Integrative Medicine

中西医结合
  • 文章类型: Journal Article
    在公立和私立医院以及其他综合护理环境中追求职业机会的脊医迅速增长。在综合护理环境中繁荣的脊医提供以患者为中心的护理,专注于机构使命,理解并遵守组织规则,精通复杂系统的导航。脊骨疗法教育认证标准委员会没有概述综合护理临床培训的具体元能力。
    这项研究的目的是为DC计划开发初步的综合医疗保健能力,以指导临床脊骨疗法教育的发展。
    进行了系统的文献检索。筛选文章的合格性并一式两份提取。域和种子声明是从这些文献中产生的,在会议研讨会上试点,并通过修改后的德尔菲共识过程进行评估。在被邀请的42人中,36名脊医作为小组成员参加。公众意见征询期产生了20条意见,没有导致能力发生实质性变化。
    在1718次引用中,23篇文章符合资格标准。经过2次修改的Delphi轮回,就所有能力声明达成了共识。共商定了78份能力声明,其中包含4个结构域和11个子结构域。这4个领域是:1)合作,(2)临床卓越,(3)沟通,和(4)系统管理。
    我们确定了78个初步能力,适合为DC学生和早期职业脊医在综合医疗环境中的临床实践做好准备。教育计划可以考虑课程设计和改革的这些能力,以加强DC计划毕业生的综合实践,高级培训,和就业。
    UNASSIGNED: There has been rapid growth of chiropractors pursuing career opportunities in both public and private hospitals and other integrated care settings. Chiropractors that prosper in integrated care settings deliver patient-centered care, focus on the institutional mission, understand and adhere to organizational rules, and are proficient in navigating complex systems. The Council on Chiropractic Education Accreditation Standards do not outline specific meta-competencies for integrated care clinical training.
    UNASSIGNED: The purpose of this study was to develop preliminary integrated health care competencies for DC programs to guide the advancement of clinical chiropractic education.
    UNASSIGNED: A systematic literature search was performed. Articles were screened for eligibility and extracted in duplicate. Domains and seed statements were generated from this literature, piloted at a conference workshop, and evaluated via a modified Delphi consensus process. Of 42 invited, 36 chiropractors participated as panelists. Public comment period yielded 20 comments, none resulting in substantive changes to the competencies.
    UNASSIGNED: Of 1718 citations, 23 articles met eligibility criteria. After 2 modified Delphi rounds, consensus was reached on all competency statements. A total of 78 competency statements were agreed upon, which encompassed 4 domains and 11 subdomains. The 4 domains were: 1) Collaboration, (2) Clinical Excellence, (3) Communication, and (4) Systems Administration.
    UNASSIGNED: We identified 78 preliminary competencies appropriate for preparing DC students and early career chiropractors for clinical practice in integrated healthcare settings. Educational programs may consider these competencies for curricular design and reform to strengthen DC program graduates for integrated practice, advanced training, and employment.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    背景:ASCO和综合肿瘤学会合作制定了在焦虑管理中应用综合方法的指南,抑郁症,癌症患者的疲劳和大麻素和大麻的使用。这些指南提供了基于证据的建议,以通过综合方式增强常规癌症治疗来改善预后和生活质量。
    方法:由患者倡导者组成的专家小组审查了所有告知指南建议的研究,ASCO方法学家,肿瘤学提供者,和综合医学专家。小组成员审查了每个审判的证据质量,确定了等级质量评估标签,并得出了建议的结论。
    结果:针对治疗期间癌症疲劳的管理提出了强有力的建议,包括面对面或基于网络的正念减压,基于正念的认知疗法,太极拳或气功。针对癌症治疗后癌症疲劳的管理提出了基于正念的计划。除非在临床试验的背景下,临床医生应建议不要使用大麻或大麻素作为癌症导向治疗。推荐的焦虑管理方式包括基于正念的干预(MBIs),瑜伽,催眠,放松疗法,音乐疗法,反射疗法,针灸,太极,和薰衣草精油。指南中最强烈的建议是应该向癌症患者提供MBI,在积极治疗和后处理期间,来解决抑郁症。
    结论:癌症治疗综合干预措施的证据越来越多,现在的研究支持在癌症护理连续体中进行综合干预的益处。
    BACKGROUND: ASCO and the Society for Integrative Oncology have collaborated to develop guidelines for the application of integrative approaches in the management of anxiety, depression, fatigue and use of cannabinoids and cannabis in patients with cancer. These guidelines provide evidence-based recommendations to improve outcomes and quality of life by enhancing conventional cancer treatment with integrative modalities.
    METHODS: All studies that informed the guideline recommendations were reviewed by an Expert Panel which was made up of a patient advocate, an ASCO methodologist, oncology providers, and integrative medicine experts. Panel members reviewed each trial for quality of evidence, determined a grade quality assessment label, and concluded strength of recommendations.
    RESULTS: Strong recommendations for management of cancer fatigue during treatment were given to both in-person or web-based mindfulness-based stress reduction, mindfulness-based cognitive therapy, and tai chi or qigong. Strong recommendations for management of cancer fatigue after cancer treatment were given to mindfulness-based programs. Clinicians should recommend against using cannabis or cannabinoids as a cancer-directed treatment unless within the context of a clinical trial. The recommended modalities for managing anxiety included Mindfulness-Based Interventions (MBIs), yoga, hypnosis, relaxation therapies, music therapy, reflexology, acupuncture, tai chi, and lavender essential oils. The strongest recommendation in the guideline is that MBIs should be offered to people with cancer, both during active treatment and post-treatment, to address depression.
    CONCLUSIONS: The evidence for integrative interventions in cancer care is growing, with research now supporting benefits of integrative interventions across the cancer care continuum.
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  • 文章类型: Journal Article
    目标:即使有几家德国儿童医院提供综合服务,除了标准的医疗护理之外,人工医学治疗,这些人工疗法的指南仍然很少见。因此,我们调查了实施已发布的,在社区医院Herdecke采用人工疗法治疗急性胃肠炎(aGE)儿童的共识性指南。
    方法:对社区医院Herdecke综合儿科收治的aGE儿科患者(≤18岁)进行了前瞻性病例系列研究。人口统计,在初次就诊和随访时记录临床和治疗数据.对医生进行了问卷调查,以评估实施该指南的可行性。
    结果:62名患者(0-15岁;22名男性,病例系列中包括40名女性)。所有患者都接受了某种形式的人工疗法。最常用的疗法是Geumurbanum,马钱子和牛丸。治疗医生在其处方治疗中表现出对专家共识指南的高度坚持。所有医生都表示他们熟悉该指南,并使用该建议来告知他们的治疗决定。医生对日常使用的适宜性和治疗aGE主要症状的有效性进行了高度评价。
    结论:成功实施了基于共识的儿童aGE人工疗法指南,并发现对临床实践中的医生有用。
    OBJECTIVE: Even though several German children\'s hospitals offer integrative, anthroposophic medical therapies in addition to the standard medical care, guidelines for these anthroposophic therapies are still rare. Therefore, we investigated the feasibility of implementing a published, consensus-based guideline for the treatment of children with acute gastroenteritis (aGE) with anthroposophic therapies in the community hospital Herdecke.
    METHODS: A prospective case series of paediatric patients (≤18 years) with an aGE admitted to the department of integrative paediatrics of the community hospital Herdecke was conducted. Demographic, clinical and therapeutic data was recorded at initial presentation and at follow-up visits. Physicians were surveyed with a questionnaire to evaluate feasibility of implementing the guideline.
    RESULTS: Sixty-two patients (0-15 years; 22 male, 40 female) were included in the case series. All patients received some form of anthroposophic therapy. The most frequently used remedies were Geum urbanum, Nux vomica and Bolus alba comp. Treating physicians showed a high adherence to the expert-based consensus guideline in their prescribed therapies. All physicians stated that they were familiar with the guideline and used the recommendation to inform their therapy decision. Suitability for daily use and effectiveness in treating the main symptoms of aGE were highly scored by the physicians.
    CONCLUSIONS: The consensus-based guideline of anthroposophic therapies for aGE in children was successfully implemented and found to be useful for physicians in clinical practice.
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  • 文章类型: Journal Article
    术后胃肠功能紊乱(POGD)是麻醉手术后常见的并发症。中西医结合的策略显示出一些明显的效果,但尚无标准化的临床实践指南。因此,来自各个专业机构的多学科专家团队,包括中国中西医结合协会(CAIM)的围手术期和麻醉专业委员会,与甘肃省中西医结合麻醉学临床研究中心/甘肃省中医院麻醉与疼痛医学中心、世卫组织指南实施与知识翻译合作中心/建议中文分级,评估,发展,与评价(等级)中心/甘肃省医学指南产业技术中心/兰州大学循证医学中心,旨在制定循证指南。通过文献综述和专家共识会议确定了临床问题(7个背景问题和12个临床问题)。基于系统评价/荟萃分析,分析了证据质量,并根据患者偏好的输入权衡了干预措施的优缺点。最后,通过基于德尔菲的共识会议提出了20项建议。这些建议包括疾病定义,病因,发病机制,辨证,诊断,围手术期的预防和治疗。
    Postoperative gastrointestinal disorder (POGD) was a common complication after surgery under anesthesia. Strategies in combination with Traditional Chinese Medicine and Western medicine showed some distinct effects but standardized clinical practice guidelines were not available. Thus, a multidisciplinary expert team from various professional bodies including the Perioperative and Anesthesia Professional Committees of the Chinese Association of Integrative Medicine (CAIM), jointly with Gansu Province Clinical Research Center of Integrative Anesthesiology/Anesthesia and Pain Medical Center of Gansu Provincial Hospital of Traditional Chinese Medicine and WHO Collaborating Center for Guideline Implementation and Knowledge Translation/Chinese Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Center/Gansu Provincial Center for Medical Guideline Industry Technology/Evidence-based Medicine Center of Lanzhou University, was established to develop evidence-based guidelines. Clinical questions (7 background and 12 clinical questions) were identified through literature reviews and expert consensus meetings. Based on systematic reviews/meta-analyses, evidence quality was analyzed and the advantages and disadvantages of interventional measures were weighed with input from patients\' preferences. Finally, 20 recommendations were developed through the Delphi-based consensus meetings. These recommendations included disease definitions, etiologies, pathogenesis, syndrome differentiation, diagnosis, and perioperative prevention and treatment.
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  • 文章类型: Journal Article
    本文-COVID-19护理的中西医结合(IM)建议和指南-是亚太经济合作组织(APEC)项目(中西医结合(IM)和COVID-19护理)在2022年5月至2023年3月期间的成果之一。在护理提供者的努力下,研究人员,APEC经济体中的卫生政策制定者和医疗保健行政领导人,本文件的目的是为COVID-19护理提供全面的IM系统,作为建议和提示性指南,包括护理方法,工具,程序,症状状况和目标选择,在护理应用期间需要考虑的要点。所有引用的COVID-19护理实践都证实了其单独使用或与常规药物联合使用的有效性和实用性。本文提供了当前有关IM的有用医疗信息,用于COVID-19护理,这可能使APEC经济体和世界卫生界的医疗保健系统受益。
    This article - Recommendations and Guidelines of Integrative Medicine (IM) for COVID-19 Care - was one of the outcomes from an Asia-Pacific Economic Cooperation (APEC) Project (Integrative Medicine (IM) and COVID -19 Care) during the time between May 2022 and March 2023. With the efforts from care providers, researchers, health policy makers and healthcare administrative leaders among APEC economies, the purpose of this file was to provide comprehensive IM systems for COVID-19 care as recommendations and suggestive guidelines including care methods, tools, procedures, symptom conditions and targets selections, and points need to be considered during care applications. All cited COVID-19 care practices have confirmed their efficacy and usefulness either used alone or combined with conventional medicine. This article provides current useful medical information on IM for COVID-19 care which could benefit APEC economies and world health communities on their healthcare system.
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  • 文章类型: Journal Article
    背景:医学指南是定性和具有成本效益的患者护理的重要依据。然而,在人工医学(AM)中缺乏临床建议,在欧洲经常实行的综合医学(CAIM)方法。急性扁桃体炎,包括扁桃体咽炎,是一种常见的儿童疾病。这主要是由病毒感染引起的。因此,对症治疗非常重要,AM可以提供多种治疗选择。
    方法:来自德国的53名医生,西班牙,荷兰,瑞士,奥地利,和匈牙利至少有一年的人工儿科医学经验被邀请参加在线Delphi过程。该过程包括五轮调查,从开放式问题开始,到最后陈述结束,这需要75%的专家同意才能达成共识。专家回答由两名独立审稿人使用MAXQDA和Excel进行评估。
    结果:反应率在28%和45%之间。拟订的建议包括15个子专题。这些覆盖临床,诊断,急性扁桃体炎的治疗和社会心理方面。六个子主题达成了高度共识(>90%),九个子主题达成了共识(75-90%)。
    结论:儿童急性扁桃体炎的临床建议旨在简化患者的日常护理,并在考虑和处方人工疗法时提供决策支持。此外,这项建议使人工医学对医生来说更加透明,父母,也许还有政治利益相关者。
    BACKGROUND: Medical guidelines are an important basis for qualitative and cost-effective patient care. However, there is a lack of clinical recommendations in anthroposophic medicine (AM), an integrative medicine approach frequently practised in Europe. Acute tonsillitis, which includes tonsillopharyngitis, is a common childhood disease. that is mostly caused by a viral infection. Symptomatic treatment is therefore of high importance, and AM can offer several therapy options.
    METHODS: 53 physicians from Germany, Spain, Netherlands, Switzerland, Austria, and Hungary with at least one year of experience in anthroposophic paediatric medicine were invited to participate in an online Delphi process. The process comprises five survey rounds starting with open-ended questions and ending with final statements, which need 75% agreement of experts to reach consensus. Expert answers were evaluated by two independent reviewers using MAXQDA and Excel.
    RESULTS: Response rate was between 28% and 45%. The developed recommendation included 15 subtopics. These covered clinical, diagnostic, therapeutic and psychosocial aspects of acute tonsillitis. Six subtopics achieved a high consensus (>90%) and nine subtopics achieved consensus (75-90%).
    CONCLUSIONS: The clinical recommendation for acute tonsillitis in children aims to simplify everyday patient care and provide decision-making support when considering and prescribing anthroposophic therapies. Moreover, the recommendation makes AM more transparent for physicians, parents, and maybe political stakeholders as well.
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  • 文章类型: English Abstract
    根据循证医学原则和专家共识,由中国中西医结合协会骨伤科专业委员会制定《中西医结合诊治脊髓型颈椎病临床指南》,并为临床医生提供CSM临床诊断和治疗的学术指导。主要内容包括诊断要点,疾病分级评估,中医辨证,手术适应症和时机,中西医结合治疗,和术后康复。本指引首次提出CSM的处理应遵循分级原则,明确手术治疗的时机和方法,建立中医常见的辨证分型,重视术后中西医结合康复,加强日常跟踪管理。它希望促进标准化,有效性,CSM临床治疗的安全性。
    The \"Clinical Guidelines for Diagnosis and Treatment of Cervical Spondylotic Myelopathy with the Integrated Traditional Chinese and Western Medicine\" were formulated by the Orthopedic and Traumatology Professional Committee of the Chinese Association of Integrative Medicine in accordance with the principles of evidence-based medicine and expert consensus, and provide clinicians with academic guidance on clinical diagnosis and treatment of CSM. The main content includes diagnostic points, disease grading assessment, TCM syndrome differentiation, surgical indications and timing, integrated traditional Chinese and Western medicine treatment, and postoperative rehabilitation. This guideline proposes for the first time that the treatment of CSM should follow the principle of grading, clarify the timing and methods of surgical treatment, establish common TCM syndrome differentiation and classification, attach importance to postoperative integrated rehabilitation of Chinese and Western medicine, and strengthen daily follow-up management. It hopes to promote the standardization, effectiveness, and safety of clinical treatment of CSM.
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  • 文章类型: Journal Article
    肩袖撕裂是中老年人常见病,这对患者的身心健康和生活质量有很大影响。以中医为基础的中西医结合在肩袖撕裂的诊治中具有一定的特色和优势。中医,主要专注于植物性天然产物,具有相对稳定可靠的疗效。以循证医学为基础制定肩袖撕裂的联合诊治方案具有重要意义,有助于使中西医临床诊疗技术更加科学化、规范化,达到更好的治疗效果。该指南从范围方面规范了肩袖撕裂的诊断和治疗过程,术语和定义,诊断,中医辨证,治疗,功能锻炼,预防和护理,等。能更好地为临床医生提供诊治策略和建议。该指南很好地适应临床实践,既安全又有效。
    Rotator cuff tear is a common injury among middle-aged and elderly people, and it has a great impact on patients\' physical and mental health and quality of life. Integrative medicine based on Traditional Chinese Medicine (TCM) has certain advantages in the diagnosis and treatment of rotator cuff tears. TCM, which mainly involves the use of plant-based products, has relatively stable and reliable curative effects. It is of great significance to formulate a combined diagnosis and treatment plan for rotator cuff tear based on evidence-based medicine, which can help to standardize the clinical diagnosis and treatment techniques of TCM and Western medicine and achieve better therapeutic effects. This guideline standardizes the diagnosis and treatment process of rotator cuff tear from the aspects of range, terminology and definition, diagnosis, TCM syndrome differentiation, treatment, functional exercise, and prevention and care. It makes recommendations that cover the adoption of manual therapy, acupuncture, and other integrative medicine based on TCM. Users of these guidelines are most likely to include clinicians and health managers in healthcare settings.
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  • 文章类型: English Abstract
    Myopia in children shows a trend of high incidence and younger age. To standardize the integrated Chinese and western medicine methods of diagnosis, classification, prevention and control of myopia in children, as well as to improve the prevention and control effectiveness, the Chinese Association of Integration Medicine, China Association of Chinese Medicine and Chinese Medical Association have gathered relevant experts to investigate clinical problems, retrieve, screen, extract and synthesize evidence, and form expert consensus opinions in accordance with the requirements of evidence-based medicine methodology. The diagnosis and treatment guideline for integrated Chinese and western medicine for myopia prevention and control in children includes recommendations on how to effectively delay the occurrence of myopia in healthy children, avoid the development of pseudomyopia to myopia, delay the development of low myopia to high myopia, prevent and treat complications of high myopia. Eye health-related behavior monitoring and correction, acupuncture, transcutaneous electrical acupoint stimulation, optics, and medications are introduced. This guideline can provide guidance not only for medical professionals and technical personnel in clinical and scientific research practice, but also for the myopic, pseudomyopic, premyopic and healthy population in preventing and controlling myopia.
    儿童青少年近视呈现高发、低龄化趋势。为了规范儿童青少年近视中西医结合诊断、分类、预防和控制等方法,提高儿童青少年近视综合防控水平和效果,中国中西医结合学会、中华中医药学会和中华医学会汇集相关专家,严格按照循证医学方法学,调研和构建临床问题,检索、筛选、提取和综合证据,通过专家共识形成推荐意见,最终征求专家意见并通过审查,形成与儿童青少年近视中西医结合防控相关的诊疗指南。本指南从有效延缓健康儿童青少年发生近视、避免假性近视发展为真性近视、延缓低度近视发展为高度近视、预防和治疗高度近视并发症等方面,提出中西医结合预防和控制推荐意见,涵盖用眼行为监测与矫正,针刺或经皮穴位电刺激、光学、药物等预防和控制近视发生和发展技术等内容,以供医疗专业技术人员在临床及科研实践中参考和使用,也可作为近视、假性近视、近视临床前期或健康人群自我预防的健康指导。.
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