摘要
目的建立具有高等级循证医学证据的、科学的、可行的老年高血压早期肾损害(Elderly Hypertension with Early Renal Damage,EH-ERD)中医防控方案。方法基于文献研究与证据评价,建立EH-ERD中医综合防控方案的适宜技术及其具体处方或操作方法的条目池。应用德尔菲(Delphi)法,咨询全国40位高级职称专家展开2轮问卷,分析专家积极系数、权威系数(Cr)、意见集中程度、协调程度等;并根据意见对EH-ERD中医综合防控方案具体条目进行修正。结果遴选证据等级为Ⅰ-Ⅱ类,推荐级别为A-B级的适宜干预技术,建立了EH-ERD中医防控方案条目池。两轮专家咨询积极系数分别为92.5%,97.14%;总体Cr>0.70,协调系数<0.25;积极系数较好、Cr较高、意见集中与协调较为统一,形成了包含复方中药制剂、针灸与推拿、中医特色健康教育、药膳食疗、中医养生保健操与“足浴方”6个一级指标,17个二级指标的EH-ERD中医综合防控方案。结论本研究构建的EH-ERD中医综合防控方案,可为进一步形成专家共识或指南提供依据,并为EH-ERD中医药全流程健康管理提供策略与范式。
Objective To establish a scientific and feasible Chinese medicine(CM)comprehensive control and prevention program for elderly hypertension with early renal damage(EH-ERD)patients through high-level evidencebased medicine(EBM)evidence.Methods On the basis of literature research and evidence evaluation,we construct a database of specific prescriptions and implementation methods of CM comprehensive control and prevention program with EH-ERD.40 senior titled-experts were consulted in two rounds of questionnaires based on Delphi methods.We selected,evaluated,and revised specific CM comprehensive control and prevention program of EH-ERD through the analysis of multiple factors,such as expert′s positive activity coefficient,authority coefficient,degree of opinion concentration and degree of coordination.Results In view of the CM appropriate intervention techniques with highgrade evidence(levelⅠandⅡ)and recommendation(level A and B),we have developed the CM comprehensive control and prevention plan items for EH-ERD.The activity coefficients in two-round consultation were 92.5%and 97.14%respectively,the overall authority coefficient(Cr)was exceeded 0.70,and the coordination coefficient was less than 0.25.With a sound activity coefficient,a relatively high Cr and a rather unified degree of opinion concentration and coordination,the CM comprehensive control and prevention program for EH-ERD was established,which included six primary indicators(CM compound preparation,acupuncture and massage,CM health education,medicinal diet therapy,health care exercise and foot bath)and seventeen secondary indicators.Conclusion The CM comprehensive control and prevention program for EH-ERD established in this study can provide a basis for the further formation of expert consensus or guidelines.Moreover,it can supply the strategy and paradigm for standardization of CM-based health management of EH-ERD.
作者
方锐
杨勇
谢乐
杨燕
周月
徐文峰
葛金文
FANG Rui;YANG Yong;XIE Le;YANG Yan;ZHOU Yue;XU Wenfeng;GE Jinwen(Hunan Academy of Chinese Medicine,Changsha 410012,China;Hunan Provincial Hospital of Integrated Chinese and Western Medicine(The Affiliated Hospital of Hunan Academy of Chinses Medicine),Changsha 410006,China;Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou 310007,China;China Science and Technology Development Center for Chinese Medicine(Talent Exchange Center of the National Administration of Traditional Chinese Medicine),Beijing 100027,China;The First Hospital of Hunan University of Chinese Medicine,Changsha 410007,China)
出处
《世界科学技术-中医药现代化》
北大核心
2025年第7期1867-1877,共11页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
中华人民共和国科学技术部国家重点研发计划(2018YFC1704904):脑泰方防治高血压脑小血管病变的循证优化研究,负责人:葛金文
湖南省科学技术厅省重点研发计划(2022SK2016):高血压脑小血管病中西医结合诊疗的循证优化研究,负责人:葛金文
湖南省教育厅科学研究项目优秀青年项目(20B432):基于内皮细胞焦亡探讨脑泰方“异病同治”干预H型高血压脑肾损害的作用机制,负责人:徐文峰。
关键词
老年高血压
早期肾损害
中医学
德尔菲法
Elderly hypertension
Early renal damage
Chinese medicine
Delphi method
