中国基层临床指南现状分析及评价  

Analysis and evaluation of China's clinical guidelines for management of chronic disease in primary clinics

作　　者：唐杨琛[1] 沈干[1,2] 胡世莲[1,2] 唐海沁[3] 徐维平 徐婷娟 王海[1] 杨雯雯 方中良[1] 黄毕林[1] 

机构地区：[1]安徽医科大学附属省立医院老年医学科,安徽合肥230001 [2]安徽循证医学中心 [3]安徽医科大学第一附属医院

出　　处：《中华高血压杂志》2013年第1期48-52,共5页Chinese Journal of Hypertension

基　　金：安徽省科技攻关项目(08010302180)

摘　　要：目的分析我国慢性病基层临床指南现状,为基层慢性病防治提供循证依据。方法描述性分析指南的名称、发表年份、发表机构、制定方法、参考文献等内容。使用指南研究和评价的工具(AGREE),评价我国慢性病的基层版临床指南及其对应的最新版临床指南的质量。结果我国有关慢性病的基层版临床指南只检索出《中国高血压防治指南(2009年基层版)》,其他慢性疾病未检索出类似基层版版本。应用AGREE工具评估对比《中国高血压防治指南(2009年基层版)》和《中国高血压防治指南2010》的范围和目的、利益相关人员参与情况、开发严谨程度、指南表达的明确性和代表性、适用性、编辑的独立性,这6领域的平均得分为93.4%、58.4%、49.0%、85.0%、61.1%、60.0%,两部指南均为积极推荐指南。2009基层版指南更适合基层使用。结论适合我国基层慢性病防治的基层版指南较少,需要制定符合基层实际情况的常见慢性病防治指南,《中国高血压防治指南(2009年基层版)》适合基层推广运用。Objective To analyze the status of China＇s clinical guidelines for management of chronic disease in prima- ry clinics chronic disease management, so as to provide evidence for the prevention and treatment of chronic diseases. Methods Titles, publishing years, publishers, methodologies of development, and references of guidelines were de- scriptively analyzed. The Appraisal of Guidelines for Research and Evaluation （AGREE） instrument was used to e- valuate the quality of the existing guidelines for primary care and the latest corresponding clinical guidelines. Results Guidelines for Prevention and Treatment of Hypertension in China （2009 Primary Edition） was the only Chinese primary clinical guidelines for chronic disease management. There were no similar primary clinical guide- lines for the management of other chronic diseases. Guidelines for Prevention and Treatment of Hypertension in China （2009 Primary Edition） and the corresponding 2010 edition were compared and evaluated by AGREE instru- ment. The average scores in 6 areas, including constraints and goals, relevant participants, rigorousness in the de- velopment, clarity and representativeness, practicability, and editing independence, were 93.4%, 58.4%, 49%, 85%, 61. 1%, and 60%, respectively. Guidelines for Prevention and Treatment of Hypertension in China （2009 Primary Edition） and Guidelines for Prevention and Treatment of Hypertension in China 2010 were both actively rec- ommended, while the 2009 primary edition was more suitabie for application at the basic level. Conclusion There is a lack of primary guidelines for prevention and treatment of chronic diseases in China, which makes it urgent to de- velop the guidelines for prevention and treatment of common chronic diseases according to the reality at the grassro- ots level. Guidelines for Prevention and Treatment of Hypertension in China （2009 Primary Edition） is worthy of be- ing recommended for further application at the basic level.

关 键 词：临床指南 基层 高血压防治指南 评价 

分 类 号：R544.1[医药卫生—心血管疾病]