《中医皮肤科常见病诊疗指南》临床应用评价研究

Clinical application evaluation of Guidelines for Diagnosis and Treatment of Common Diseases of Dermatology in Traditional Chinese Medicine

该研究采用调查问卷方法和前瞻性临床病例观察的方法,对《中医皮肤科常见病诊疗指南》的质量水平和应用效果分别进行了适用性以及应用性评价。适用性评价包括指南使用情况、质量水平、临床适用情况等,评价结果显示指南熟悉率85.37%,使用率48.78%,不同职称人员评价熟悉、使用程度不同,初级职称人员最低(70.97%,29.03%);《指南》整体质量水平较好,其他治法与调摄预防合理性评分稍低(80.49%,85.37%),与《指南》应用符合度评价一致。应用性评价包括《指南》应用的符合度、效果评价、综合评价等内容,评价结果显示安全性评分最高,其次是经济性和疗效;适用性综合评价表明,完全适用的比例为29.27%,适用比例达到87.80%,应用性综合评价的3项指标评分显示,选择7~9分的累计在75.65%,73.89%,71.12%。通过适用性和应用性评价,《中医皮肤科常见病诊疗指南》的整体质量水平较好,临床应用安全性高,疗效和经济性较好。但是《指南》在制定方法和一些内容上存在不足,需要进一步修订完善。此外,需要加强《指南》应用推广策略研究,促进《指南》的认知和使用。

To assess the quality and application effect of Guidelines for Diagnosis and Treatment of Common Diseases of Dermatology in Traditional Chinese Medicine（ Guidelines） through the applicability and applicability evaluation respectively. The questionnaire survey was adopted to evaluate the applicability of the Guidelines,including the utilization,quality,and clinical application conditions.The results showed that the familiarity rate and utilization rate of the Guidelines were 85. 37%,48. 78%,respectively. The data showed that the familiarity and the utilization rates were different in the working staff with different professional titles. The evaluation level was the lowest given by the staff with junior professional title（ 70. 97%,29. 03%） in comparison. The assessment showed the overall quality of the Guideline was good and slightly low level for the rationality scores of the other therapeutic methods as well as for the recuperation and prevention（ 80. 49%,85. 37%）,which was in line with the clinical compliance of the Guideline. The perspective observation of clinical cases was used for the applicability evaluation,including clinical compliance of the Guideline,effect evaluation,and comprehensive assessment,et al. The results showed that the safety score was the highest,followed by the economic issue and efficacy. For the comprehensive evaluation of the applicability,complete applicability accounted for 29. 27%,and the general applicability accounted for 87. 80%. It was showed in the three index scores of the applicability evaluation that the accumulative score 7-9 scores were 75. 65%,73. 89%,71. 12%. Through the applicability and applicability evaluation,the Guideline was satisfactory in the overall quality,high in the safety of clinical application and good in efficacy and economic issues. There are some limits on the development method and technical issues in the Guideline,which is required to be supplemented in the revision. Additionally,the strategy study on the promotion of the Guideline should be enhanced so as to expedite the recognition and utilization of the Guideline.