| 摘要: |
| [目的] 系统评估心力衰竭中医/中西医临床实践指南的质量，并整合高质量指南中证据级别较高或获得强推荐的中医药治疗方案。[方法] 全面检索中英文数据库、学术机构网站及指南平台，纳入心力衰竭相关指南、共识及规范（简称“指南”）。采用AGREE Ⅱ、RIGHT清单及中医药临床实践指南评价规范，对纳入指南的方法学质量、报告质量和临床适用性进行评价。筛选高质量指南，提取并整合其中推荐的治疗方案。[结果] 共纳入16部指南。质量评价显示：方法学质量总体中等（B级为主），严谨性和应用性存在不足；报告质量两极分化（1篇A级，过半为C级），证据与评审环节透明度低；临床适用性均为B级，但可操作性普遍较弱。从5篇高质量指南中整合出40项治疗方案，涵盖急慢性心力衰竭不同阶段与证型，形成结构化诊疗集合：急性期以静脉制剂“回阳固脱”；慢性射血分数降低型心力衰竭以口服中成药为主；射血分数保留型心力衰竭稳定期采用中药汤剂/中成药、静脉制剂、运动康复与中医技术相结合的“综合调理”模式；伴利尿剂抵抗者选用中药汤剂“温阳利水”。[结论] 当前心力衰竭中医/中西医临床实践指南整体质量中等，虽在清晰性与目的性方面较好，但制定严谨性、报告透明度与临床可操作性仍需提升。整合方案为临床实践提供了循证参考，未来需进一步开展高质量研究以夯实证据基础。 |
| 关键词: 心力衰竭 指南 共识 AGREE Ⅱ RIGHT清单 中医药临床实践指南评价规范 |
| DOI：10.11656/j.issn.1672-1519.2026.09.07 |
| 分类号:R541.61 |
| 基金项目:津药达仁堂集团股份有限公司横向课题（HX2025-88）。 |
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| Quality evaluation of traditional Chinese medicine and integrated Chinese and Western medicine clinical practice guidelines for heart failure |
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GAO Zixuan, SUN Ruoning, JIANG Qingxu, JIAO Linlin, GAO Shan, YU Chunquan
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Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
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| Abstract: |
| [Objective] To evaluate the quality of traditional Chinese medicine（TCM）and integrative Chinese and Western medicine clinical practice guidelines for heart failure（HF）and synthesize treatment plans with strong recommendations or higher-level evidence from high-quality guidelines. [Methods] A systematic search was conducted across databases，academic websites，and guideline platforms for relevant HF guidelines，consensuses，and standards. The AGREE Ⅱ tool，RIGHT checklist，and TCM guideline evaluation criteria were used to assess methodological quality，reporting quality，and clinical applicability. High-quality guidelines were selected to extract and integrate recommended treatment plans. [Results] Sixteen guidelines were included. Methodological quality was moderate（predominantly Grade B），with deficiencies in rigor and applicability. Reporting quality was polarized（one Grade A；over half Grade C），showing low transparency in evidence and review reporting. Clinical applicability was uniformly Grade B，but operability was generally low. From 5 high-quality guidelines，40 treatment plans were synthesized，covering acute/chronic HF stages and syndromes. A structured framework was formed：intravenous preparations for“yang restoration and collapse reversal”in acute HF；oral Chinese patent medicines for chronic HF with reduced ejection fraction（HFrEF）；a“comprehensive regulation”model （herbal decoctions/ patent medicines，intravenous preparations，exercise，TCM techniques）for stable HF with preserved ejection fraction（HFpEF）；and herbal decoctions formulas for“yang-warming and diuresis-promotion”in diuretic-resistant cases. [Conclusion] Current TCM and integrative HF guidelines are of moderate overall quality，adequate in clarity and purpose but requiring improvement in development rigor，reporting transparency，and clinical operability. The synthesized plans provide evidence-based references for practice，but higher- quality research is needed to strengthen the evidence. |
| Key words: heart failure guidelines consensus AGREE Ⅱ RIGHT checklist evaluation criteria for traditional Chinese medicine clinical practice guidelines |
