A review and reflection on the consensus develpment of Traditional Chinese Medicine diagnosis and treatment for gastrointestinal disorder——A case study of ulcerative colitis
-
摘要: 中医诊疗共识可为临床医生提供规范的指导，促进临床疗效的提高，并能推动中医药的标准化和国际化。因此，中医诊疗共识的制定至关重要。本文对已公布的3版消化系统疾病中医诊疗共识的制定进行系统回顾，并结合笔者制定过程中的体会，以溃疡性结肠炎为例，分别从病名、诊断、病机、治疗目标与原则、治法、病证结合、疗效评价、预防调摄和如何利用证据等方面提出建议，为今后共识的优化、修订提供参考。Abstract: The establishment of Traditional Chinese Medicine(TCM) diagnosis and treatment consensus is crucial as it provides standardized guidance for clinicians, facilitates the enhancement of clinical efficacy, and contributes to the standardization and internationalization of TCM. This paper systematically reviewed the three published versions of TCM diagnosis and treatment consensus for digestive system diseases. Drawing from my own experience, using ulcerative colitis as an example, suggestions are proposed regarding disease nomenclature, diagnosis, pathogenesis, treatment goals and principles, therapeutic approaches, integration of disease and syndrome differentiation, efficacy evaluation, prognosis adjustment, and evidence-based utilization. These recommendations offer valuable insights for optimizing and revising the consensus.
-
-
表 1 3版共识的疾病名称
类型 2009版 2017版 2023版 西医病名类 肠易激综合征、非酒精性脂肪肝、溃疡性结肠炎、慢性便秘、慢性浅表性胃炎、慢性萎缩性胃炎、胃食管反流病、消化不良、消化性溃疡 胃食管反流病、慢性胃炎、消化性溃疡、功能性消化不良、肠易激综合征、溃疡性结肠炎、胆囊炎、非酒精性脂肪肝病、肝硬化腹水、急性胰腺炎 复发性口腔溃疡、胃食管反流病、慢性胃炎、消化性溃疡、功能性消化不良、胃下垂、肠易激综合征、功能性腹胀、功能性腹泻、溃疡性结肠炎、克罗恩病、(急、慢性)胆囊炎、胆石症、非酒精性脂肪性肝病、肝硬化腹水、急性胰腺炎、慢性胰腺炎 中医证候类 肝脾不调证、脾胃湿热证、脾虚证、脾胃病症状量化标准 肝脾不调证、脾胃湿热证、脾虚证 中医病名类 便秘、泄泻、胃脘痛 口臭、痞满、反酸(嘈杂)、嗳气、胃缓、胁痛、臌胀、肝积、肝癖、黄疸、腹痛、腹胀、便秘、泄泻、久痢 
下载: 导出CSV
-
[1] 张声生, 李乾构, 沈洪, 等. 溃疡性结肠炎中医诊疗共识(2009)[J]. 中国中西医结合杂志, 2010, 30(5): 527-532. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXJ201005030.htm
[2] 张声生, 沈洪, 郑凯, 等. 溃疡性结肠炎中医诊疗专家共识意见(2017)[J]. 中华中医药杂志, 2017, 32(8): 3585-3589. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201708071.htm
[3] 史瑞, 李军祥, 沈洪, 等. 溃疡性结肠炎中医诊疗专家共识(2023)[J]. 中华中医药杂志, 2024, 39(1): 288-296. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202401099.htm
[4] Turner D, Ricciuto A, Lewis A, et al, International Organization for the Study of IBD. STRIDE-Ⅱ: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease(STRIDE)Initiative of the International Organization for the Study of IBD(IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD[J]. Gastroenterology, 2021, 160(5): 1570-1583. doi: 10.1053/j.gastro.2020.12.031
[5] Shen H, Zhang S, Zhao W, et al. Randomised clinical trial: Efficacy and safety of Qing-Chang-Hua-Shi granules in a multicenter, randomized, and double-blind clinical trial of patients with moderately active ulcerative colitis[J]. Biomed Pharmacother, 2021, 139: 111580. doi: 10.1016/j.biopha.2021.111580
[6] Naganuma M, Sugimoto S, Mitsuyama K, et al. INDIGO Study Group. Efficacy of Indigo Naturalis in a Multicenter Randomized Controlled Trial of Patients With Ulcerative Colitis[J]. Gastroenterology, 2018, 154(4): 935-947. doi: 10.1053/j.gastro.2017.11.024
[7] Tang T, Targan SR, Li ZS, et al. Randomised clinical trial: herbal extract HMPL-004 in active ulcerative colitis-a double-blind comparison with sustained release mesalazine[J]. Aliment Pharmacol Ther, 2011, 33(2): 194-202. doi: 10.1111/j.1365-2036.2010.04515.x
[8] Zhang F, Li Y, Xu F, et al. Comparison of Xilei-san, a Chinese herbal medicine, and dexamethasone in mild/moderate ulcerative proctitis: a double-blind randomized clinical trial[J]. J Altern Complement Med, 2013, 19(10): 838-842. doi: 10.1089/acm.2012.0296
[9] Fukunaga K, Ohda Y, Hida N, et al. Placebo controlled evaluation of Xilei San, a herbal preparation in patients with intractable ulcerative proctitis[J]. J Gastroenterol Hepatol, 2012, 27(12): 1808-1815. doi: 10.1111/j.1440-1746.2012.07215.x
[10] 刘建平. 传统医学证据体的构成及证据分级的建议[J]. 中国中西医结合杂志, 2007, 27(12): 1061-1065. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXJ200712003.htm
[11] 陈薇, 方赛男, 刘建平. 基于证据体的中医药临床证据分级标准建议[J]. 中国中西医结合杂志, 2019, 39(3): 358-364. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXJ201903021.htm
[12] 陈薇, 陈可冀, 刘建平. 中医药真实世界研究证据的构成及分级标准建议[J]. 中国中西医结合杂志, 2021, 41(5): 608-611. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXJ202105021.htm
[13] 中华医学会消化病学分会炎症性肠病学组, 中国炎症性肠病诊疗质量控制评估中心. 中国溃疡性结肠炎诊治指南(2023年·西安)[J]. 中华炎性肠病杂志, 2024, 8(1): 33-58.
[14] 梁彪, 卢宇畅, 尹相宜, 等. 国内中医药防治溃疡性结肠炎临床试验注册现况分析[J]. 中国中医药信息杂志, 2023, 30(10): 63-68. https://www.cnki.com.cn/Article/CJFDTOTAL-XXYY202310011.htm
-
计量
- 文章访问数: 273
- 施引文献: 0