对2010年第二版中国《慢性乙型肝炎防治指南》和修订指南的几点个人看法

Personal comments on the original and revised versions of "Guidelines for Prevention and Treatment of Chronic Hepatitis B"(Second edition,China 2010)

2010年版《慢性乙型肝炎防治指南》受到临床医生的密切关注。修订指南的目的是不断规范临床医生的诊治行为。对专家在临床实践中积累的经验,既不可盲目推广,又不可一概否定,需要加强研究以提高循证医学证据级别。指南应根据临床实际,提高其可操作性和指引作用,比如如何正确处理抗病毒药物的常见副反应;如何把握核苷类药物停药时机和指征;如何处理初治用药的"优选"与应答不佳或耐药后的"优化"等,均可以给予更为明确、具体和详细的描述。

＂Guidelines for Prevention and Treatment of Chronic Hepatitis B （2010） ＂ has drawn intensive attention from clinicians. This revised copy of the guidelines was aimed at successive standardization of diagnosis and treatment. The expert opinions that arise from personal expertise should not be put to unquestioned promotion or complete rejection,but subjected to further investigation for a higher level of evidences. In addition,the guide- lines should be adapted to clinical practices in order to achieve good operability and guiding function. For example,issues such as proper management of common side effects of antiviral drugs,＂ optimal selection＂ of primary medications and ＂optimal strategy＂ after unfavorable response or resistance to primary medications, can be addressed with even more definite, specific and detailed descriptions.