《中医药单用/联合抗生素治疗单纯性下尿路感染临床实践指南》临床应用评价研究  

Clinical application evaluation of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for uncomplicated lower urinary tract infection

作　　者：于国泳[1] 谢雁鸣[2] 高宁[1] 孙玥[1] 苗润培 韩帅杰 杨涵雯[1] 熊敏[1] 刘桓 廖星[2] 王耀献[1] 苏小南 徐晓芳 王莉斐 李艳丽[1] 张俊华[3] 张伯礼[3] YU Guo-yong;XIE Yan-ming;GAO Ning;SUN Yue;MIAO Run-pei;HAN Shuai-jie;YANG Han-wen;XIONG Min;LIU Heng;LIAO Xing;WANG Yao-xian;SU Xiao-nan;XU Xiao-fang;WANG Li-fei;LI Yan-li;ZHANG Jun-hua;ZHANG Bo-li(Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine,Belling 100700,China;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]中国中医科学院中医临床基础医学研究所,北京100700 [3]天津中医药大学,天津300193

出　　处：《中国中药杂志》2018年第24期4746-4752,共7页China Journal of Chinese Materia Medica

基　　金：中央级公益性科研院所基本科研业务费专项(ZZ10-018-02,ZZ11-021,Z0546)

摘　　要：该研究采取调查问卷的方式,调查来自不同级别医院的1 000名有治疗单纯性下尿路感染经验的临床医生,主要针对《中医药单用/联合抗生素治疗单纯性下尿路感染临床实践指南》(以下简称《指南》)临床适用性和应用性进行评价。研究过程严格执行全程三级质量控制,数据真实、可信。调查结果显示:绝大多数医生认为《指南》临床适应性好,《指南》中推荐的药物可及性和价格适中,中医药治疗单纯性下尿路感染具有明显的特色和优势,可以减少抗生素的用量,缩短抗生素应用的疗程。在建议板块中,临床医生希望增加用药指导、希望及时更新《指南》,另外还有希望增加治疗方法和手段者、加强宣传推广者、加强循证方法使用等。在应用性评价中,绝大多数临床医生认为《指南》定义、中西医鉴别诊断描述准确,治疗基本原则及中医药治疗方法选择恰当,中药处方、中成药临床应用效果好。部分临床医生建议细化淋证证候分型。部分医生认为《指南》中推荐方药疗效一般,在其他疗法的推荐中,部分医生对于熏洗操作方法存疑,针对中医特色疗法中药熏洗和针灸治疗单纯性下尿路感染的操作规范及流程待完善。A questionnaire survey of 1 000 clinicians having experience in treating uncomplicated lower urinary tract infections from different levels of hospitals was conducted to mainly evaluate the applicability and effectiveness of clinical application of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for uncomplicated lower urinary tract infection( hereinafter referred to as Guideline). The research was conducted with the three-level quality control strictly throughout the process,and the data was real and reliable. The survey’s results showed that: most clinicians considered that the Guideline had good clinical applicability. The availability and price of the recommended medicine were moderate. Traditional Chinese medicine had obvious features and advantages in treating lower urinary tract infection for it could reduce the usage of antibiotics and shorten the course of antibiotic application. In the recommendation section,clinicians proposed increasing medication guidance,updating the Guideline timely,as well as increasing treating methods and techniques,strengthen propaganda and promotion,and improve the use of evidence-based methods. In the evaluation of effectiveness,the majority of clinicians agreed that the definition in both traditional Chinese medicine( TCM) and Western medicine and differential diagnosis in the Guideline were accurately described and the basic principle of treatment as well as the treating method of TCM were recommended appropriately. The TCM formulas and Chinese patent medicine had good effect. Some clinicians suggested refining the syndrome differentiation of stranguria. Some clinicians considered that the formulas and herbs recommended in Guideline didn’t have obvious effect and some had doubts about the manipulation of fumigation and washing in the part of other methods recommended in Guideline. Moreover,specification and procedure of manipulation of fumigation and washing using herbs and the acupuncture included in characteristic

关 键 词：单纯性下尿路感染 临床实践指南 适用性评价 应用性评价 

分 类 号：R691.3[医药卫生—泌尿科学]