《中医药单用/联合抗生素治疗小儿急性上呼吸道感染临床实践指南》临床应用评价与修订意见
|
摘要
该文采用调查问卷和病例调查的方法,以中华中医药学会发布的《中医药单用/联合抗生素治疗小儿急性上呼吸道感染临床实践指南》为研究对象,邀请来自全国29个地区187家医院医生评价研究《指南》的适用性及临床应用效果,征集《指南》的修订意见。508位临床医生接受《指南》的适用性调查,认为《指南》结构、内容合理,比例分别高达98. 23%,98. 03%。在辨证论治内容中,评价合理性较高的为治则治法(99. 41%)、诊断要点(98. 82%)、辨证分类(98. 03%);合理性相对较低的为康复调摄(97. 05%)、并发症预防(97. 24%); 98. 03%临床医生认为《指南》完全适用和基本适用,1. 97%认为修订后适用。通过观察491份病例,对《指南》进行应用性评价分析,符合度较高的为西医疾病诊断(100%)、中医疾病诊断(99. 18%);较低的为治疗措施方面,方剂成药、其他治法符合率分别为77. 18%,83. 05%;《指南》的安全性和经济性较好,分别为97. 35%,93. 89%;综合评价较好,99. 41%被调查者愿意遵从《指南》推荐的治疗方案,适合临床推广应用。对于《指南》修订意见主要集中在辨证治疗、并发症预防及康复调摄部分。积极广泛征求意见修订《指南》,可以更好的提高《指南》质量,指导临床,从而提高临床疗效水平。
Questionnaires and case investigation methods were taken in this paper,taking the clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for upper respiratory tract infection in children published by the Chinese Medicine Association as the research object. Doctors from 187 hospitals in 29 regions across the country were invited to evaluate the applicability of the Guideline and clinical application effects,so as to collect the opinions on revising the Guideline. Clinicians about 508 accepted the applicability survey of the Guideline,and considered that the structure and content of the Guideline were reasonable,with the proportions being as high as 98. 23% and 98. 03%,respectively. In the content of syndrome differentiation-based treatment,the factors with higher rationality included therapeutic principle and method( 99. 41%),diagnosis elements( 98. 82%),and syndrome differentiation classification( 98. 03%); while the factors with lower rationality included the rehabilitation and health preserving( 97. 05%) and complication prevention( 97. 24%). 98. 03% of the clinicians considered theat the Guideline was to be fully applicable and basically applicable,and 1. 97% of the clinicians considered it to be applicable after revision. By observing 491 cases,the Guide was applied for evaluation and analysis. The factors with higher compliance included diagnosis of Western medicine disease( 100%) and the diagnosis of TCM disease( 99. 18%); while the factors with lower compliance included the treatment measures,with a compliance rate of 77. 18% and 83. 05% respectively for simple preparations and other treatment method. The safety and economy of the Guideline were good,97. 35%,93. 89%,respectively. The comprehensive evaluation was good,and 99. 41% of the respondents were willing to follow the treatment schemes recommended in the Guideline,suitable for clinical application. The opinions on revision were mainly focused on dialectical treatment,complication prevention and rehabilitation. It indicates that only by actively and extensively soliciting opinions to revise the Guideline,can we improve the quality of the Guideline for clinical practice,so as to raise the level of clinical efficacy.
Questionnaires and case investigation methods were taken in this paper,taking the clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for upper respiratory tract infection in children published by the Chinese Medicine Association as the research object. Doctors from 187 hospitals in 29 regions across the country were invited to evaluate the applicability of the Guideline and clinical application effects,so as to collect the opinions on revising the Guideline. Clinicians about 508 accepted the applicability survey of the Guideline,and considered that the structure and content of the Guideline were reasonable,with the proportions being as high as 98. 23% and 98. 03%,respectively. In the content of syndrome differentiation-based treatment,the factors with higher rationality included therapeutic principle and method( 99. 41%),diagnosis elements( 98. 82%),and syndrome differentiation classification( 98. 03%); while the factors with lower rationality included the rehabilitation and health preserving( 97. 05%) and complication prevention( 97. 24%). 98. 03% of the clinicians considered theat the Guideline was to be fully applicable and basically applicable,and 1. 97% of the clinicians considered it to be applicable after revision. By observing 491 cases,the Guide was applied for evaluation and analysis. The factors with higher compliance included diagnosis of Western medicine disease( 100%) and the diagnosis of TCM disease( 99. 18%); while the factors with lower compliance included the treatment measures,with a compliance rate of 77. 18% and 83. 05% respectively for simple preparations and other treatment method. The safety and economy of the Guideline were good,97. 35%,93. 89%,respectively. The comprehensive evaluation was good,and 99. 41% of the respondents were willing to follow the treatment schemes recommended in the Guideline,suitable for clinical application. The opinions on revision were mainly focused on dialectical treatment,complication prevention and rehabilitation. It indicates that only by actively and extensively soliciting opinions to revise the Guideline,can we improve the quality of the Guideline for clinical practice,so as to raise the level of clinical efficacy.
引文
[1]刘孟宇,杨伟,赵学尧,等.中医临床诊疗指南应用评价方法研究[J].中华中医药杂志,2016,31(2):552.
[2]刘孟宇,韩学杰,杨伟,等.基于中医诊疗指南调摄预防内容的临床应用评价研究[J].中华中医药杂志,2016,31(3):907.
[3]刘孟宇,史楠楠,王燕平,等.中医临床诊疗指南应用评价项目的组织管理与质量监查[J].中华中医药杂志,2016,31(1):172.
[4]王蓓,李金鑫,温建民.综合医院西医医师使用中成药情况调查分析[J].中国中医药信息杂志,2016,23(9):120.
[5]王丽.高度关注儿童用药的安全性[J].儿科药学杂志,2009,15(5):1.
[6]袭雷鸣.儿童急性上呼吸道感染病原学检测与中医辨证分型相关性研究[D].济南:山东中医药大学,2006.
[7]唐杨琛,沈干,胡世莲,等.中国基层临床指南现状分析及评价[J].中华高血压杂志,2013,21(1):48.
[8]戎萍,马融,刘全慧,等.中成药治疗小儿急性上呼吸道感染研究述评[J].中国中药杂志,2017,42(8):1455.
[2]刘孟宇,韩学杰,杨伟,等.基于中医诊疗指南调摄预防内容的临床应用评价研究[J].中华中医药杂志,2016,31(3):907.
[3]刘孟宇,史楠楠,王燕平,等.中医临床诊疗指南应用评价项目的组织管理与质量监查[J].中华中医药杂志,2016,31(1):172.
[4]王蓓,李金鑫,温建民.综合医院西医医师使用中成药情况调查分析[J].中国中医药信息杂志,2016,23(9):120.
[5]王丽.高度关注儿童用药的安全性[J].儿科药学杂志,2009,15(5):1.
[6]袭雷鸣.儿童急性上呼吸道感染病原学检测与中医辨证分型相关性研究[D].济南:山东中医药大学,2006.
[7]唐杨琛,沈干,胡世莲,等.中国基层临床指南现状分析及评价[J].中华高血压杂志,2013,21(1):48.
[8]戎萍,马融,刘全慧,等.中成药治疗小儿急性上呼吸道感染研究述评[J].中国中药杂志,2017,42(8):1455.