中成药治疗糖尿病肾脏病临床应用专家共识

Expert consensus statement on clinical application of Chinese patent medicines for patients with diabetic kidney disease in clinical practice

关键词:  中成药  糖尿病肾脏病  专家共识  循证

Key words:  Chinese patent medicine  diabetic kidney disease  expert consensus  evidence-based

摘要:

近年来，中成药在糖尿病肾脏病的治疗中应用广泛，其在改善临床症状、降低尿蛋白等指标方面具有显著疗效，然而中成药治疗糖尿病肾脏病的临床应用存在不合理情况，缺乏规范化指导。本共识依托天津市中医药学会糖尿病专业委员会，通过德尔菲法构建临床问题，在文献系统回顾的基础上，进行证据质量分级评价，再结合全国20家单位30余位中医、西医临床专家和方法学专家的推荐意见或共识建议而形成。本共识推荐了16种中成药用于糖尿病肾脏病的治疗，涉及6类中医证型，对每种中成药的作用机制、疗效指标、适宜人群、用法用量、注意事项等予以推荐，旨在推动中成药的临床合理使用，提高临床疗效，减少用药风险。共识会在未来根据实际应用中新出现的临床问题及循证证据予以修订。

Abstract:

In recent years,Chinese patent medicine has been widely used in the treatment of diabetic kidney disease (DKD),which has significant efficacy in improving clinical symptoms,reducing proteinuria and other indicators. But the clinical application of Chinese patent medicine in the treatment of DKD is unreasoned and lacks standardized guidance. This consensus relies on the Diabetes Professional Committee of Tianjin Association of Traditional Chinese Medicine. Constructing clinical problems through Delphi method,and evaluating the quality of evidence in a hierarchy based on a systematic review of the literature, and then combining the recommendations or consensus suggestions of more than 30 Chinese and Western medicine clinical experts and methodologists from 20 units across China,and using GRADE system to classify and evaluate the quality of evidence on the basis of systematic review of research literature, this consensus is formed by combining recommendations or consensus recommendations of more than 30 multidisciplinary experts in traditional Chinese medicine,Western medicine clinical and methodology from 20 units nationwide. There are 16 kinds of Chinese patent medicines for the treatment of DKD recommended in this consensus,involving six types of traditional Chinese medicine syndromes. The mechanism,efficacy indicators,appropriate crowd,dosage and usage,and precautions of each Chinese patent medicine are recommended,aiming to promote the clinical rational use of Chinese patent medicine,improve clinical efficacy and reduce medication risks. This consensus will be revised in the future based on new clinical issues and evidence-based evidence arising in practical applications.