Abstract: Background Carotid atherosclerosis (CAS) is an important cause of ischemic stroke. Existing guidelines and consensus statements mainly address Western medical diagnosis and treatment or traditional Chinese medicine syndrome based interventions separately, and an integrated clinical pathway combining Chinese and Western medicine remains lacking. Objective To integrate recommendations from CAS-related guidelines and consensus statements and develop an integrated Chinese and Western medicine clinical pathway for CAS. Methods PubMed, Web of Science, CNKI, Wanfang, VIP, SinoMed, and relevant guideline platforms were searched from inception to March 27, 2026. CAS-related guidelines and consensus statements were included. Two researchers independently screened the literature and extracted data. The methodological quality was assessed using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument. Recommendations were then integrated, mapped to the evidence, and translated into a clinical pathway. Results A total of 14 guidelines and consensus statements were included, comprising 9 Chinese and 5 international publications. The AGREE Ⅱ assessment showed that the domain of "scope and purpose" had the highest score [(89.9±5.1)%], followed by "clarity of presentation" [(89.3±7.0)%] and "applicability" [(72.9±10.1)%]. Relatively lower scores were observed for "rigour of development" [(53.1±24.4)%], "stakeholder involvement" [(58.9±17.1)%], and "editorial independence" [(59.5±23.5)%]. In the overall assessments, 11 documents were rated as Grade A and 3 as Grade B. Based on the integrated recommendations, an integrated Chinese and Western medicine clinical pathway for CAS was developed, encompassing risk screening, integrated diagnosis of disease and syndrome, stratified treatment, therapeutic efficacy assessment, and long-term follow-up. Conclusion This pathway integrates imaging-based risk stratification and standardized Western medical treatment with TCM syndrome identification and interventions based on syndrome differentiation. It may serve as a reference for standardized CAS management throughout the disease course and for the clinical practice of integrated Chinese and Western medicine.

Key words: Carotid atherosclerosis, Evidence-based guidelines, Clinical pathway, Integrative medicine, Systematic review

摘要： 背景 颈动脉粥样硬化（CAS）是缺血性脑卒中的重要病因，现有指南/共识多分别论述西医诊疗或中医辨证干预，尚缺乏中西医结合临床路径。目的 整合 CAS 相关指南/共识推荐意见，构建 CAS 中西医结合临床路径。方法 检索 PubMed、Web of Science、中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统（SinoMed）等数据库及指南平台，检索时限为建库至 2026-03-27。纳入 CAS 相关指南/共识，由 2 名研究者独立筛选、提取资料，采用临床指南研究与评价工具Ⅱ（AGREE Ⅱ）评价方法学质量，并进行推荐意见整合、证据映射和路径化转化。结果 共纳入指南/共识 14 篇，其中国内 9 篇、国际 5 篇。AGREE Ⅱ评价显示，“范围和目的”得分最高（89.9±5.1）%，其次为“清晰性”（89.3±7.0）% 和“应用性”（72.9±10.1）%；“严谨性”（53.1±24.4）%、“参与人员”（58.9±17.1）%和“独立性”（59.5±23.5）% 相对较低。推荐级别判定 A 级 11 篇、B 级 3 篇。基于推荐意见整合，本研究形成了涵盖风险筛查、病证结合诊断、分层治疗、疗效评价和长期随访的 CAS 中西医结合临床路径。结论 本路径将影像风险分层、标准化西医治疗与中医证候辨识和辨证干预相结合，可为 CAS 全病程规范化管理及中西医结合临床实践提供参考。

关键词: 颈动脉粥样硬化, 循证指南, 临床路径, 中西医结合, 系统评价