中西医结合脑卒中循证实践指南(2019)

Evidence-based practice guideline on integrative medicine for stroke 2019

脑卒中是我国成年人死亡和残疾的主要原因。尽管中西医结合治疗现已广泛应用到脑卒中的临床实践中,但尚无高质量的中西医结合治疗脑卒中的循证实践指南。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定手册》研制而成。其中,系统评价制订与更新参考Cochrane协作网方法,证据质量与推荐强度分级采用GRADE系统方法,并遵循RIGHT条目进行报告。本指南成立了包括4个小组在内的多学科工作组。通过问卷调查、面对面专家共识会和问题解构的方法遴选临床指南需回答的临床问题,最终从15个关键的临床问题中确定了11个研究问题。在系统评价结果的基础上,综合考虑了证据的利弊、干预成本、证据质量、患者的偏好与价值观、多学科临床调查对象的反馈及面对面的专家共识意见,最终形成了关于中西医结合治疗脑梗死、脑出血及卒中并发症的14条推荐意见。本指南聚焦于中西医结合治疗脑卒中的临床实践,适用于我国各级医院及康复机构的医务工作者。

Stroke is the leading cause of mortality and disability in China.Chinese medicine integrated with conventional medicine is current widely used in the prevention and treatment of stroke.A clinical practice guideline for application of integrative medicine in stroke was urgently required.This guideline was developed according to the World Health Organisation Handbook for Guideline Development and the Guideline Development Handbook for Diagnosis and Therapy of Integrative Medicine.The systematic reviews were conducted following the Cochrane handbook.The quality of evidence and strength of recommendations were evaluated using the GRADE approach.The reporting of guideline followed the RIGHT statement.A multi-disciplinary working team was established.Eleven research questions from 15 clinical questions were identified by questionnaire surveys,face-to-face meetings,and analysis by the working team.Fourteen recommendations regarding integrative medicine for ischaemic stroke,haemorrhagic stroke,and complications of stroke were formulated&om systematic reviews of the benefits,harms,cost-effectiveness,quality of evidence,the values and preferences of patients and their family members,feedback on proposed recommendations from medical practitioners from a variety of disciplines,and a face-to-face consensus meeting.This guideline focuses on clinical treatments that are specific to integrative medicine for stroke and can be used by medical practitioners at all levels in medical institutions and rehabil itation facilities.