± 14.55% of the CPGs, respectively. Five high-quality CPGs mentioned 56 Chinese herbal formulas. Half of the recommendations had moderate or strong evidence level in the GRADE evaluation. The most frequently recommended herbal medicines were Lianhua Qingwen granule/capsule and Jinhua Qinggan granule; however, the strength of recommendation for each prescription varied across CPGs and populations.
The overall quality of current CPGs for COVID-19 for CHM still needs to be improved; moreover, the strength of the evidence remains to be standardized across CPGs.
系统评价2019冠状病毒病（COVID-19）患者使用中药治疗的临床实践指南（CPG），评估方法学质量以及具体推荐意见的临床可信度和可实施性，并总结关键推荐意见。
截至2022年4月，我们在主要电子数据库、指南网站、学术团体网站和政府网站上进行了全面检索，分别使用《研究与评价指南评估（AGREE）II》工具和《评估-推荐卓越（AGREE-REX）》说明来评估纳入的CPG的方法学质量和临床适用性。
检索共获得61篇CPG，大多发表于2020年；此外，98.4%的CPG发表于中国。只有5篇CPG获得了AGREE II的高质量评分；此外，6篇CPG可直接推荐，大多数CPG仍有很大的改进空间。CPG在AGREE-REX评估中的总体得分较低，临床适用性、价值观和偏好以及可实施性领域分别在21.80%±12.56%、16.00%±11.81%和31.33%±14.55%的CPG中得到规范。5篇高质量CPG提及了56个中药方剂。在GRADE评估中，一半的推荐意见具有中等或强证据水平。最常推荐的草药是连花清瘟颗粒/胶囊和金花清感颗粒；然而，每个方剂的推荐强度在不同的CPG和人群中有所不同。
目前COVID-19中药治疗CPG的总体质量仍需提高；此外，各CPG之间证据强度仍有待规范。
