Exploration on the Development of Evidence-based Grading System for Chinese Medicine Interventional Clinical Evidence

LIU Shaonan; GUO Xinfeng; WU Darong; ZHANG Anthony Lin; XUE Charlie Changli; WEN Zehuai

doi:10.13288/j.11-2166/r.2023.18.010

您当前的位置：

首页 >

文章列表页 >

Exploration on the Development of Evidence-based Grading System for Chinese Medicine Interventional Clinical Evidence

更新时间：2023-09-12

- Exploration on the Development of Evidence-based Grading System for Chinese Medicine Interventional Clinical Evidence
- Journal of Traditional Chinese Medicine Vol. 64, Issue 18, Pages: 1885-1889(2023)
- 作者机构：
  
  1.广州中医药大学第二附属医院/广东省中医院，广东省广州市越秀区大德路111号，510120
  2.省部共建中医湿证国家重点实验室（广州中医药大学第二附属医院）
  3.China-Australia International Research Center for Chinese Medicine， School of Health and Biomedical Sciences， RMIT University
  4.广州中医药大学科技创新中心
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2023.18.010
  CLC：
- Received：12 January 2023，
  
  Revised：2023-06-26，
  
  Published：17 September 2023
- 稿件说明：
移动端阅览
刘少南,郭新峰,吴大嵘等.中医干预类临床证据分级系统构建思路探讨[J].中医杂志,2023,64(18):1885-1889.

LIU Shaonan,GUO Xinfeng,WU Darong,et al.Exploration on the Development of Evidence-based Grading System for Chinese Medicine Interventional Clinical Evidence[J].Journal of Traditional Chinese Medicine,2023,64(18):1885-1889.
刘少南,郭新峰,吴大嵘等.中医干预类临床证据分级系统构建思路探讨[J].中医杂志,2023,64(18):1885-1889. DOI： 10.13288/j.11-2166/r.2023.18.010.

LIU Shaonan,GUO Xinfeng,WU Darong,et al.Exploration on the Development of Evidence-based Grading System for Chinese Medicine Interventional Clinical Evidence[J].Journal of Traditional Chinese Medicine,2023,64(18):1885-1889. DOI： 10.13288/j.11-2166/r.2023.18.010.

摘要

证据分级水平是进行临床决策的重要考虑因素。中医药领域完全照搬国际常用证据评价体系存在一定局限性，故提出中医临床证据分级思路，即在遵循国际证据分级标准基础上，充分考虑中医药临床实践特点，以GRADE（Grades of Recommendation，Assessment， Development， and Evaluation）证据评价系统为基础，结合中医古籍证据及现代名医经验证据分级标准，进而整合形成中医干预类临床证据分级系统，其中古籍证据从医案来源、诊疗内容的全面性和传承性三方面进行评价，现代名医经验证据根据名医的资质、经验内容完整性、经验传承性进行评价。针对中医古籍、现代名医经验及现代研究多来源证据的整合，以定性综合为主，多来源证据的分级水平与现代研究GRADE证据评价保持一致，而中医古籍及现代名医经验作为辅助证据呈现，以期更加客观、全面地评价中医临床证据，进而指导临床实践。

Abstract

The grading of evidence is an important factor in clinical decision-making. The current evidence grading system based on western medicine is limited in the clinical practice of traditional Chinese medicine （TCM）， therefore we propose the solutions to the development of grading system for TCM interventional evidence， following the international evidence grading standards， taking into considerations of the unique characteristics of TCM practice， based on the Grades of recommendation， assessment， development and evaluation （GARDE） evaluation system， and integrating with grading system regarding TCM classical literature and empirical evidence from modern famous doctors. The evidence from classical literature is suggested to be evaluated from three aspects including source of ancient medical records， comprehensive of treatment details， and the inheritance. The qualification of famous doctors， content integrity， and inheritance of experiences will be used to evaluate the evidence from famous doctors' experience. The multi-sourced evidence such as TCM classical literature， experience of modern famous doctors， and modern researches is mainly integrated in a qualitative way， and the overall level of evidence of TCM interventions will be graded consistently with the GRADE system based on modern research. The evidence from classical literature and modern famous doctors' experience will be assessed and considered as supplementary evidence， which will make the evaluation of clinical evidence more objectively and comprehensively， thereby guiding clinical practice further.

关键词

Keywords

references

ZHANG YQ ， LU L ， XU N ， et al . Increasing the usefulness of acupuncture guideline recommendations ［J］. BMJ ， 2022 ， 376 ： e070533 . doi： 10.1136/bmj-2022-070533 http://dx.doi.org/10.1136/bmj-2022-070533 .

ATKINS D ， BEST D ， BRISS PA ， et al . Grading quality of evidence and strength of recommendations ［J］. BMJ ， 2004 ， 328 （ 7454 ）： 1490 .

Oxford Centre for Evidence-Based Medicine Levels of Evidence Working Group . The Oxford Levels of Evidence 2 ［EB/OL］. （ 2011-01-01 ）［ 2023-01-12 ］. https：//www.cebm.ox.ac.uk/resources/levels-of-evidence/ocebm-levels-of-evidence https://www.cebm.ox.ac.uk/resources/levels-of-evidence/ocebm-levels-of-evidence .

GYLLENHAAL C ， KADUSHIN MR ， SOUTHAVONG B ， et al . Ethnobotanical approach versus random approach in the search for new bioactive compounds： support of a hypothesis ［J］. Pharm Biol ， 2012 ， 50 （ 1 ）： 30 - 41 .

陈薇，方赛男，刘建平 . 基于证据体的中医药临床证据分级标准建议［J］. 中国中西医结合杂志， 2019 ， 39 （ 3 ）： 358 - 364 .

衷敬柏 . 建立适合中医临床诊疗证据评价方法的建议［J］. 中华中医药杂志， 2016 ， 31 （ 4 ）： 1146 - 1148 .

汪受传，陈争光，徐珊，等 . 建立循证中医临床实践指南证据分级体系的构想［J］. 世界科学技术-中医药现代化， 2013 ， 15 （ 7 ）： 1488 - 1492 .

张薇，李小娟，邓宏勇 . 中医临床证据分级和推荐体系发展现状［J］. 中国中医药信息杂志， 2020 ， 27 （ 5 ）： 133 - 136 .

夏鸿杰，赵峥嵘，郭静，等 . 中医相关证据质量及推荐意见分级体系的系统评价［J］. 中国循证医学杂志， 2022 ， 22 （ 2 ）： 187 - 195 .

苏鹏丽，刘骏，于亚南，等 . 中医药证据体系及评价要素研究现状分析［J］. 中医杂志， 2022 ， 63 （ 3 ）： 288 - 292

李敬华 . 中医治疗文献质量评价方法及示范应用研究［D］. 北京：中国中医科学院， 2009 .

任玉兰，吴曦，梁繁荣 . 基于循证医学针灸临床研究证据评价体系的初步构建［J］. 辽宁中医杂志， 2012 ， 39 （ 2 ）： 205 - 209 .

姚钰宁，曹克刚，托托，等 . 基于专家问卷的中医古籍证据分级及推荐方法的构建［J］. 中医杂志， 2021 ， 62 （ 7 ）： 572 - 576 .

施秀青，李红艳，周婕，等 . 中医/中西医结合临床实践指南与专家共识中证据质量评价与推荐意见的应用现状分析［J］. 中医杂志， 2023 ， 64 （ 6 ）： 581 - 586 .

陈耀龙，刘萧，王燕平，等 . 西医指南与中医药指南：在相互学习中共同提高［J］. 协和医学杂志， 2020 ， 11 （ 5 ）： 615 - 620 .

刘少南 . 基于GRADE构建中医干预类临床证据分级系统及应用研究［D］. 广州：广州中医药大学， 2021 .

卢传坚，薛长利，郭新峰，等 . 中医药整体证据研究的标准化操作规程第2部分：古籍证据的梳理（T/ CACM 1335.2-2020 ）［S］. 北京：中华中医药学会， 2020 .

陈远彬，吴蕾，于旭华，等 . “培土生金”中医理论溯源及治疗慢性阻塞性肺疾病的古籍文献研究［J］. 辽宁中医杂志， 2019 ， 46 （ 6 ）： 1193 - 1196 .

陈昊，王艳，陈耀龙，等 . 从GRADE系统方法学看中医药临床证据体系的构建［J］. 中华中医药杂志， 2017 ， 32 （ 1 ）： 25 - 28 .

施逸凡，范志朔，陈腾飞，等 . 中医医案临床证据应用与疗效评价体系探索［J］. 中国中医药信息杂志， 2022 ， 29 （ 12 ）： 9 - 15 .

丁楠，武晓冬，赵楠琦，等 . 中医古籍文献分级和推荐体系的发展现状［J］. 中华中医药杂志， 2021 ， 36 （ 10 ）： 6014 - 6017 .

查看原文

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Professor TONG Xiaolin's Experience in Treating Prediabetes with Overweight and Obesity Using the Method of Relieving Depression and Reducing Turbidity

CHAO Enxiang's Experience in Treating Idiopathic Pulmonary Hemosiderosis by Staging：from the Perspective of Heat，Phlegm，Stasis and Deficiency

YAN Huimin's Experience in Staged Treatment of Pediatric IgA Vasculitis

LIU Shenlin's Experience in Treating Gastric Cancer with the Thinking of "Prescription According to Tendency"

YE Jianzhou's Experience in Treating Atopic Dermatitis in Children with the Method of Regulating the Heart and Treating the Spirit

Related Author

仝小林

ZHAO Linhua

XU Xiaoxuan

LI Qingwei

ZHANG Boxun

JIN Zishan

YAN Yan

LIU Yangyang

Related Institution

Affiliated Hospital of Chengdu University of Traditional Chinese Medicine

Beijing University of Chinese Medicine

The Affiliated Hospital of Changchun University of Chinese Medicine

Guang 'anmen Hospital，China Academy of Chinese Medical Sciences

Japan Friendship Hospital

Address：No.16, Nanxiao street, Dongzhimen, Dongcheng District, Beijing Postal code：100700
Tel：010-64035632 Email：jtcmcn@188.com
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备09064830号-19 京公网安备11010102007558号
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰