缺血性脑卒中中医康复治疗指南的系统评价

Traditional Chinese Medicine Rehabilitation Guidelines for Ischemic Stroke:A Systematic Review

目的:系统评价缺血性脑卒中中医康复治疗指南的质量,为指南的制定规范提供借鉴。方法:计算机检索数据库:PubMed、国家知识基础设施数据库、中国学术期刊数据库、中文科技期刊数据库、中国生物医学文献数据库,检索指南相关网站:卫生保健规范研究所(NICE)、国际网指南(GIN)数据库,梅斯医学数据库,中华中医药学会标准化委员会网站(http://www.cacm.org.cn/category/zyzn/bzh/)、中国中西医结合学会网站(http://www.caim.org.cn/),检索时限为建库至2021年9月,收集缺血性脑卒中中医康复治疗指南。应用研发与评价指南评估Ⅱ(AGREEⅡ)工具对纳入指南进行质量评价,并汇总中等质量及以上的指南推荐意见。结果:共纳入13部指南,AGREEⅡ的平均得分分别为范围和目的65.67%、参与人员43.02%、严谨性43.64%、清晰性63.82%、应用性19.87%和独立性32.05%。13部指南中7部指南为中等质量,6部指南为低质量。本研究得到23条中医康复治疗的推荐意见,其中2条为强推荐。结论:指南总体质量不高,未来指南的制定应该从指南应用性、严谨性和独立性方面规范,同时重视开展高质量的临床研究,为指南的制定提供证据支持。

Objective:To systematically evaluate the quality of traditional Chinese medicine(TCM)rehabilitation guidelines for ischemic stroke,and provide reference for the formulation of guidelines.Methods:TCM rehabilitation guidelines for ischemic stroke were collected from PubMed,China National Knowledge Infrastructure(CNKI),Chinese Science Citation Database(CSPD),Chinese Citation Database(CCD),China Biology Medicine(CBM)the National Institute for Health and Care Excellence(NICE),Guidelines International Network(GIN),MedSci,China Association of Chinese Medicine(http://www.cacm.org.cn/category/zyzn/bzh/),and Chinese Association of Integrated Traditional and Western Medicine(http://www.caim.org.cn/)from the inception of the databases to September,2021.The Appraisal of Guidelines for Research and Evaluation(AGREE)Ⅱwas used to evaluate the quality of the included guidelines,and the recommendations from the guidelines of medium quality and above were summarized.Results:A total of 13 guidelines were included.The average scores of the guidelines in six domains of AGREEⅡwere:scope and purpose 65.67%,stakeholder involvement 43.02%,rigor of development 43.64%,clarity of presentations 63.82%,applicability 19.87%,and independence 32.05%.In the 13 guidelines,7 were of medium quality and 6 were of low quality.And 23 recommendations for TCM rehabilitation treatment were obtained,of which 2 were highly recommended.Conclusion:The overall quality of the included guidelines is not high.Future guidelines should be standardized from the aspects of applicability,rigor and independence.Moreover,high quality clinical research should be carried out to provide evidence support for the formulation of guidelines.