中医适宜技术治疗脑卒中后偏瘫的循证临床实践指南

Evidence-based clinical practice guidelines for the application of traditional Chinese medicine techniques in post-stroke hemiplegia rehabilitation

脑卒中是成年人死亡和残疾的主要原因之一。中医适宜技术在脑卒中后偏瘫的康复治疗中广泛应用,然而尚缺乏系统的、高质量的循证指南来指导这些实践。本指南根据《世界卫生组织指南制订手册》和《中西医结合诊疗指南制订手册》制定,遵循卫生保健实践指南的报告要求,并参照推荐分级的评估、制定与评价系统对证据质量及推荐强度进行分级。本指南组建了包括5个小组在内的跨学科工作团队,通过问卷、面对面专家会议和问题解构方法来选择指南中需要回答的关键临床问题。从25个关键问题中筛选出10个进行研究。基于系统评价的结果,考虑到证据的优缺点、干预成本、证据质量、患者偏好及价值观、多学科专家的反馈和共识,本指南提出了20条关于中医适宜技术在脑卒中后偏瘫康复治疗中应用的推荐意见。本指南主要面向中国各级医院和康复机构的医务工作者,专注于中医适宜技术在脑卒中后偏瘫康复治疗中的临床应用。

Stroke is one of the leading causes of death and disability in adults.Traditional Chinese Medicine(TCM)techniques have been widely applied in the rehabilitation treatment of post-stroke hemiplegia,yet there is a lack of systematic and high-quality evidence-based guidelines to inform these practices.This guideline was developed in accordance with the"WHO Handbook for Guideline Development"and the"Manual for the Development of Integrated Traditional Chinese and Western Medicine Treatment Guidelines".It adheres to the reporting principles of the Appraisal of Guidelines for Research&Evaluation(AGREE)in healthcare practice guidelines and utilizes the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system for grading the quality of evidence and the strength of recommendations.A multidisciplinary team,including five groups,was established to select key clinical questions to be addressed in the guideline through questionnaires,face-to-face expert meetings,and a problem-deconstruction approach.10 research topics were to be selected from 25 key questions.Based on the results of systematic reviews,and considering the pros and cons of the evidence,intervention costs,quality of evidence,patient preferences and values,and feedback and consensus from multidisciplinary experts,this guideline proposes 20 recommendations for the application of TCM techniques in the rehabilitation treatment of post-stroke hemiplegia.Primarily aimed at medical practitioners in hospitals and rehabilitation institutions across China,it focuses on the clinical application of TCM techniques in the rehabilitation treatment of post-stroke hemiplegia.