Research-Based On The Standardization Of Traditional Chinese Medicine To Evaluate Clinical Practice Guide Of Nephritic Syndrome In Children

【Background】Chinese medicine is a treasure of Chinese culture belongs to the context of traditional knowledge. Chinese medicine to the development and prosperity, and is bound to implement the process of internationalization, and to play an active role in human disease prevention and health promotion. The improvement of the standard system, is the premise and guarantee of the internationalization process, and therefore must attach great importance to the construction of the standardization of Chinese medicine and its implementation. TCM clinical treatment guidelines is an important part of the standardization process, organized by the State Administration of Traditional Chinese Medicine drafted into the evaluation of the amendment stage. The official standardization program which children with nephrotic syndrome has not yet released the characteristics of TCM Clinical Practice Guidelines The inclusion evaluation Amendment of the disease.【Objective】A variety of medical and analyzed over the past decade domestic by finishing clinical children with nephrotic syndrome treatment program, and efficacy, economic evaluation, comparison, pharmaceutical standardization project in children with nephrotic syndrome clinic draft guidance, the evaluation of the guidelines on the clinical applicability;literature journals clinics and efficacy of nephrotic syndrome, care, economics, literature, explore and summarize the law of nephrotic syndrome diagnosis and treatment of clinical disease treatment guidelines draft. And both compared with draft treatment guidelines, to considering and explore the law of the diagnosis and treatment of children with nephrotic syndrome, and to provide a reference for further amendments to the species of the disease treatment guidelines.【Methods】Collected from July2012to December2012in the Hospital of Hubei Province, Shandong University of Traditional Chinese Medicine Affiliated Hospital of Henan University of Chinese Medicine First Affiliated Hospital pediatric outpatient and inpatient department treatment of148patients with nephrotic syndrome clinical data observedits diagnosis is based on, syndrome type hair cut herbs, the efficacy and economic evaluation, the related input Excel statistical classification, comprehensive analysis, summarized in children with nephrotic syndrome treatment law and contrast the applicability of the treatment guidelines; retrieval Chinese JournalFull‐text Database (Breast Cancer Chinese Journal of,2001‐2012) published nephrotic syndrome clinical diagnosis and evaluation of the literature, the choice of keywords to form a literature search type electronic retrieval, by reading the title of the article, the summary of the earlysieve. Screening by full‐text articles to read selected literature, with reference to the inclusion criteria to select. Related content input Excel statistical classification, statistical analysis of the frequency and clustering analysis, summarized in children with nephrotic syndrome common syndromes and clinics of law. Combined with the results of clinical observation and document analysis to evaluate the applicability of the draft of children with nephrotic syndrome of TCM treatment guidelines, and put forward the views of the relevant amendments.【Result】1.148children with NS age distribution were:0to5years of age accounted for43.92%, from6to9years of age accounted for31.08%,18.24%from10to13years old,14to18years old accounted for6.76%; sex ratio of3.23:1.2.Observed cases no edema in28cases (18.92%), edema in36cases (24.32%), edema in84cases (56.76%).3.Chinese disease diagnosis and guide the diagnostic criteria of coincidence rate of91.89%,8.11%more in line does not meet the evaluation is0. Western diagnostic coincidence rate was98.65%. TCM Syndrome Types Guide, the evaluation "in accordance with"87.84%, more in line with "10.81%" do not meet the two cases (1.35%).4.In the treatment of the Governing Law and guidelines were evaluated by comparing "consistent with"108cases (72.97%),32cases (21.62%),"general" in7cases (4.73%), does not meet the "1" more in line with (0.96%). The Recipe Guide compare, evaluate compliance with97cases (65.54%),"more in line" in32cases (21.62%),"general" in9cases (6.08%),"does not meet the10cases (6.76%). Other treatment methods and guidelines, evaluation consistent with108cases (72.97%), more in line with23cases (15.54%), generally consistent with the7cases (4.73%), does not meet the "1(0.68%), and another nine cases (6.08%) without making the evaluation. Photo transfer and prevention, evaluation Guide conformity with88.51%, more in line with4.73%, generally consistent with the "1.35%" does not meet the "8cases (5.41%). 5.148cases of children with NS treatment time distribution:14<d≤21days and52cases (35.14%),21<d≤28days and44cases (29.73%),≤14days43cases (29.05%), the treatment time is greater than28days of NS cases9cases (6.08%).6.The clinical efficacy distributed as follows:69cases (46.62%) were cured; effective in65cases (43.92%); improved in11cases (7.43%), healed in3cases (2.03%). The better disease kinds of traditional Chinese medicine treatment effect (E), markedly effective rate was90.54%.7.This clinic security program distributed as follows: of well106cases (71.62%), good in41cases (27.70%), fair in1case (0.68%), evaluated as bad cases. To evaluate the economy: good102cases (68.92%), good in46cases (31.08%), evaluated as fair, and poor cases.8.Literature review, included in16of the31expertise, clinical observation of15, of Chinese literature evidence grading standards I0, Ⅱ grade7, Ⅲ grade1, grade IV0Ⅴ level23. By the dialectical type and prescription frequency statistics, match the results with clinical cases.【Conclusion】1.By observing the treatment process and treatment evaluation of clinical cases, children with nephrotic syndrome Chinese medicine treatment guidelines suitable for clinical application meets the evaluation of each project in more than60%.2.Using the method of literature review published cases of clinical observation and Chinese experts on the diagnosis and treatment of children with nephrotic syndrome group status, in line with clinical observations, guidelines evaluation and revision of reference.3.recommendations guide in the card, marked cards, and change card Standardization specification, consider the combination of edema and non‐edema (incidence and remission), or to the the hormone application process for clues Break guidance, attention to blood stasis wet pathological status, with Chinese characteristics, diagnosis and treatment guidelines for standardization of system.4.large sample of Chinese medicine clinics, multi‐center, randomized controlled trials (RTC), the relative lack of standardized treatment program can not be given to the development of a more objective and accurate support. Recommendations for future clinical trials focus on the principles of randomized controlled to provide a basis for Chinese medicine standardization process.