中国全科医学 ›› 2026, Vol. 29 ›› Issue (10): 1239-1245.DOI: 10.12114/j.issn.1007-9572.2023.0833

所属专题: 指南/共识最新文章合辑

• 指南·共识 • 上一篇    下一篇

中国支气管哮喘指南质量的系统评价与思考

王高明1,2, 王明航1,*(), 杨江1, 孟圆圆1, 赵娣1, 董晓升1   

  1. 1.450000 河南省郑州市,河南中医药大学第一附属医院呼吸科
    2.450000 河南省郑州市,河南中医药大学第一临床医学院
  • 收稿日期:2025-01-15 修回日期:2025-07-25 出版日期:2026-04-05 发布日期:2026-03-25
  • 通讯作者: 王明航

  • 作者贡献:

    王高明、王明航负责文章的构思与设计、论文撰写;王高明、杨江、孟圆圆负责统计学处理;杨江、孟圆圆进行表格的制作;王高明、赵娣、董晓升负责资料收集与处理;王明航对文章整体负责。

  • 基金资助:
    国家自然科学基金资助项目(82474483); 河南省高校科技创新团队(23IRTSTHN027); 国家中医药管理局青年岐黄学者支持项目(国中医药人教发[2020]7号); 国家重点研发计划项目(2023YFC3502602)

Systematic Evaluation and Reflection on the Quality of Bronchial Asthma Guidelines in China

WANG Gaoming1,2, WANG Minghang1,*(), YANG Jiang1, MENG Yuanyuan1, ZHAO Di1, DONG Xiaosheng1   

  1. 1. Department of Respiratory Medicine, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, China
    2. The First Clinical Medical College of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, China
  • Received:2025-01-15 Revised:2025-07-25 Published:2026-04-05 Online:2026-03-25
  • Contact: WANG Minghang

摘要: 背景 支气管哮喘(以下简称哮喘)是常见的呼吸系统疾病,其发病率逐年上升,疾病负担重。高质量的临床实践指南和专家共识可以帮助医生在诊疗中做出更为科学的决策,提高临床疗效,减少资源浪费。遴选和制订高质量指导性文件对哮喘的治疗具有重要意义。 目的 系统评价国内发布的哮喘指南/共识的方法学质量,为进一步完善、更新和制订更高质量的指南提供依据和借鉴。 方法 检索中国知网、万方数据知识服务平台、维普网、中华医学期刊全文数据库收录的哮喘相关指南/共识,检索时限2013-01-01—2023-10-20。采用中国临床实践指南评价体系(AGREE-China)工具对指南/共识质量进行评价,并对较高质量的5部指南/共识的主要推荐意见进行总结分析。 结果 最终纳入指南/共识15部。AGREE-China各领域平均得分率:科学性/严谨性33.98%,有效性/安全性38.00%,经济性20.00%,可用性/可行性73.71%,利益冲突84.00%。整体质量较好的有5部指南,主要推荐意见包括诊断、治疗(药物治疗和非药物治疗)以及健康教育和管理3个方面。 结论 国内哮喘指南的总体质量一般,方法学质量不断提高,但在科学性/严谨性、经济性领域仍有待进一步改进。

关键词: 哮喘, 指南, 专家共识, 系统评价, 中国临床实践指南评价体系

Abstract:

Background

Bronchial asthma is a common respiratory disease, with its incidence increasing yearly and a high disease burden. High-quality clinical practice guidelines and expert consensus can help physicians make more scientific decisions in diagnosis and treatment, improve clinical efficacy, and reduce the waste of resources. The selection and development of high-quality guidance documents are of great significance to the treatment of asthma.

Objective

In order to provide a basis and reference for further improvement, as well as updating and developing the higher-quality guidelines, we systematically evaluated the methodological quality of asthmatic guidelines/expert consensus published in China.

Methods

We searched the asthmatic guidelines/consensus from CNKI, Wanfang, VIP database, and Full-Text Database of Chinese Medical Journal. The time limitation was from January 1, 2013 to October 20, 2023. The AGREE-China tool was used to evaluate the quality of the guidelines/consensus, summarize and analyze the main recommendations of the included guidelines/consensus.

Results

Fifteen guidelines/consensuses were finally included. Average score rate of each domain of AGREE-China were as follows. Scientific validity/rigor was 33.98%, validity/safety was 38.00%, economy was 20.00%, usability/feasibility was 73.71%, and conflict of interest was 84.00%. The overall quality of 5 guidelines were relatively good. The main recommendations had 3 areas, including diagnosis, treatment (drug therapy and non-drug therapy) , as well as health education and management.

Conclusion

The overall quality of domestic asthmatic guidelines is general. The methodological quality is improving constantly, but further improvement is still needed in the areas of science/rigor and economy.

Key words: Asthma, Guidebook, Expert consensus, Systematic reviews, AGREE-China

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