中国骨关节炎疼痛管理临床实践指南(2020年版)

Chinese clinical practice guideline for pain management in osteoarthritis (2020 edition)

骨关节炎(osteoarthritis,OA)是常见的关节疾病。疼痛是OA患者就医的首要主诉,因此有必要对OA的疼痛管理进行规范。本指南的制订过程参考世界卫生组织推荐的指南制订方法。由多学科专家组成指南制订小组,通过多轮针对临床医生的在线问卷调研确定指南中需要定义的重要临床问题。对OA领域已发布的相关指南、系统评价以及临床随机对照研究进行文献综述,并对相关证据进行评价。经过多轮德尔菲投票确定指南的推荐意见及其推荐强度。最终形成14条推荐意见,涉及OA疼痛管理的非药物治疗(运动治疗、健康教育、体重管理等)和药物治疗(外用及口服非甾体抗炎药、度洛西汀、关节腔药物注射等)多方面干预措施。以期为我国OA疼痛管理的实践提供临床指导和帮助。

Osteoarthritis(OA)is the most prevalent disorder of articulating joints in humans.Pain is the predominant symptom for people with OA mandating the development of evidence-based recommendations for pain management.The present clinical practice guideline was developed according to WHO guideline handbook.A Guideline Working Group was established.The clinical questions and importance of these questions were framed according to several round online survey intended to get the clinical questions from doctors.A systematic review of existing guidelines for the management of OA and of systematic reviews and high-quality randomized control trials published recently were undertaken to evaluate evidence quality.Consensus recommendations regarding assessment and pain treatment and strength of recommendations were produced following several round Delphi exercises.Finally,a total of 14 recommendations,including pharmaceutical and non-pharmaceutical interventions,were developed.This guideline can provide guidance and help for clinicians in clinical practice of OA pain management in China.