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1.中国中医科学院 西苑医院,北京 100091
2.北京中医药大学,北京 100029
3.中国中医科学院,北京 100700
邱文然,在读博士,从事中医药防治脑病研究,E-mail:qiuwenran@163.com
梁晓,主治医师,从事中医药防治脑病研究,E-mail:liangxiao022@126.com
张允岭,主任医师,博士生导师,从事中医药防治脑病研究,E-mail:yunlingzhang2004@163.com; *
纸质出版日期:2022-06-20,
网络出版日期:2022-04-07,
收稿日期:2022-02-16,
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邱文然,徐榛敏,申伟等.中医药治疗缺血性脑卒中优势定位评价情况概述[J].中国实验方剂学杂志,2022,28(12):225-232.
QIU Wen-ran,XU Zhen-min,SHEN Wei,et al.Evaluation of Dominant Diseases of Traditional Chinese Medicine: A Case Study of Ischemic Stroke[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(12):225-232.
邱文然,徐榛敏,申伟等.中医药治疗缺血性脑卒中优势定位评价情况概述[J].中国实验方剂学杂志,2022,28(12):225-232. DOI: 10.13422/j.cnki.syfjx.20221238.
QIU Wen-ran,XU Zhen-min,SHEN Wei,et al.Evaluation of Dominant Diseases of Traditional Chinese Medicine: A Case Study of Ischemic Stroke[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(12):225-232. DOI: 10.13422/j.cnki.syfjx.20221238.
为探索实现传统医学在“治未病中的主导作用,重大疾病治疗中的协同作用,疾病康复治疗中的核心作用”的有效途径,并总结经验,为其他优势病种评价提供可行性方案。中国中医药循证医学中心脑病项目组聚焦中医药治疗缺血性脑卒中方面有效性、安全性及经济性,成立评价工作组,确定工作方案,并在方法学、临床专家指导下,依据快速评估的方法,围绕高质量证据、专家意见调研、专家访谈及药物目录梳理以上4个方面,按照制定计划书、资料收集与数据提取、证据的合成和评价、报告撰写4个环节完成了评价工作。最终通过中、西医专家审议,将中医药治疗缺血性卒中的优势定位于恢复期的治疗,优势作用为改善神经功能缺损,提高日常生活能力。有效性表现在,卒中恢复期,中医干预措施可改善卒中后运动功能障碍、卒中后认知障碍、意识障碍、吞咽障碍、失语、便秘、泌尿功能、复视等,以针刺、中药、传统功法的优势较为突出。安全性表现在,中医治疗缺血性脑卒中安全性较好,不良反应发生率较低、不良事件出现次数较少,且相关症状程度较轻。经济性表现在,中西医结合方案可起到协同增效的作用,并有使诊疗费用更加合理的可能,中西医结合康复方案相比常规干预更具经济效益和社会效益。
The present study explored the effective approaches to realize the leading role of traditional Chinese medicine (TCM) in preventing diseases, the synergistic role in treating serious diseases, the core role in the rehabilitation of diseases and summarized the experience to provide feasible plans for the evaluation of other dominant diseases of TCM. To evaluate the effectiveness, safety, and economy of TCM in the treatment of ischemic stroke, encephalopathy project team of the China Center for Evidence-based Traditional Chinese Medicine(CCEBTCM) established an evaluation group to determine the work plan and complete the evaluation work. The concepts of the evaluation involved high-quality evidence, expert opinion survey, expert interview, and drug catalog. Under the guidance of clinical experts and methodologists, the evaluation work was completed in accordance with four steps, i.e., plan making, data collection and data extraction, evidence synthesis and evaluation, and report writing with the rapid review method. Through the review of TCM and western medicine experts, the advantage of TCM in the treatment of ischemic stroke was positioned in the convalescence period with the predominant effects of improving the neurological function defect and improving the daily living ability. In the convalescence period of stroke, TCM treatment could improve post-stroke motor dysfunction, post-stroke cognitive impairment, consciousness disorder, swallowing disorder, aphasia, constipation, urinary function, diplopia, etc., and the advantages of acupuncture, Chinese medicine, and traditional exercise were more prominent. In terms of safety, TCM treatment of ischemic stroke showed lower incidence of adverse reactions, fewer adverse events, and a milder degree of related symptoms. In terms of economic performance, the combined treatment of TCM and western medicine played a synergistic role and made the treatment cost more reasonable. Compared with conventional intervention, the integrated TCM and western medicine rehabilitation program showed more economic and social benefits.
中医优势病种缺血性脑卒中优势定位快速评估循证证据
dominant disease of traditional Chinese medicineischemic strokepositioning of advantagerapid reviewevidence-based evidence
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