从循证医学看《药物性肝损伤诊治指南》的制定和价值  

The formulation and value of CSH guideline for the diagnosis and treatment of drug-induced liver injury: opinions from the evidence-based medicine

作　　者：于乐成[1] 陈成伟[2] YU Yuecheng;CHEN Chengwei(Liver Disease Center of PLA,the 81th Hospital of PLA,Nanjing 210002;Shanghai Research Center of Clinical Liver Disease,the 85th Hospital of PLA,China)

机构地区：[1]中国人民解放军第八一医院全军肝病中心,江苏南京210002 [2]中国人民解放军第八五医院上海临床肝病研究中心

出　　处：《胃肠病学和肝病学杂志》2018年第9期964-968,共5页Chinese Journal of Gastroenterology and Hepatology

摘　　要：中华医学会肝病学分会制定的《药物性肝损伤诊治指南》是我国关于药物性肝损伤诊治、预防和管理的首部系统规范的指南,其制定过程遵循WHO临床指南写作规程,推荐意见均基于严谨的循证医学(evidence-based medicine,EBM)证据评估和分析。该指南不仅显著促进了我国药物性肝损伤临床诊治和研究的规范化,也反映出了有关药物性肝损伤的流行病学、发病机制、病理组织学、诊断和鉴别诊断、治疗及药物肝毒性的预测和预防,还有许多问题有待深入的EBM研究加以探索和论证。随着《中国临床实践指南评价体系》(AGREE-China)的发布,及相关EBM证据的不断积累,必将推动指南的修订和完善。The guideline for the diagnosis and treatment of drug-induced liver injury issued by the Chinese Society of Hepatology （CSH） is the first systematic and standardized guideline on the diagnosis, treatment, prevention and manageinent of drug-induced liver injury. The tormulation of this guideline is based on the systematic analysis of evidencebased medicine （EBM） data, and strictly complies with the items of WHO handbook for guideline development. This guideline is believed to promote and facilitate the standardization of drug-induced liver injury clinical research in China; in addition, we can find from the guideline that many key problems are still to be further investigated through future EBM research in the epidemiology, pathogenesis, histopathology, diagnosis and differential diagnosis, treatment options, prediction and prevention of drug＇ s hepatotoxicity. With the guidance of recent published China-indigenized Appraisal of Guidelines Research and Evaluation in Europe （AGREE-China） and the accumulation of new-durg-induced liver injury-related EBM data, we believe that the revision of this EBM-based guideline of durg-induced liver injury will be necessary, thus to be more practical.

关 键 词：药物性肝损伤 指南 标准化 循证医学 评价体系 

分 类 号：R575[医药卫生—消化系统]