中医诊疗指南与中医临床路径、中医诊疗方案的比较  

Comparison of Clinical Practice Guidelines with Clinical Pathways and Diagnosis & Treatment Schemes in Chinese Medicine

作　　者：王丽颖[1] 赵学尧[1] 宇文亚[1] 刘玉祁[1] 王跃溪[1] 刘孟宇[1] 刘兴方[1] 韩学杰[1] 

机构地区：[1]中国中医科学院中医临床基础医学研究所

出　　处：《中医杂志》2015年第24期2112-2115,共4页Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局中医药标准化项目(ZYYS-2011[0027];ZYYS-2014[01]);中国中医科学院自主选题项目(Z0299)

摘　　要：目的分析中医诊疗指南与中医临床路径及其配套的中医诊疗方案推荐证候、方药的一致性程度,为促进中医诊疗指南和中医临床路径及中医诊疗方案的协调统一提供数据支持。方法提取中华中医药学会发布的422项中医诊疗指南、国家中医药管理局医政司发布的304种疾病的中医临床路径及其配套的中医诊疗方案中的基本信息,对比其在病种、起草人员、证候、方药之间的异同,并采用Jaccard系数法对证候分类、方药的相似度进行分析。结果中医临床诊疗指南与中医临床路径、中医诊疗方案涉及相同的病种有183个。中医临床路径的疾病诊断、证候分类、治疗方案中引用中医诊疗指南的比例分别为22.47%、2.25%、44.94%。中医诊疗指南、中医诊疗方案推荐证候分类的相似度为0.54,两者完全一致占18%。中医诊疗指南、中医诊疗方案推荐方药的相似度为0.38,证候相同、两者推荐方药一致的疾病占48.68%。结论中医诊疗指南与中医临床路径及中医诊疗方案之间存在较大的差异,尤其是证候分类的一致性较差。建议加强中医诊疗指南与中医临床路径及中医诊疗方案制定的方法学研究,尤其是要加强对于中医证候分类标准的方法学研究。Objective To analyze the consistency degree of recommended syndromes and prescriptions among Chinese medical clinical practice guidelines, Chinese medical clinical pathways and matched Chinese medical diagno- sis and treatment schemes, in order to provide data support for promoting compatibility and unity of Chinese medical clinical practice guidelines, Chinese medical clinical pathways and Chinese medical diagnosis and treatment schemes. Methods The basic information was extracted from 422 Chinese medical clinical practice guidelines issued by the China Association of Chinese Medicine, and Chinese medical clinical pathways and matched Chinese medical diagno- sis and treatment schemes about 304 kinds of disease issued by the Department of Medical Administration of the State Administration of Traditional Chinese Medicine. Differences and similarities of the information on involved diseases, members of drafting panels, syndromes and prescriptions in those documents were compared, and the the Jaccard coefficient method was used to analyze the similarity of syndrome classification and prescriptions. Results There are 183 identical diseases in Chinese medical clinical practice guidelines, Chinese medical clinical pathways and Chinese medical diagnosis and treatment schemes. In disease diagnosis, syndrome classification and therapeutic schedule of Chinese medical clinical pathways the quotation proportions of Chinese medical clinical practice guidelines accounted for 22.47%, 2. 25% and 44. 94%, respectively. The similarity of recommended syndrome classification was 0. 54 between Chinese medical clinical practice guidelines and Chinese medical diagnosis ＆ treatment schemes, and the totally identical content accounted for 18%. The similarity of recommended prescriptions was 0. 38 between Chinese medical clinical practice guidelines and Chinese medical diagnosis and treatment schemes, and diseases with the same syndrome and recommended prescription accounted for 48. 68%. Conclusion There are many differences between Chi

关 键 词：中医诊疗指南 中医临床路径 中医诊疗方案 

分 类 号：R242[医药卫生—中医临床基础]