基于牛津證據(jù)等級(jí)評(píng)價(jià)中藥治療腦卒中的證據(jù)質(zhì)量研究
發(fā)布時(shí)間:2018-05-05 10:19
本文選題:牛津證據(jù)等級(jí) + 腦卒中。 參考:《新疆醫(yī)科大學(xué)》2017年碩士論文
【摘要】:目的:應(yīng)用2001牛津循證醫(yī)學(xué)中心臨床證據(jù)分級(jí)評(píng)價(jià)2011-2015年中醫(yī)類雙核心期刊雜志文章中藥治療腦卒中的證據(jù)等級(jí)分布情況,并應(yīng)用循證醫(yī)學(xué)核心內(nèi)容簡(jiǎn)化成的PICOFSn七大要素主要對(duì)納入研究文獻(xiàn)的結(jié)局、隨訪進(jìn)行評(píng)價(jià),對(duì)臨床應(yīng)用中藥治療腦卒中臨床研究證據(jù)進(jìn)行詳細(xì)評(píng)價(jià),以期為臨床治療腦卒中循證用藥指南的制定提供依據(jù)。方法:選擇2014年最新北大圖書館中國(guó)中文核心期刊目錄和最新2015-2016年CSCD目錄共有的雙核心中醫(yī)類期刊共計(jì)19種為目標(biāo)期刊,以電子檢索和手工檢索的形式檢索,包括中國(guó)知網(wǎng)數(shù)據(jù)庫(kù)、相關(guān)期刊論文、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)網(wǎng)絡(luò)版、重慶維普中文科技期刊數(shù)據(jù)庫(kù)、萬(wàn)方數(shù)據(jù)庫(kù)和中國(guó)中醫(yī)藥期刊文獻(xiàn)數(shù)據(jù)庫(kù)在內(nèi)的國(guó)內(nèi)各大中文數(shù)據(jù)庫(kù),交叉檢索以防漏檢或誤檢。全部數(shù)據(jù)庫(kù)檢索時(shí)間從2011年1月1日至2015年12月31日。由2位研究員依照納入與排除標(biāo)準(zhǔn)篩選文獻(xiàn),提取資料和采用PICOFSn七要素(患者、干預(yù)措施、對(duì)照組、結(jié)局指標(biāo)、隨訪時(shí)間、研究類型、樣本例數(shù))進(jìn)行論文分解,并按2001牛津循證醫(yī)學(xué)中心臨床證據(jù)水平分級(jí)進(jìn)行證據(jù)分級(jí)。結(jié)果:按照納入及排除標(biāo)準(zhǔn),共納入33篇文獻(xiàn),其中隨機(jī)對(duì)照試驗(yàn)文獻(xiàn)占36.4%,半隨機(jī)對(duì)照試驗(yàn)占48.6%,系統(tǒng)綜述/Meta分析占6%,同期非隨機(jī)對(duì)照試驗(yàn)研究占3%,回顧性分析占6%;其中8篇文獻(xiàn)報(bào)告了主要結(jié)局指標(biāo),占24.2%;所有納入33篇文獻(xiàn)均報(bào)告了次要結(jié)局指標(biāo),報(bào)告率為100.0%;納入文獻(xiàn)中9篇文章對(duì)安全性指標(biāo)進(jìn)行了報(bào)告,報(bào)告率為27.3%;所納入文獻(xiàn)中只有1篇文章做了隨訪,其余32篇文章均未提及隨訪內(nèi)容;研究所納入的目前中藥治療腦卒中臨床研究證據(jù)主要集中在Ⅱb類、Ⅲb類,分別占36.4%和51.6%,而證據(jù)等級(jí)級(jí)別最高的Ⅰ類證據(jù)僅占9%,包括Ⅰa類6%,Ⅰb類3%,此外還包括少量Ⅳ類證據(jù),占3%。結(jié)論:研究發(fā)現(xiàn)納入文獻(xiàn)所報(bào)告的主要結(jié)局指標(biāo)報(bào)告率偏低。研究納入文獻(xiàn)中只有1篇文章做了隨訪。基于2001牛津證據(jù)等級(jí)分級(jí)分析可以發(fā)現(xiàn)目前中藥治療腦卒中臨床研究證據(jù)等級(jí)級(jí)別仍然有待于進(jìn)一步提高。活血化瘀仍然是治療腦卒中不可忽視的方法。
[Abstract]:Objective: to evaluate the distribution of evidence levels in the treatment of stroke with traditional Chinese medicine (TCM) in 2001 Oxford Center for Evidence-Based Medicine (Oxford Center for Evidence-Based Medicine) from 2011 to 2015. The seven elements of PICOFSn, which were simplified as the core content of evidence-based medicine, were mainly used to evaluate the outcome of the study and follow-up, and to evaluate the clinical evidence of clinical treatment of stroke with traditional Chinese medicine in detail. In order to provide evidence-based medication guidelines for the clinical treatment of stroke. Methods: a total of 19 double-core TCM periodicals were selected from the Chinese core journals catalogue of the latest Peking University Library in 2014 and the latest CSCD catalogue from 2015 to 2016, which were retrieved by electronic and manual retrieval. Including the China knowledge Network Database, the full text Database of Chinese Journals, the online Edition of China Biomedical Literature Database, the Chongqing Weipu Chinese Science and Technology Journal Database, The Chinese databases of Wanfang database and Chinese traditional Chinese medicine periodical literature database are cross-searched to prevent missed or false detection. All databases are retrieved from January 1, 2011 to December 31, 2015. Two researchers sifted the literature according to the inclusion and exclusion criteria, extracted the data and used the seven elements of PICOFSn (patient, intervention, control group, outcome index, follow-up time, type of study, sample number) to decompose the paper. The evidence was classified according to the level of clinical evidence of Oxford Evidence-based Medical Center (Oxford) 2001. Results: according to the criteria of inclusion and exclusion, 33 articles were included. Among them, the literature on randomized controlled trials accounted for 36.4%, semi-randomized controlled trials accounted for 48.6%, systematic review / meta-analysis accounted for 6%, non-randomized controlled trials accounted for 3%, retrospective analysis accounted for 6%, eight of them reported the main outcome indicators. 24.2%; all 33 articles included reported secondary outcome indicators with a reporting rate of 100.0; 9 articles included reported safety indicators with a reporting rate of 27.3x; only 1 article was followed up. The other 32 articles did not mention the contents of follow-up, and the clinical evidence of traditional Chinese medicine for stroke was mainly in category 鈪,
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