碟脉灵~?苦碟子注射液临床应用专家共识

Expert consensus statement on Diemailing~? Kudiezi Injection in clinical practice

碟脉灵~?苦碟子注射液目前被广泛用于治疗脑梗死、冠心病心绞痛等疾病。长期的临床应用和相关研究证据均表明,该药在改善心脑血管疾病临床症状方面有较好疗效。但该药目前尚未被收录入任何临床实践指南之中,且近年来发现该药在临床应用中存在使用不规范的问题。为进一步提高临床医生对该药的认识,更好地指导其临床合理用药,邀请来自全国心脑血管疾病领域的临床一线专家编写该专家共识。该共识采用GRADE系统,根据不同结局按照降级因素对证据进行质量分级,然后对证据总体进行评级。然后通过名义组法形成本共识的推荐意见或共识建议。专家共识意见的形成主要考虑6个方面的因素:证据质量、经济性、疗效、不良反应、病人可接受性以及其他。基于这6个方面,如果证据充分,则形成有证据支持的'推荐意见',采用GRADE网格计票规则。如果证据不充分,则形成'共识建议',采用多数计票规则。该共识采用简洁明了的体例格式,对该药的临床适应证、有效性、安全性证据以及相关前期资料进行了系统全面的梳理和总结,可为该药的临床使用提供有价值的参照。该共识已通过中华中医药学会的审核,并进行了发布,编号GS/CACM 202-2019。

Diemailing■Kudiezi Injection(DKI)is widely used in the treatment of cerebral infarction,coronary heart disease and angina pectoris.Long-term clinical application and related research evidence showed that DKI has a good effect in improving the clinical symptoms of cardiovascular and cerebrovascular diseases.However,this injection has not been included in any clinical practice guideline.It has been found that the use of DKI is in wrong way in clinical practice in recent years.Therefore,clinical experts from the field of cardiovascular and cerebrovascular diseases nationwide are invited to compile this expert consensus in order to guide clinicians.GRADE system is used to grade the quality of evidence according to different outcomes according to degrading factors.Then it forms the recommendation or consensus suggestion through the nominal group method.The formation of expert consensus mainly considers six factors:quality of evidence,economy,efficacy,adverse reactions,patient acceptability and others.Based on these six aspects,if the evidence is sufficient,a'recommendation'supported by evidence is formed,and GRADE grid voting rule is adopted.If the evidence is insufficient,a'consensus suggestions'will be formed,using the majority voting rule.In this consensus,the clinical indications,efficacy,safety evidences and related preliminary data of DKI were systematically and comprehensively summarized in a concise and clear format,which could provide valuable reference for the clinical use of DKI.This consensus has been approved by China association of Chinese medicine which is numbered GS/CACM 202-2019.