摘要
目的 探讨中国发布的中医药临床实践指南和专家共识中古籍证据的应用现状及存在的问题,为古籍在中医药临床实践指南制定中的应用提供方法学建议.方法 检索中国知网(CNKI)、万方数据(Wanfang data)、维普网(VIP)、中国生物医学文献数据库(SinoMed)、PubMed、Embase,补充检索中华中医药学会、全国团体标准信息平台、中国中西医结合学会、中国针灸学会、世界中医药学会联合会、世界针灸学会联合会6个网站,检索2017年1月1日至2022年11月26日期间发布的中医药临床实践指南或专家共识.纳入明确提及古籍应用的临床实践指南或专家共识,分析古籍检索情况、古籍获取来源、证据等级评价方法、推荐意见等级评价方法、古籍的证据评价方法.结果 共检索到中医药临床实践指南或专家共识1215篇,明确提及古籍应用的442篇,包括临床实践指南300篇(67.87％)、专家共识142篇(32.13％).442篇中明确报告进行了古籍检索的60篇(13.57％);60篇中明确报告古籍检索策略的27篇(45.00％),古籍检索最多的方式为手工检索,共计24篇(40.00％),检索来源最多的为古籍数据库中华医典,共计18篇.442篇中明确报告证据等级评价标准的197篇(44.57％),197篇中涉及古籍评价标准的141篇(71.57％);413篇(93.44％)文献在推荐意见中提及了古籍,但其中409篇(99.03％)仅提及方药名称出处.结论 目前中医药临床实践指南和专家共识对古籍的应用有限,存在检索、证据等级评价和推荐意见标准不规范的问题.未来研究需明确古籍应用范围与方法,注重其与现代研究证据结合,提升古籍证据在中医药临床实践指南制定中的价值和质量.
Abstract
Objective To explore the current status and issues regarding the application of ancient books in clinical practice guidelines and expert consensus of traditional Chinese medicine(TCM)published in China,and to provide methodological recommendations for the incorporation of ancient books in the development of TCM guidelines.Methods We searched China National Knowledge Infrastructure(CNKI),WanFang Data,VIP,SinoMed,PubMed,Embase,as well as six industry websites including China Association of Chinese Medicine,National Group Standards Information Platform,and Chinese Association of the Integration of Traditional and Western Medicine,etc.TCM clinical practice guidelines or expert consensus issued during January 1st,2017,to November 26th,2022 were searched.Clinical practice guidelines or expert consensus that explicitly referred to ancient books were included,and the content regarding the searching for ancient books,sources of access to ancient books,methods of evaluating the level of evidence,methods of evaluating the level of recommendation,and methods of evaluating the evidence for the ancient books were analysed.Results A total of 1,215 TCM clinical practice guidelines or expert consensus were re-trieved,with 442 articles explicitly mentioning the application of ancient books,including 300(67.87％)clinical practice guidelines and 142(32.13％)expert consensus.Sixty of the 442 publications explicitly reported that ancient books searching had been conducted(13.57％);among these 60 publications 27(45.00％)explicitly reported ancient books searching strategies,and the most frequent method was manual searching with a total of 24 articles(40.00％).The most popular search source was Chinese Medical Dictionary,a TCM classics database,with a total of 18 articles.197 articles(44.57％)explicitly reported the evaluation criteria for the level of evidence,of which 141 articles(71.57％)involved the evaluation criteria for the ancient books;413 articles(93.44％)mentioned ancient books in the recommendations,and only the source of formula name was mentioned in 409(99.03％)of the publica-tions.Conclusion The current application of ancient books in TCM clinical practice guidelines and expert consensus is limited,with issues of non-standard searching and evaluation methods.Standar-dization and uniformity are needed in evidence grading and recommendation standards.Future research should clarify the scope and methods of apply-ing ancient book,emphasize their integration with modern research evidence,and enhance their value and quality in the development of TCM clinical practice guidelines.
基金项目
新疆维吾尔自治区重点研发计划(2022B03011-4)
北京中医药大学本博贯通学生科学研究课题(2023)(XBB23048)
国家科技期刊平台
NSTL
万方数据