Chinese Medicine Based On Evidence-based Clinical Practice Guidelines Developed By The Method Of Study

During the past 20 years, as a result of the large differents between practical behaviors,the inuse of the medical cure,and the care of the medical expanses,the establish and application of clinical guideline has been improved quickly. The clinical guideline can improve the quality of the clinical standard and help the patients get the most efficient clinical effects.diagnosis and treatment of decision made under the guidance of the guideline with the specific patients can help to implemented the principle of evidence-based medicine better in clinical practice, standardize the clinician's medical behavior, improve the medical service quality.At present our country health care system also faces the problems, so clinical guidelines development by science are more needed to solve related problems and standard clinical services. With the development of scientific research and achievement transformation, clinical trials provided some evidence,for the formulation of TCM clinical practice guidelines.Thus "the clinical guidelines based on consensus " transformates to "the evidence-based clinical guidelines ",.which means that on the ground of clinical evidence, according to some methods of evidence-based medicine,a set of clinical guidelines has been developed and recommended opinions are linked to existing evidence.So according to the result of evidence evaluation,we can determine the recommendation and formulate guidelines.In this study, accompany by the development and application of the clinical guideline of cerebral infarction as a example, the author analyzed and summarized the definition, basic theory,evaluation of clinical guideline, tried to establish the guidelines,to deal with key issues and the measurement, so that the author can apply the study for the standardized study of TCM.Objectives1 by System analysising and evaluating existing Chinese medicine clinical practice guidelines, Try tou discussthe necessity,pplicability and realistic significance..2.Try to establish the evidence-based systematic and scientific methodology structure of clinical guidelines,including how to design,meature,appraise of a certain disease.3.Try to propose strategies for resolution of the difficulties and key issres in designing an evidence-based Chinese clinical guidelines while analyuzing the experience of preliminary application of of cerebral infarction.MethodsFirstly,the study review and analyse domestic and international clinical practice guidelines, clear the concept, basic principle and establishment method, of the clinical practice guidelines, explained the necessity methods and index system, of Clinical practice guidelines, compared the clinical practice guidelines, system evaluation and clinical pathway, and explains implementation effect of clinical practice guidelines.According to the theory of the clinical guideline,the author value the existing domestic Chinese clinical guideline by the AGREE, discusses the basic thought of TCM clinical practice guidelines,and presented the ecessity, applicability and realistic significance.of clinical practice guidelines based on evidence-based medicine.Combined with the development and application practice of the TCM evidence-based clinical practice guidelines about cerebral infarction, through some qualitative and quantitative research methods, such as in depth-interview, questionnaire, expert consensus (brainstorming method, Delphi, consensus conference, etc), case studies, promotion evaluation of clinical test,the authou put forward to the formulation and implementation methodology flow, about the evidence-based medicine clinical practice guidelines,discuss the difficulties, key issues and the solution.FindingsThrough the systematic review and evaluation of the literature,by evaluating the existing domestic published TCM clinical practice guidelines and analysis, this study drew a conclusion:TCM evidence-based clinical practice guidelines research has very important significance. It can help the principle of evidence-based medicine implemented in clinical practice standardize Chinese medicine clinical medical technologies, promote medical service quality, help clinicians and patients to choose the best treatment plan and decision-making, and thus achieve better curative effect. Compare to western medicine, Chinese medicine clinical practice guidelines should reflect in making its features and advantages of differentiation, establish methodology framework which accords with the methodology of evidence-based medicine and also reflect the core content.Through the systematic methodological exploration, this study explores the principle of the development about theTCM evidence-based guidelines and put forward to the theory that Based on evidence-based medicine clinical practice guidelines are mainly divided into five steps:Establish clinical practice guidelines group; Determine the theme and purpose; Development evidence-based guidelines; Draft clinical guidelines; revise, Review and finalize. The guideline. through some qualitative and quantitative research methods, such as in depth-interview, questionnaire, expert consensus (brainstorming method, Delphi, consensus conference, etc), case studies, promotion evaluation of clinical test,the authou put forward to the formulation and implementation methodology flow, about the evidence-based medicine clinical practice guidelines,discuss the difficulties, key issues and the solution; Discuss the standardization and the consistency of TCM treatment technology; Choose the evidence-based medical evidence; Guide to the methodology of the implementation and evaluation. Combined with case analysis, the corresponding countermeasures are put forward: Carry out standardized study to provide evidence for guideline; Choose appropriate consensus method and clinical test evaluation according to the objective for the aftereffects evaluation.