CAJ | 학술논문

目的：采用AGREEⅡ工具评价分析国内外慢性病基层临床指南现状，为规范我国慢性病基层临床指南的开发及制定提供参考。方法计算机检索中国生物医学文献数据库（CBM）、中国知网（CNKI）、维普数据库（VIP）、万方数据库（WANFANG DATA）、PUBMED数据库与指南发布及指南资料的相关网站，年份为2008~2014年。纳入公开发表的基层慢性病临床指南，文种为中英文。描述性分析纳入指南的名称、发表年份及机构、开发方法、参考文献数目等内容。采用AGREEⅡ工具评价国内外基层慢性病临床指南的质量。结果①共纳入基层临床指南11部，分别来自美国、澳大利亚、欧洲、中国，发表年份为2008~2014年；②指南涵盖领域包括高血压、心血管病、糖尿病、慢性阻塞性肺病、支气管哮喘等；③纳入指南参考文献在从未标注至146篇不等；④纳入指南在范围和目的、参与人员、制定严谨性、表达明晰性、应用性、编辑独立性共6个评价领域的平均得分分别为88.1%、50.2%、31.4%、90.1%、49.7%、38.3%，其中有3个领域＜50%，纳入的11部指南均未描述检索方法及其依据、更新程序也未清楚描述。结论目前世界范围内基层慢性病防治指南较少，制定速度慢，质量有待提高；我国基层慢性病临床指南相对较少，缺乏冠心病和慢性阻塞性肺病等基层常见慢病的基层临床指南，建议借鉴国外经验，在政府主导下针对国情和基层全科医生特点，制定符合国情，内容简洁实用，注重慢病管理的基层慢病防治指南。
목적：채용AGREEⅡ공구평개분석국내외만성병기층림상지남현상，위규범아국만성병기층림상지남적개발급제정제공삼고。방법계산궤검색중국생물의학문헌수거고（CBM）、중국지망（CNKI）、유보수거고（VIP）、만방수거고（WANFANG DATA）、PUBMED수거고여지남발포급지남자료적상관망참，년빈위2008~2014년。납입공개발표적기층만성병림상지남，문충위중영문。묘술성분석납입지남적명칭、발표년빈급궤구、개발방법、삼고문헌수목등내용。채용AGREEⅡ공구평개국내외기층만성병림상지남적질량。결과①공납입기층림상지남11부，분별래자미국、오대리아、구주、중국，발표년빈위2008~2014년；②지남함개영역포괄고혈압、심혈관병、당뇨병、만성조새성폐병、지기관효천등；③납입지남삼고문헌재종미표주지146편불등；④납입지남재범위화목적、삼여인원、제정엄근성、표체명석성、응용성、편집독립성공6개평개영역적평균득분분별위88.1%、50.2%、31.4%、90.1%、49.7%、38.3%，기중유3개영역＜50%，납입적11부지남균미묘술검색방법급기의거、경신정서야미청초묘술。결론목전세계범위내기층만성병방치지남교소，제정속도만，질량유대제고；아국기층만성병림상지남상대교소，결핍관심병화만성조새성폐병등기층상견만병적기층림상지남，건의차감국외경험，재정부주도하침대국정화기층전과의생특점，제정부합국정，내용간길실용，주중만병관리적기층만병방치지남。
Objective To review the current status of grassroots clinical guidelines of chronic diseases at home and abroad by applying AGREE Ⅱ instrument, and provide reference for developing and formulating grassroots clinical guidelines of chronic diseases in China. Methods The databases of CBM, CNKI, VIP Database, WanFang Database and PubMed, and related websits to issuing and data of guidelines were retrieved from 2008 to 2014. The publushed grassroots clinical guidelines of chronic diseases were included and language was limited in Chinese and English. The names, publishing years and organizations, development methods and quantity of references of included guidelines were descriptively analyzed. Results ①There were totally 11 guidelines included from USA, Australia, Europe and China, and publish years were from 2008 to 2014. ②These guidelines covered hypertension, cardiovascular diseases, diabetes, chronic obstructive pulmonary disease (COPD) and bronchia asthma. ③The quantity of reference was from 0 to 146. ④The average score was, respectively, 88.1%, 50.2%, 31.4%, 90.1%, 49.7%and 38.3%in 6 domains of included guidelines including range and purpose, participants, preciseness, pellucidity, applicability and editor’s independence, and among them, there were 3 domains lower than 50%. All 11 included guidelines did not describe methods and evidence of retrieving and update program. Conclusion ①At present, the grassroots clinical guidelines of chronic diseases are less with slow development and lower quality in the world. ②The grassroots clinical guidelines of chronic diseases and the guidelines for grassroots common diseases including coronary heart disease and COPD are relatively few. It is suggested to develop simple and practical grassroots clinical guidelines of chronic diseases based on learning from foreign experience, aiming at Chinese situations and characteristics of grassroots general clinicians, and regarding prevention and treatment of chronic diseases.