Endometriosis Of Traditional Chinese Medicine Clinical Guidelines Revision Research

Purpose:The study was undertaken to formulate a draft guidelines for endometriosis clinical diagnosis and treatment of traditional Chinese medicine through systematic research on the literature and Delphi expert survey results.Based on the clinical case analysis and through standard conformance testing with things,It was to evaluate the degree of coincidence between the clinical guidelines of the extent to the actual processing,and to understand endometriosis of clinical diagnosis and treatment of traditional Chinese medicine draft guidance technology level,coordination degree of compatibility,structure,content,application and function.With further evaluation and revision,The purpose was to form a TCM clinical guidelines which was of strong consciousness,high industry consensus,the exact clinical curative effect,standard and practical,so as to promote the standardization and scientificity of TCM evaluation method.Methods:1.Literature research:Related literature was queried following the principle and method of evidence-based medicine,using retrieval tools,adopting the method of combine manual retrieval,computer retrieval and network retrieval.Reliable literature from ancient times to present associated with endometriosis diagnosis and treatment of TCM were excavated and collected.According to the literature selection criteria higher level of evidences were selected.Based on the strength of the evidence standard the selected literature were classified and under statistical simple descriptive analysis in frequency.The content more frequent than a certain number was filtrated to provide literature basis for preparation of expert consultation questionnaire.2.The expert investigation:On the basis of the literature system evaluation which included literature retrieval,syndrome analysis and assessment of curative effect,expert questionnaire was designed and carried out three rounds of expert investigation by reference to the Delphi method.3.The applied evaluation:Method of case investigation and analysis was adopted based on the literature study and expert investigation.Combined with cases clinicians compared diagnosis,therapeutic principle,treatment,prevention and cultivate aspects to guidelines and filled out the application cases of evaluation questionnaire of TCM clinical diagnosis and treatment guidelines and the conformance testing report of traditional Chinese medicine clinical diagnosis and treatment guidelines(appendix 2,3).Case questionnaires were collected and summaried and database was set up after the data extracted were put in Excel table.These data were under general descriptive analysis and the clinical application effect of guide was at last evaluated.Results:1.Literature research:69 class literature books since the western han dynasty recorded endometriosis related were retrieved.There were 120 reported literature conform to the adopt standards.Based reported literature on Chinese medicine therapy of literature,taking Chinese medicine internal decoction,proprietary Chinese medicine and external treatment of Traditional Chinese medicine as the main research objects there respectively were 63,28,29 pieces among them.According to the level of evidence classification,there were 13 class ? literature,65 class ? literature,19 class ?literature and 21 class ? literature respectively of the adopted literature.2.The expert investigation:Each round 30 copies of experts consultation questionnaires were sent out,the first and second round 29 copies of questionnaires were returned,with the third round 25 copies.The recovery rate of first and second round was 96.67%and that of the third round was 83.33%.Experts gived highly attention to the survey.After three rounds of data analysis,experts reached a consensus of endometriosis in terms,definitions,syndrome types,syndrome elements,diagnosis and treatment and the draft guidelines were formed.3.The applied evaluation:Guide clinical application conformity degree:evaluation for the total 244 cases,coincidence rates of traditional Chinese medicine diagnosis and traditional Chinese medicine diagnosis basis were both 99.59%.Coincidence rates western medicine diagnosis and western medicine diagnosis basis were 100%.Consistent rate of syndromes diagnosis was 90.57%and that of syndrome diagnosis basis was 96.31%,with the therapeutic principle coincidence rate 96.72%,prescription and drug composition coincidence rate respectively 76.64%?74.59%,proprietary Chinese medicine coincidence rate 55.74%,other treatment coincidence rate 54.09%and cultivate and prevent coincidence rate 83.20%.Conclusion:Based on the authority,the latest clinical research dynamic and the result of professional experts consultation on EMT diagnosis and treatment,this clinical subject draw up the draft guidelines of endometriosis TCM clinical diagnosis and treatment,and evaluated its clinical application effect.The draft guidlines were of promotion application value which reflected the currently traditional Chinese medicine resources available and of high coincidence rates of clinical application and maneuverability.Original guideline should be consummated later according to the the evaluation result of clinical application and expert advice.Based on the research progress the guidelines should also be updated regularly in the process of practical application with the best evidence and new methods of intervention.