心血管病中医健康管理指南的研制思路

Development of Traditional Chinese Medicine Guidelines for Health Management of Cardiovascular Diseases

在分析国内外心血管病健康管理现状的基础上,提出有必要开展基于家庭-社区/乡村医师-三级医院防控体系的心血管病中医健康管理。在心血管病中医健康管理指南的研制过程中,建议充分了解基层心血管病中医健康管理工作中的临床问题,注重临床问题的构建;按照心血管病-中医健康监测/风险评估/干预模式检索证据,进行证据评价后按照心血管病-中医健康监测/风险评估、心血管病-中医证型-干预模式合并证据,同时结合基层医疗现状调研结果形成适用于基层心血管病患者健康管理的推荐意见;突出包括中药、中医适宜技术、中医康复调摄方案在内的中医干预方案,区分家庭、社区/乡村医师、三级医院的功能定位,形成以“患者为核心、社区/乡村医师为执行主体、三级医院专科医师为主导”的心血管病中医健康管理体系。

By analyzing the domestic and international situation of health management of cardiovascular diseases(CD),it is considered necessary to develop a traditional Chinese medicine(TCM)health management system based on family-community/village doctors-tertiary hospital network for prevention and treatment of CD. When developing guidelines,it is suggested to fully understand the clinical problems of TCM health management of CD in primary health care and lay emphasis on the construction of clinical questions in the guidelines. The evidence should be retrieved with the keywords of“cardiovascular disease-TCM health monitoring/risk assessment/intervention”,and the quality of the evidence should be evaluated before pooling data together according to“cardiovascular disease-TCM health monitoring/risk assessment,cardiovascular disease-TCM syndromes-intervention”. And the recommendations for health management of CD patients in primary health care can be developed based on the results of survey on situation of primary health care. It is also suggested that TCM formulas,drugs,techniques,and rehabilitation programs should all be highlighted,and the function of families,community/village doctors,and tertiary hospitals should be clearly differentiated,so as to establish a TCM health management system for CD with the principle of“taking patients as the top priority,community/village doctors as the principal executors,and specialists of tertiary hospitals as the leading force”.