中医循证临床实践指南制定面临的问题与应对策略

Problems and Strategies in Developing Chinese Medicine Evidence-Based Clinical Practice Guidelines

中医循证临床实践指南制定在个体化治疗、研究质量、报告偏倚、安全性评价等方面面临着一些问题。通过全面检索补充与替代医学领域现有的循证临床实践指南制定方法,并与目前公认标准的对抗医学循证临床实践指南制定方法进行优化组合,笔者提出了针对以上问题的应对策略:在个体化治疗方面,可考虑纳入实用性随机对照试验;在研究质量方面,提出了证据不足时形成指南建议的方法;在报告偏倚方面,列出了常用的补充与替代医学数据库;在安全性评价方面,建议采用GRADE系统。

Some problems are confronted in the development of Chinese medicine（CM） evidence-based clinical practice guidelines in the aspects of individualized treatment,quality of research,reporting bias,safety assessment,and so on. After comprehensive retrieving of current methods for developing evidence-based clinical practice guidelines in the field of complementary and alternative medicine,and an optimal combining with widely accepted standardized methods in evidence-based clinical practice guidelines for allopathic medicine,we put forward strategies for these aforesaid problems. In terms of individualized treatment,practical randomized control trials could be considered for inclusion. In terms of quality of research,the method to formulate guideline recommendations was proposed in case of insufficient evidence. In terms of reporting bias,commonly used databases in complementary and alternative medicine were listed. In terms of safety evaluation,GRADE system was suggested to adopt.