Article type
Year
Abstract
Background: Western medicine (WM) and traditional Chinese medicine (TCM) are established healthcare systems in China, and during the past decades, clinical practice guidelines (CPGs) have been developed in both TCM and WM. Previous study has showed that 12% (74/604) of WM CPGs recommended TCM therapies.
Objectives: To understand how TCM recommendations for 18 diseases in the WM and TCM CPGs are evidence-based.
Methods: From our previous study, we identified 18 diseases with both WM guidelines and TCM guidelines. We extracted relevant data from the guidelines, and searched four Chinese databases, PubMed, and the Cochrane Library from their inception till April 2014, to identify systematic reviews and randomized trials on TCM therapies for the 18 diseases. We then compared the references to support TCM recommendations in the guidelines with the best available evidence.
Results: A total of 17 WM CPGs that had TCM recommendations were published from 2004 to 2014, while TCM CPGs were issued between 2008 and 2012 (Table 1). Chinese herbal medicine (oral decoction, Chinese proprietary medicine or external application), acupuncture, moxibustion, tuina and massage were recommended in both WM and TCM CPGs. Cupping, scrapping, acupoint injection, qigong were recommended in only WM CPGs. Only one TCM CPG provided supporting evidence with references when giving recommendations, but did not provide evidence gradings or a recommendation of strength. Ten out of 18 TCM CPGs provided literature evidence, amongst which nine adopted an evidence grading standard, and one used the Delphi process to establish a grading standard. By searching electronic databases, we identified a total of 4228 publications (including 336 systematic reviews and 3892 randomized trials) on TCM therapy for the 18 diseases that were largely ignored in the both WM and TCM CPGs (Figure 1).
Conclusions: Substantial clinical evidence is not fully reflected in guidelines for TCM recommendations, especially in the case of WM guidelines in China. We suggest the development of CPGs based on systematic collection and synthesis of current best evidence for the target diseases.
Objectives: To understand how TCM recommendations for 18 diseases in the WM and TCM CPGs are evidence-based.
Methods: From our previous study, we identified 18 diseases with both WM guidelines and TCM guidelines. We extracted relevant data from the guidelines, and searched four Chinese databases, PubMed, and the Cochrane Library from their inception till April 2014, to identify systematic reviews and randomized trials on TCM therapies for the 18 diseases. We then compared the references to support TCM recommendations in the guidelines with the best available evidence.
Results: A total of 17 WM CPGs that had TCM recommendations were published from 2004 to 2014, while TCM CPGs were issued between 2008 and 2012 (Table 1). Chinese herbal medicine (oral decoction, Chinese proprietary medicine or external application), acupuncture, moxibustion, tuina and massage were recommended in both WM and TCM CPGs. Cupping, scrapping, acupoint injection, qigong were recommended in only WM CPGs. Only one TCM CPG provided supporting evidence with references when giving recommendations, but did not provide evidence gradings or a recommendation of strength. Ten out of 18 TCM CPGs provided literature evidence, amongst which nine adopted an evidence grading standard, and one used the Delphi process to establish a grading standard. By searching electronic databases, we identified a total of 4228 publications (including 336 systematic reviews and 3892 randomized trials) on TCM therapy for the 18 diseases that were largely ignored in the both WM and TCM CPGs (Figure 1).
Conclusions: Substantial clinical evidence is not fully reflected in guidelines for TCM recommendations, especially in the case of WM guidelines in China. We suggest the development of CPGs based on systematic collection and synthesis of current best evidence for the target diseases.