绝经后骨质疏松症中医临床实践指南编制要点解读

为了使指南使用者了解绝经后骨质疏松症中医临床实践指南的编制过程，笔者针对编制过程中的要点问题予以解读。主要包括4项内容，分别是临床问题/结局指标的收集与遴选、证据获取、证据质量评价、推荐意见形成。其中，临床问题的收集与遴选分为3轮，第一轮是广泛收集本指南需要解决的临床问题，第二轮是对第一轮收集的临床问题进行重要性评分，第三轮是通过共识会议法，最终确定19个临床问题及结局指标。证据获取方面，首先检索中英文数据库，然后进行文献的合并与查重，文献的初筛，文献的分类、再筛选，最终纳入系统评价1篇，随机对照研究114篇。证据质量评价及推荐意见形成均按照GRADE原则完成。推荐意见形成过程中，需要注意虽然中医药文献的证据质量普遍偏低，但并不等于中药本身的疗效不佳。需要专家结合临床经验进行全面评估，形成推荐意见。本编制要点解读可使绝经后骨质疏松症中医临床实践指南的制定更加公开透明，并为今后中医临床实践指南的制定提供参考。

Interpretation of key points for the clinical practice guideline for postmenopausal osteoporosis with traditional Chinese medicine

To help the guideline users to understand the compilation process of TCM clinical practice guide for postmenopausal osteoporosis, this paper interprets the key points in the compilation process. It mainly includes four contents, the collection and selection of clinical problems/outcome indicators, evidence acquisition, evidence quality evaluation, and recommendation opinion formation. Among them, the collection and selection of clinical problems can be divided into three rounds. The first round is to extensively collect the clinical problems to be solved in this guideline, the second round is to score the importance of the clinical problems collected in the first round, and the third round is to determine 19 clinical questions and final indicators through consensus meeting. In terms of evidence acquisition, first of all, Chinese and English databases are searched. Then, literature merge and double check are carried out, as well as preliminary screening, classification, and re-screening of the literature. Finally, 1 systematic review paper and 114 randomized controlled studies are included. The evaluation of evidence quality and the formation of recommendation are completed in accordance with GRADE principle. In the process of recommendation formation, it should be noted that although the quality of evidence in TCM literature is generally low, it does not mean that the efficacy of TCM itself is poor. This requires a comprehensive evaluation by experts combined with clinical experience to form recommendations. The key points of this compilation can make the formulation of TCM clinical practice guidelines for postmenopausal osteoporosis opener and more transparent, and provide reference for the formulation of TCM clinical practice guidelines in the future.