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Abstract：
OBJECTIVE: To systematically review Clinical Practice Guidelines (CPGs) for the management of menopause-related vasomotor symptoms (VMS) to 1) identify those that include Natural Health Products (NHPs); 2) identify which NHPs were included and the evidence supporting the recommendation for the place in therapy; and 3) compare methodological quality of the CPGs.
METHODS: PubMed, EMBASE, Web of Science, BMJ Best Practice, DynaMed Plus and websites of gynecological and menopausal societies were searched (Jan 2000-Nov 2018). Records were screened to identify CPGs that were published in English, since 2000 and were for use in North America. CPGs were reviewed for inclusion of NHPs. Data regarding NHPs (evidence, recommendation) were extracted and analyzed. CPGs were critically appraised using the AGREE II tool.
RESULTS: Five of six CPGs that met general inclusion criteria included NHPs. Black cohosh, isoflavones, soy food/extracts and phytoestrogens were included in all five CPGs. Comparative analysis of recommendations and level of supporting evidence revealed differences. All CPGs included recommendations regarding the use of NHPs in general, although recommendations differed. Four of five CPGs made recommendations for unique NHPs, however, recommendations differed. Using the AGREE II tool, CPGs scored well on domains for purpose and clarity. Lack of detailed description of methodology and author expertise affected scores in other domains.
CONCLUSIONS: Five CPGs included general recommendations for the role of NHPs in treating VMS, with recommendations ranging from use with caution to not recommended. There were inconsistencies among CPGs regarding NHPs included and what evidence was used in making recommendations.
METHODS: PubMed, EMBASE, Web of Science, BMJ Best Practice, DynaMed Plus and websites of gynecological and menopausal societies were searched (Jan 2000-Nov 2018). Records were screened to identify CPGs that were published in English, since 2000 and were for use in North America. CPGs were reviewed for inclusion of NHPs. Data regarding NHPs (evidence, recommendation) were extracted and analyzed. CPGs were critically appraised using the AGREE II tool.
RESULTS: Five of six CPGs that met general inclusion criteria included NHPs. Black cohosh, isoflavones, soy food/extracts and phytoestrogens were included in all five CPGs. Comparative analysis of recommendations and level of supporting evidence revealed differences. All CPGs included recommendations regarding the use of NHPs in general, although recommendations differed. Four of five CPGs made recommendations for unique NHPs, however, recommendations differed. Using the AGREE II tool, CPGs scored well on domains for purpose and clarity. Lack of detailed description of methodology and author expertise affected scores in other domains.
CONCLUSIONS: Five CPGs included general recommendations for the role of NHPs in treating VMS, with recommendations ranging from use with caution to not recommended. There were inconsistencies among CPGs regarding NHPs included and what evidence was used in making recommendations.
摘要：
目的：系统地审查用于管理更年期相关血管舒缩症状（VMS）的临床实践指南（CPG），以1）确定包括天然健康产品（NHP）的那些；2）确定包括哪些NHP以及支持治疗推荐的证据；3）比较CPG的方法学质量。
方法：PubMed，EMBASE,WebofScience,BMJ最佳实践,搜索了DynaMedPlus和妇科和更年期协会的网站（2000年1月至2018年11月）。对记录进行了筛选，以识别以英文出版的CPG，自2000年以来，在北美使用。对纳入NHP的CPG进行了审查。有关NHP的数据(证据，推荐)进行提取和分析。使用AGREEII工具对CPG进行了严格评估。
结果：符合一般纳入标准的6个CPG中有5个包括NHP。黑升麻,异黄酮,大豆食品/提取物和植物雌激素包括在所有五个CPG中。建议和支持证据水平的比较分析显示出差异。所有CPG都包括关于一般使用NHP的建议，尽管建议有所不同。五个CPG中有四个为独特的NHP提出了建议，然而,建议有所不同。使用AGREEII工具，在目的和清晰度方面，CPG在领域得分很高。缺乏对方法和作者专业知识的详细描述会影响其他领域的分数。
结论：五个CPGs包括关于NHP在治疗VMS中的作用的一般性建议，建议从谨慎使用到不推荐。关于纳入的NHP以及在提出建议时使用了哪些证据，CPG之间存在不一致。
方法：PubMed，EMBASE,WebofScience,BMJ最佳实践,搜索了DynaMedPlus和妇科和更年期协会的网站（2000年1月至2018年11月）。对记录进行了筛选，以识别以英文出版的CPG，自2000年以来，在北美使用。对纳入NHP的CPG进行了审查。有关NHP的数据(证据，推荐)进行提取和分析。使用AGREEII工具对CPG进行了严格评估。
结果：符合一般纳入标准的6个CPG中有5个包括NHP。黑升麻,异黄酮,大豆食品/提取物和植物雌激素包括在所有五个CPG中。建议和支持证据水平的比较分析显示出差异。所有CPG都包括关于一般使用NHP的建议，尽管建议有所不同。五个CPG中有四个为独特的NHP提出了建议，然而,建议有所不同。使用AGREEII工具，在目的和清晰度方面，CPG在领域得分很高。缺乏对方法和作者专业知识的详细描述会影响其他领域的分数。
结论：五个CPGs包括关于NHP在治疗VMS中的作用的一般性建议，建议从谨慎使用到不推荐。关于纳入的NHP以及在提出建议时使用了哪些证据，CPG之间存在不一致。
