卵巢早衰中医诊疗指南评价与修订
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摘要
目的:通过对系统检索已发表的关于中医药治疗卵巢早衰的文献,在文献研究的基础上,结合Delphi法进行3轮专家问卷调查,并组织专家会议评审,最终形成卵巢早衰中医诊疗指南修订征求意见稿,为临床指南的制定提供参考。方法:通过检索符合条件的文献,进行整理总结,为专家调查问卷条目提供依据。采用改良的德尔菲法,事先拟定专家库,通过3轮专家咨询,收集专家意见,采用SPSS 17. 0对专家的权威程度、专家的积极系数、专家意见的集中程度、专家意见的协调程度进行计算,最后根据专家咨询的结果确定需要纳入的条目。结果:共检出文献共297篇,其中筛选符合要求的目标文献68篇,高质量文献11篇,结合文献研究,进行3轮专家问卷调查。根据调查结果,形成了卵巢早衰中医诊疗指南修订初稿,通过专家论证会及评审,最终制定出科学规范的卵巢早衰中医临床诊疗指南修订征求意见稿。结论:采用文献研究、德尔菲法专家问卷调查和专家论证会相结合的方法,修订了《中医妇科常见病诊疗指南——卵巢早衰》,指南的制定具有科学性和可操作性,有利于中医诊疗规范化研究的发展。
Objective: By systematically searching the published literature on the treatment of premature ovarian failure with traditional Chinese medicine,and on the basis of literature research,three rounds of expert questionnaires were conducted with Delphi method,expert meetings were organized to review them. Finally,a revised draft of the guidelines for the diagnosis and treatment of premature ovarian failure was formed,which could provide reference for the formulation of clinical guidelines. Methods: By searching the qualified literature,we sorted out and summarized to provide the basis for the entries of the expert questionnaire. The improved Delphi method was used,and the expert database was drawn up in advance. Through three rounds of expert consultation,expert opinions were collected. Then the authoritative degree,positive coefficient,concentration degree and coordination degree of expert opinions were calculated by SPSS17. 0. Finally,according to the results of expert consultation,the articles that needed to be included were determined. Results: A total of 297 literatures were detected,68 of which met the requirements,11 of which were of high quality. Three rounds of expert questionnaires were conducted based on literature research. According to the results of the investigation,the revised draft of TCM diagnostic and therapeutic guidelines for premature ovarian failure was formed. Through expert demonstration meeting and evaluation,a scientific and standardized revised draft of TCM clinical diagnostic and therapeutic guidelines for premature ovarian failure was formulated. Conclusion: By means of literature research,Delphi expert questionnaire survey and expert demonstration meeting,The Guidelines for the Diagnosis and Treatment of Common Gynecological Diseases in Traditional Chinese Medicine-Premature Ovarian Failure has been revised,and the formulation of the guidelines is scientific and operable,which is conducive to the development of standardized research of TCM diagnosis and treatment.
Objective: By systematically searching the published literature on the treatment of premature ovarian failure with traditional Chinese medicine,and on the basis of literature research,three rounds of expert questionnaires were conducted with Delphi method,expert meetings were organized to review them. Finally,a revised draft of the guidelines for the diagnosis and treatment of premature ovarian failure was formed,which could provide reference for the formulation of clinical guidelines. Methods: By searching the qualified literature,we sorted out and summarized to provide the basis for the entries of the expert questionnaire. The improved Delphi method was used,and the expert database was drawn up in advance. Through three rounds of expert consultation,expert opinions were collected. Then the authoritative degree,positive coefficient,concentration degree and coordination degree of expert opinions were calculated by SPSS17. 0. Finally,according to the results of expert consultation,the articles that needed to be included were determined. Results: A total of 297 literatures were detected,68 of which met the requirements,11 of which were of high quality. Three rounds of expert questionnaires were conducted based on literature research. According to the results of the investigation,the revised draft of TCM diagnostic and therapeutic guidelines for premature ovarian failure was formed. Through expert demonstration meeting and evaluation,a scientific and standardized revised draft of TCM clinical diagnostic and therapeutic guidelines for premature ovarian failure was formulated. Conclusion: By means of literature research,Delphi expert questionnaire survey and expert demonstration meeting,The Guidelines for the Diagnosis and Treatment of Common Gynecological Diseases in Traditional Chinese Medicine-Premature Ovarian Failure has been revised,and the formulation of the guidelines is scientific and operable,which is conducive to the development of standardized research of TCM diagnosis and treatment.
引文
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[2] ERTUQ K,SCHUTT A K. Premature ovarian failure:clinical pres-entation and treatment[J]. Obstetrics Gynecol Clin North Am,2015,42(1):153-161.
[3]中华医学会妇产科分会绝经学组.早发性卵巢功能不全的激素补充治疗专家共识[J].中华妇产科杂志,2016,51(12):881-886.
[4]陈子江,田秦杰,乔杰,等.早发性卵巢功能不全的临床诊疗中国专家共识[J].中华妇产科杂志,2017,52(9):577-581.
[5] Committee on Gynecologic Practice. Committee opinion no. 618:o-varian reserve testing[J]. Obstet Gynecol,2015,125(1):268-273.
[6] PYUN J A,CHA D H,KWACK K. LAMC1 gene is associated withpremature ovarian failure[J]. Maturitas,2016,71(4):402-406.
[7]叶娜,董晓英,李冬华.卵巢早衰的颗粒细胞凋亡机制研究进展[J].首都医科大学学报,2014,35(3):379-383.
[8]焦智慧,史惠蓉.卵巢早衰诊治进展[J].国际妇产科学杂志,2014,41(2):108-111.
[9] WANG J,WANG B B,SONG J J,et al. New candidate genePOU5F1 associated with premature ovarian failure in Chinese pa-tients[J]. Reproductive Bio Medicine Online,2017,22(3):312-316.
[10] FONSECA D J,JEDA D,LAKHAL B,et al. CITED2 mutationspotentially cause idiopathic premature ovarian failure[J]. Trans-lational Research,2014,160(5):384-388.
[11] OJEDA D,LAKHAL B,FONSECA D J,et al. Sequence analysisof the CDKN1B gene in patients with premature ovarian failurereveals a novel mutation potentially related to the phenotype[J].Fertility and Sterility,2015,95(8):2658-2660.
[12] YOUNG J J,YOUNG S C,SUNG H S,et al. Vascular endothelialgrowth factor genepoly morphismsin Korean patients with prema-ture ovarian failure[J]. European Journal of Obstetrics&Gyne-cology and Reproductive Biology,2015,159(3):138-142.
[13] LIU L,TAN R,CUI Y,et al. Estrogen receptorαgene(ESR1)polymorphisms associated with idiopathic premature ovarian fail-ure in Chinese women[J]. Gynecol Endocrinol,2013,29(2):182-185.
[14] BARASOAIN M,BARRENETXEA G,HUERTA I,et al. Study ofFMR1 gene association with ovarian dysfunction in a sample fromthe Basque Country[J]. Gene,2013,521(1):145-149.
[15]中华中医药学会.中医妇科常见病诊疗指南[M].北京:中国中医药出版社,2012:79-80.
[16]徐颖,叶晓倩,杨珊莉,等.基于德尔菲针刺方案改善卒中后平衡功能障碍的临床研究[J].中华中医药杂志,2018,33(5):2116-2120.
[17]江述荣,李涛,张海峰,等.痴呆心理社会干预质量指标的德尔菲法研究[J].中国心理卫生杂志,2018,18(5):363-368.
[18]张倩岚,应春妹.抗苗勒管激素临床应用进展[J].中国医疗器械信息,2018,24(18):10-11.
[19]刘晓程,郭婷,李斌.早发性卵巢功能不全相关常染色体基因异常的研究进展[J].老年医学与保健,2017,23(6):592-593.
[2] ERTUQ K,SCHUTT A K. Premature ovarian failure:clinical pres-entation and treatment[J]. Obstetrics Gynecol Clin North Am,2015,42(1):153-161.
[3]中华医学会妇产科分会绝经学组.早发性卵巢功能不全的激素补充治疗专家共识[J].中华妇产科杂志,2016,51(12):881-886.
[4]陈子江,田秦杰,乔杰,等.早发性卵巢功能不全的临床诊疗中国专家共识[J].中华妇产科杂志,2017,52(9):577-581.
[5] Committee on Gynecologic Practice. Committee opinion no. 618:o-varian reserve testing[J]. Obstet Gynecol,2015,125(1):268-273.
[6] PYUN J A,CHA D H,KWACK K. LAMC1 gene is associated withpremature ovarian failure[J]. Maturitas,2016,71(4):402-406.
[7]叶娜,董晓英,李冬华.卵巢早衰的颗粒细胞凋亡机制研究进展[J].首都医科大学学报,2014,35(3):379-383.
[8]焦智慧,史惠蓉.卵巢早衰诊治进展[J].国际妇产科学杂志,2014,41(2):108-111.
[9] WANG J,WANG B B,SONG J J,et al. New candidate genePOU5F1 associated with premature ovarian failure in Chinese pa-tients[J]. Reproductive Bio Medicine Online,2017,22(3):312-316.
[10] FONSECA D J,JEDA D,LAKHAL B,et al. CITED2 mutationspotentially cause idiopathic premature ovarian failure[J]. Trans-lational Research,2014,160(5):384-388.
[11] OJEDA D,LAKHAL B,FONSECA D J,et al. Sequence analysisof the CDKN1B gene in patients with premature ovarian failurereveals a novel mutation potentially related to the phenotype[J].Fertility and Sterility,2015,95(8):2658-2660.
[12] YOUNG J J,YOUNG S C,SUNG H S,et al. Vascular endothelialgrowth factor genepoly morphismsin Korean patients with prema-ture ovarian failure[J]. European Journal of Obstetrics&Gyne-cology and Reproductive Biology,2015,159(3):138-142.
[13] LIU L,TAN R,CUI Y,et al. Estrogen receptorαgene(ESR1)polymorphisms associated with idiopathic premature ovarian fail-ure in Chinese women[J]. Gynecol Endocrinol,2013,29(2):182-185.
[14] BARASOAIN M,BARRENETXEA G,HUERTA I,et al. Study ofFMR1 gene association with ovarian dysfunction in a sample fromthe Basque Country[J]. Gene,2013,521(1):145-149.
[15]中华中医药学会.中医妇科常见病诊疗指南[M].北京:中国中医药出版社,2012:79-80.
[16]徐颖,叶晓倩,杨珊莉,等.基于德尔菲针刺方案改善卒中后平衡功能障碍的临床研究[J].中华中医药杂志,2018,33(5):2116-2120.
[17]江述荣,李涛,张海峰,等.痴呆心理社会干预质量指标的德尔菲法研究[J].中国心理卫生杂志,2018,18(5):363-368.
[18]张倩岚,应春妹.抗苗勒管激素临床应用进展[J].中国医疗器械信息,2018,24(18):10-11.
[19]刘晓程,郭婷,李斌.早发性卵巢功能不全相关常染色体基因异常的研究进展[J].老年医学与保健,2017,23(6):592-593.