The Evaluation Study Of "Guidelines For Diagnosis And Treatment Of Traditional Chinese Medicine With Asthma Syndrome(Chronic Obstructive Pulmonary Disease And Right Heart Failure)"

Objective:At the request of the State Administration of Traditional Chinese Medicine,the guideline promotion and evaluation of the "Guidelines for Diagnosis and Treatment of Asthma(Chronic Obstructive Pulmonary Disease and Right Heart Failure)" issued by the Chinese Association of Traditional Chinese Medicine in2019,with a view to standardizing regional medical practices,and providing Provide the basis for the later improvement and revision of the guideline.Methods:Analyse Questionnaire on applicability of TCM clinical diagnosis and treatment guidelines and Case questionnaire for application evaluation of clinical diagnosis and treatment guidelines of traditional Chinese medicine filled out by clinicians from 10 medical units including 3 tertiary hospitals,4 secondary hospitals and 3 primary hospitals to understand the applicability,application and effect of this guide for clinical diagnosis and treatment of TCM.The data were entered in an excel form,and the results were described by frequency analysis.Results:1 Evaluation of the applicability of the guideline content(N=43)(1)Basic information of the Guide43 clinicians filled out the questionnaire,the familiarity rate of the guideline content was 84%,and the clinical usage rate of the guideline was 72%.(2)Quality and level of the GuidelinesThe applicability rates of the 9 evaluation items were all greater than 70%,and the 3 items with higher applicability rates were: scope of application(95%),other treatment methods(93%),regulation and prevention(93%);3 with lower scores Items:syndrome classification(81%),prescription composition(81%),medication usage(79%);the application rates of the remaining items are: use of terms(91%),diagnostic points(91%),treatment principles and methods(91%)84%).(3)Application of the GuidelinesThe applicability rates of the 13 evaluation items were all higher than 70%.Among them,the rationality and completeness of the guideline content and structure,the economical diagnosis and treatment plan,and the safety of clinical application,these four items scored high,with an applicability rate of 93%.Compared with the level of key specialist diagnosis and treatment of the participating units(82%)and the expert experience of participating units(74%),the scores were lower.2 Evaluation of clinical applicability of guidelines(N=224)(1)DiagnosisCompared with the clinical application of the diagnostic criteria of this guideline,the conformity rate of TCM diagnosis is higher,and the conformity rate is 98.2%.(2)DialecticalCompared with the classification of clinical symptoms and signs,the compliance rate was 94.2%.In the distribution of main clinical syndromes,the frequency of phlegm-turbid obstructing lung syndrome(44.2%)was the highest,and the frequency of middle stasis syndrome(16.5%)was the highest.The frequency of the other syndromes is: main syndrome: Obstruction of lung due to phlegm-heat(15.2%),water pathogen attacking hear(13.8%),deficiency of both qi and yin(12.5%),deficiency of lung,spleen and kidney(9.8%),external cold and internal drink(4.5%);concurrently:blindfolded(2.2%).(3)TreatmentComparing the compliance of this guideline with clinical treatment,the highest compliance rate is "other treatments"(99%),and the lowest is "proprietary Chinese medicine"(56%).The frequency of distribution of main clinical prescriptions and drugs associated with the syndrome.In addition,in the clinical case investigation,it was found that 3 kinds of prescriptions were different from the main syndromes provided by the guideline.Wuling powder(3.1%),Sangbaip Decoction(2.2%),Zi Jiangqi Decoction(1.8%);1 herbal medicine,Angong Niuhuang Pill(1.3%).In the distribution of other clinical treatments,"rational oxygen therapy"(89%)and "acupoint application"(57%)had the highest frequency.There were no cases of "cupping therapy",and the frequency was 0.(4)Adjustment and preventionCompared with clinical regulation and prevention,the compliance rate of this guideline is 99.5%.Conclusions:1.Clinicians in Inner Mongolia are familiar with the contents of this guideline and believethat the scope of application of this guideline is clear and it can be used in treating patients with chronic obstructive pulmonary disease and right heart failure,but it needs to be used more.2.The diagnostic points,syndrome differentiation and treatment,other treatment methods,and regulation and prevention in the main content of the guideline have guiding significance,However,the composition of prescriptions and Chinese patent medicines need to be further meliorated and renovated according to clinical practice.