邮件订阅 RSS

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

中医药多元证据整合方法学MERGE框架

赖鸿皓,  王浙,  李滢,  唐文静,  王蓓蓓,  孙培栋,  孙铭谣,  黄嘉杰,  肖志攀,  李颖,  赵晨,  商洪才,  杨克虎,  刘杰,  葛龙

downloadPDF
文章导航 > 协和医学杂志  > 2023 > 优先出版
赖鸿皓, 王浙, 李滢, 唐文静, 王蓓蓓, 孙培栋, 孙铭谣, 黄嘉杰, 肖志攀, 李颖, 赵晨, 商洪才, 杨克虎, 刘杰, 葛龙. 中医药多元证据整合方法学MERGE框架[J]. 协和医学杂志. doi: 10.12290/xhyxzz.2023-0083
引用本文: 赖鸿皓, 王浙, 李滢, 唐文静, 王蓓蓓, 孙培栋, 孙铭谣, 黄嘉杰, 肖志攀, 李颖, 赵晨, 商洪才, 杨克虎, 刘杰, 葛龙. 中医药多元证据整合方法学MERGE框架[J]. 协和医学杂志. doi: 10.12290/xhyxzz.2023-0083
shu
LAI Honghao1, 2， WANG Zhe3， LI Ying2， TANG Wenjing2， WANG Beibei2， SUN Peidong2， SUN Mingyao 3， HUANG Jiajie4， XIAO Zhipan5， LI Ying1, 2， ZHAO Chen6， SHANG Hongcai7， YANG Kehu8, 9, 10， LIU Jie11, 12， GE Long1, 2, 9, 10, . The Multi-evidence Integration Methodology for Traditional Chinese Medicine： the MERGE Framework[J]. Medical Journal of Peking Union Medical College Hospital. doi: 10.12290/xhyxzz.2023-0083
Citation: LAI Honghao1, 2， WANG Zhe3， LI Ying2， TANG Wenjing2， WANG Beibei2， SUN Peidong2， SUN Mingyao 3， HUANG Jiajie4， XIAO Zhipan5， LI Ying1, 2， ZHAO Chen6， SHANG Hongcai7， YANG Kehu8, 9, 10， LIU Jie11, 12， GE Long1, 2, 9, 10, . The Multi-evidence Integration Methodology for Traditional Chinese Medicine： the MERGE Framework[J]. Medical Journal of Peking Union Medical College Hospital. doi: 10.12290/xhyxzz.2023-0083
shu

中医药多元证据整合方法学MERGE框架

doi: 10.12290/xhyxzz.2023-0083

  • 1 兰州大学公共卫生学院 循证社会科学研究中心;

  • 2 兰州大学公共卫生学院 社会医学与卫生事业管理研究所, 兰州 730000;

  • 3 兰州大学护理学院循证护理研究中心;

  • 4 甘肃中医药大学护理学院;

  • 5 甘肃中医药大学中西医结合学院, 兰州 730030;

  • 6 中国中医科学院中医临床基础医学研究所, 北京 100700;

  • 7 北京中医药大学东直门医院中医内科学教育部和北京市重点实验室, 北京 100700;

  • 8 兰州大学基础医学院循证医学中心, 兰州 730000;

  • 9 甘肃省循证中医药协同创新基地, 兰州 730000;

  • 10 甘肃省循证医学与临床转化重点实验室, 兰州 730000;

  • 11 中国中医科学院广安门医院肿瘤科, 北京 100053;

  • 12 中国中医药循证医学中心, 北京 100700

基金项目: 

国家自然科学基金（82204931）；中国中医科学院科技创新工程（CI2021A05502）

详细信息
    通讯作者:

    刘杰,E-mail:dr.liujie@163.com

    葛龙,E-mail:gelong2009@163.com

  • 中图分类号: R181.2;R21

The Multi-evidence Integration Methodology for Traditional Chinese Medicine： the MERGE Framework

  • 1 Evidence-based Social Science Research Center,, School of Public Health, Lanzhou University, Lanzhou 730000, China;

  • 2 Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou 730000, China;

  • 3 Evidence-based Nursing Centre, School of Nursing,, Lanzhou University, Lanzhou 730000, China;

  • 4 College of Nursing,, Gansu University of Chinese Medicine, Lanzhou 730030, China;

  • 5 School of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou 730030, China;

  • 6 Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China;

  • 7 Key Laboratory of Chinese Internal Medicine of Ministry of Education, Beijing Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China;

  • 8 Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China;

  • 9 Collaborative Innovation Center for Evidence-based Traditional Chinese Medicine in Gansu Province, Lanzhou 730000, China;

  • 10 Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China;

  • 11 Oncology Department, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, China;

  • 12 China Center for Evidence-based Traditional Chinese Medicine, Beijing 100700, China

Funds: 

National Natural Science Foundation of China (82204931)； China Academy of Chinese Medical Sciences Innovation Fund (CI2021A05502)

    摘要
  • 摘要:

    在循证医学时代下，依托规范的技术方法和标准化的操作规程发掘中医药独特优势，是实现中医药现代化、国际化发展并惠泽人类的必由之路。中医理论、人用经验和研究证据三结合证据体系的提出标志着中医药特色评价体系思维方法取得了重要进步，经过恰当方法整合后的多元证据体是中医药临床指南推荐意见和循证卫生决策的有力支撑。本文基于当前国际证据合成与分级方法学前沿与进展，初步提出中医药多元证据整合方法：MERGE，以期为该方法学走向成熟奠定基础，并为中医药循证医学方法学体系的发展提供借鉴。

    Abstract:

    In the era of evidence-based medicine， it is necessary to explore the unique advantages of traditional Chinese medicine (TCM) based on standardized technical methods and operating procedures in order to achieve the modernization and internationalization of TCM and benefit humanity. The proposal of a three-pronged evidence system combining TCM theory， human experience and experimental evidence marks an important progress in the thinking method of the TCM evaluation system. The multi-evidence body integrated through appropriate methods is a strong support for the clinical guideline recommendations and evidence-based health decisionmaking in TCM. Based on the current methodological progress of international evidence synthesis and grading， this paper proposes a novel approach for integrating multi-evidence in traditional Chinese medicine： the MERGE framework. The aim is to establish a solid foundation for the development of this methodology and to provide guidance for the advancement of the evidencebased medicine framework in traditional Chinese medicine.

    • HTML全文
    • 参考文献(61)
  • [1] 喻佳洁, 李琰, 陈雯雯, 等.循证医学的产生与发展:社会需求、学科发展和人文反思共同推动[J]. 中国循证医学杂志, 2019, 19:108-113.
    [2] Tian G, Zhao C, Zhang X, et al. Evidence-based traditional Chinese medicine research:Two decades of development, its impact, and breakthrough[J].J Evid Based Med, 2021, 14:65-74.
    [3] 国务院关于印发中医药发展战略规划纲要(2016-2030年)的通知[J].中华人民共和国国务院公报. 2016(08):21-29.
    [4] 余艳红.在中国中医药循证医学中心成立仪式上的讲话[J].中国中西医结合杂志, 2019, 39:389.
    [5] 邢冬梅, 刘新灿, 张俊华, 等.循证中医药学进展[J].中华中医药杂志, 2022, 37:3319-3323.
    [6] Chen Y, Wang C, Shang H, et al. Clinical practice guidelines in China[J].BMJ, 2018, 360:j5158.
    [7] 中华人民共和国中央人民政府.中共中央国务院关于促进中医药传承创新发展的意见[EB/OL].(2019-10-26)[2023-02-10].http://www.gov.cn/zhengce/2019-10/26/content_5445336.htm.
    [8] Guyatt G, Rennie D, Meade M, et al. Users' Guides to the Medical Literature:A Manual for Evidence-Based Clinical Practice[M].New York:McGraw-Hill Education, 2002.
    [9] 张越伦, 吴东, 李乃适, 等.试论循证医学的哲学基础[J].协和医学杂志, 2021, 12:401-406.
    [10] Toon P. What is evidence?[J].London J Prim Care (Abingdon), 2014, 6:95-97.
    [11] Mowat R, Subramanian SV, Kawachi I. Randomized controlled trials and evidence-based policy:A multidisciplinary dialogue[J].Soc Sci Med, 2018, 210:1.
    [12] Sun X, Tan J, Tang L, et al.Real world evidence:experience and lessons from China[J].BMJ, 2018, 360:j5262.
    [13] Gokhale M, Stürmer T, Buse JB.Real-world evidence:the devil is in the detail[J].Diabetologia, 2020, 63:1694-1705.
    [14] Cuello-Garcia CA, Santesso N, Morgan RL, et al.GRADE guidance 24 optimizing the integration of randomized and non-randomized studies of interventions in evidence syntheses and health guidelines[J].J Clin Epidemiol, 2022, 142:200-208.
    [15] 赖鸿皓, 田晨, 朱鸿飞, 等.如何整合随机与非随机干预研究[J].中国循证医学杂志, 2022, 22:836-841.
    [16] 陈曦, 张宇鹏, 于智敏, 等.关于中医理论体系框架研究的若干思考[J].中国中医基础医学杂志, 2013, 19:3-5, 14.
    [17] 苏鹏丽, 刘骏, 于亚南, 等.中医药证据体系及评价要素研究现状分析[J].中医杂志, 2022, 63:288-292.
    [18] 李琰, 喻佳洁, 陈雯雯, 等.循证医学的科学观和人文观[J].中国循证医学杂志, 2019, 19:114- 118.
    [19] 杨其霖,田思胜,马梅青.中医药古籍文献数据库建设研究与思考[J].中国医药导报,2018,15:119-122.
    [20] 赵雪, 戴国华, 管慧, 等.中医临床疗效评价指标的选择与应用[J].中华中医药杂志, 2022, 37:1863-1867.
    [21] Guyatt GH, Oxman AD, Kunz R, et al.What is "quality of evidence" and why is it important to clinicians?[J].BMJ, 2008, 336:995-998.
    [22] Guyatt G, Oxman AD, Akl EA, et al. GRADE guidelines:1. Introduction-GRADE evidence profiles and summary of findings tables[J].J Clin Epidemiol, 2011, 64:383-394.
    [23] 龙德怀, 尚菊菊, 刘红旭, 等.中医药随机对照试验质量评价文献再评价[J].中华中医药杂志, 2022, 37:5318-5322.
    [24] 郑玉娇, 逄冰, 刘文科, 等.中医"治未病"临床研究的现状及对策探析[J].环球中医药, 2018, 11:4.
    [25] 陆玉林, 骆文, 陆丽明.开展真实世界中医药临床研究的机遇与挑战[J].中华中医药杂志, 2021, 36:4.
    [26] Sherman RE, Anderson SA, Dal Pan GJ, et al.Real-World Evidence-What Is It and What Can It Tell Us?[J]. N Engl J Med, 2016, 375:2293-2297.
    [27] Jarow JP, LaVange L, Woodcock J.Multidimensional Evidence Generation and FDA Regulatory Decision Making:Defining and Using"Real-World" Data[J].JAMA, 2017, 318:703-704.
    [28] Schünemann HJ, Cuello C, Akl EA, et al. GRADE guidelines:18. How ROBINS-I and other tools to assess risk of bias in nonrandomized studies should be used to rate the certainty of a body of evidence[J].J Clin Epidemiol, 2019, 111:105-114.
    [29] Li L, Smith HE, Atun R, et al.Search strategies to identify observational studies in MEDLINE and Embase[J].Cochrane Database Syst Rev, 2019, 3:MR000041.
    [30] 王志稳, 冷敏敏, 孙月.证据整合研究中文献检索策略的制订[J].中华护理教育, 2021, 18:883- 888.
    [31] Faber T, Ravaud P, Riveros C, et al.Meta-analyses including non-randomized studies of therapeutic interventions:a methodological review[J].BMC Med Res Methodol, 2016, 16:35.
    [32] Bilandzic A, Fitzpatrick T, Rosella L, et al.Risk of Bias in Systematic Reviews of Non-Randomized Studies of Adverse Cardiovascular Effects of Thiazolidinediones and Cyclooxygenase-2 Inhibitors:Application of a New Cochrane Risk of Bias Tool[J].PLoS Med, 2016, 13:e1001987.
    [33] Sanderson S, Tatt ID, Higgins JP.Tools for assessing quality and susceptibility to bias in observational studies in epidemiology:a systematic review and annotated bibliography[J].Int J Epidemiol, 2007, 36:666-676.
    [34] Deeks JJ, Dinnes J, D' Amico R, et al.Evaluating non-randomised intervention studies[J].Health Technol Assess, 2003, 7:iii-x,1i-173i.
    [35] 孙凤, 高乐, 杨智荣, 等.偏倚风险评估系列:(五)非随机干预性研究[J].中华流行病学杂志, 2018, 39:374-381.
    [36] Dreier M, Borutta B, Stahmeyer J, et al.Comparison of tools for assessing the methodological quality of primary and secondary studies in health technology assessment reports in Germany[J].GMS Health Technol Assess, 2010, 6:Doc07.
    [37] 中医药真实世界研究技术规范:证据质量评价与报告[J].中医杂志, 2022, 63:293-300.
    [38] 刘建平.传统医学证据体的构成及证据分级的建议[J].中国中西医结合杂志, 2007:1061-1065.
    [39] 苏鹏丽, 刘骏, 于亚南, 等.中医药证据体系及评价要素研究现状分析[J].中医杂志, 2022, 63:288-292.
    [40] 钱静华, 郭志丽.构建适合中医药特征的临床证据评价体系[J].中华中医药杂志, 2018, 33:4302-4304.
    [41] 金锐, 王宇光, 张冰.试论完善传统中医药组方合理性评价技术在中药新药审评中的重要性[J].中药新药与临床药理, 2020, 31:1117-1122.
    [42] 刘迈兰, 吴曦, 任玉兰, 等.借鉴循证医学实践方法研究中医古籍的思考[J].时珍国医国药, 2010, 21:726-727.
    [43] 张磊, 佟琳, 曾宪涛, 等.中医古籍证据循证评价标准研究现状[J].中国中医药图书情报杂志, 2021, 45:66-69.
    [44] 陈薇, 方赛男, 刘建平.基于证据体的中医药临床证据分级标准建议[J].中国中西医结合杂志, 2019, 39:358-364.
    [45] 李承羽, 赵晨, 陈耀龙, 等.中医药临床指南/共识中推荐意见分级标准的制订[J].中医杂志, 2020, 61:486-492.
    [46] Richards DA, Bazeley P, Borglin G, et al.Integrating quantitative and qualitative data and findings when undertaking randomised controlled trials[J].BMJ Open, 2019, 9:e032081.
    [47] Fetters MD, Curry LA, Creswell JW. Achieving integration in mixed methods designs-principles and practices[J].Health Serv Res, 2013, 48:2134-2156.
    [48] Lewin S, Booth A, Glenton C, et al.Applying GRADE-CERQual to qualitative evidence synthesis findings:introduction to the series[J].Implement Sci, 2018, 13:2.
    [49] 拜争刚, 刘少堃, 黄崇斐, 等.定性系统评价证据分级工具:CERQual简介[J].中国循证医学杂志, 2015, 15:1465-1470.
    [50] 中华医学会.中医药整体证据研究的标准化操作规程[EB/OL].(2020-03-27)[2023-02- 10].http://www.cacm.org.cn/zhzyyxh/bzhsj/202003/84ca423a5f9c46e29d78509907b0b846.shtml.
    [51] 王巍巍, 杨智荣, 孙凤, 等.网状Meta分析GRADE证据总结表的制订、解读与应用[J].中国循证医学杂志, 2020, 20:1471-1476.
    [52] 秦微.中医基础理论中信息思维文献检索探究[J].辽宁中医药大学学报, 2016, 18:163-165.
    [53] 杨其霖, 田思胜, 马梅青.中医药古籍文献数据库建设研究与思考[J].中国医药导报, 2018, 15:119-122.
    [54] 段逸山.中医典籍词语索引的编制及其作用[J].中国索引, 2020(02):3-14.
    [55] 王莹莹, 白宇, 丁长林, 等.面向语义检索的中医理论知识库构建方法的研究[J].中文信息学报, 2012, 26:72-78.
    [56] 杨忠奇, 高蕊, 胡思源, 等.中药人用经验研究专家共识[J].中国中药杂志, 2022, 47:4829- 4834.
    [57] Davis K, Minckas N, Bond V, et al.Beyond interviews and focus groups:a framework for integrating innovative qualitative methods into randomised controlled trials of complex public health interventions[J].Trials, 2019, 20:329.
    [58] Djulbegovic B, Guyatt GH.Progress in evidence-based medicine:a quarter century on[J].Lancet, 2017, 390:415-423.
    [59] Miles A, Bentley P, Polychronis A, et al.Advancing the evidence-based healthcare debate[J].J Eval Clin Pract, 1999, 5:97-101.
    [60] Miles A, Bentley P, Polychronis A, et al.Evidence-based medicine:why all the fuss? This is why[J].J Eval Clin Pract, 1997, 3:83-86.
    [61] Greenhalgh T, Howick J, Maskrey N. Evidence Based Medicine Renaissance Group.Evidence based medicine:a movement in crisis?[J].BMJ, 2014, 348:g3725.
    • 相关文章
    • 施引文献
  • 资源附件(0)
  • 加载中
WeChat 点击查看大图
计量
  • 文章访问数:  40
  • HTML全文浏览量:  0
  • PDF下载量:  7
  • 被引次数: 0
出版历程
  • 收稿日期:  2023-02-15
  • 网络出版日期:  2023-04-21

目录

    /

    返回文章
    返回
    友情链接: 国家卫生健康委员会 北京协和医院 中国医学科学院 学术不端检测系统 国际知识资源总库 中国知网 术语在线 中国全科医学
    地址：北京市东城区帅府园1号 北京协和医院老楼7号楼
    3层302室 《协和医学杂志》编辑部
    电话：010-69154261/4262
    E - mail：medj@pumch.cn
    mjpumch@126.com
    期刊网站版权所有：《协和医学杂志》编辑部
    京ICP备 11002662

    本系统由 北京仁和汇智信息技术有限公司 开发    百度统计

    x 关闭 永久关闭

    【温馨提醒】近日，《协和医学杂志》编辑部接到作者反映，有多名不法人员冒充期刊编辑发送见刊通知，鼓动作者添加微信，从而骗取版面费的行为。特提醒您，本刊与作者联系的方式均为邮件通知或电话，稿件进度通知邮箱为：mjpumch@126.com，编辑部电话为：010-69154261，请提高警惕，谨防上当受骗！如有任何疑问，请致电编辑部核实。谢谢！