基于多阶段优化策略构建中医治疗膝骨关节炎的综合方案  

Constructing traditional Chinese medical treatment protocol for knee osteoarthritis based on multiphase optimization strategy

作　　者：于长禾[1] 周彦吉 安易 陈千吉 郭俊明[1] 宫媛媛[1] 刘长信[1] 王锡友[1] YU Changhe;ZHOU Yanji;AN Yi;CHEN Qianji;GUO Junming;GONG Yuanyuan;LIU Changxin;WANG Xiyou(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《中华中医药杂志》2023年第7期3383-3387,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京市科委金桥工程种子资金(No.ZZ21053);北京市科委首特课题(No.Z181100001718165)。

摘　　要：膝骨关节炎(KOA)发病率和患病率居高,严重影响患者的生活质量,造成巨大的社会负担和经济负担。单一疗法或现代医学常规综合疗法不能有效缓KOA解患者慢性疼痛。基于循证理念,采用多阶段优化策略(MOST)框架,在以筋代骨和经筋理论指导下,以KOA核心方案为基础,探索最优的中医联合疗法,从而构建KOA中医综合治疗方案,包括核心方案、经筋推拿、经筋针刺和简化太极拳。本综合方案体现最佳证据下医患共同决策的循证理念,提供中医复杂干预方案构建的方法学范例。依据MOST框架,未来将采用析因设计RCT筛选最优方案,并通过实用性RCT评价最优方案在目标解决中的疗效。With increasing aging in China,the incidence and prevalence of knee osteoarthritis(KOA)is high,which seriously affects the quality of life of patients and causes social and economic burden.Monotherapy or conventional combination therapy in modern medicine cannot effectively relieve chronic pain in KOA patients.The traditional Chinese medical treatment protocol,including core treatment pattern,meridian massage,meridian acupuncture and simplified Taijiquan,for KOA was constructed by the theory of treating sinews for bones and sinew meridians,based on the evidence-based concept and multiphase optimization strategy(MOST).Traditional Chinese medical treatment protocol embodied the evidence-based concept of doctor-patient joint decision-making based on best evidence,and provides a methodological example for the construction of complex intervention protocols in traditional Chinese medicine.According to the MOST framework,factorial design randomized controlled trial(RCT)will be used in the future to screen the optimal protocols,and practical RCT will be used to evaluate the efficacy of the optimal protocols in future.

关 键 词：多阶段优化策略 循证医学 外治法 方法学 复杂干预 

分 类 号：R274.9[医药卫生—中西医结合]