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Appraisal of the Quality and Contents of Clinical Practice Guidelines for Hypertension Management in Chinese Medicine: A Systematic Review

  • Evidence-Based Integrative Medicine
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Abstract

Objective

To evaluate the quality and consistency of recommendations in the clinical practice guidelines (CPGs) for hypertension in Chinese medicine (CM).

Methods

CM CPGs were identified from 5 electronic databases and hand searches through related handbooks published from January 1990 to December 2013. Three reviewers independently appraised the CPGs based on the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument, and compared the CPGs’ recommendations on CM syndrome pattern classification and treatment.

Results

Five CM CPGs for hypertension were included. The quality score of the evidence-based (EB) guideline was higher than those of the consensus-based with no explicit consideration of evidence-based (CB-EB) and the consensus-based (CB) guidelines. Three out of five patterns in the CPGs were recommended by the EB guideline. Tianma Gouteng Formula (天麻钩藤复方) in the EB guideline was recommended mostly for hypertension patients with pattern of ascendant hyperactivity of Gan (Liver)-yang and pattern of yin deficiency with yang hyperactivity in the CPGs. Acupuncture and massage were recommended for Grade I and Grade II hypertension with severe symptoms weakening the quality of life in the EB guideline. For Grade I and Grade II hypertension, CM could be used alone, while for Grade III hypertension, they should be used in combination with Western medicines.

Conclusion

The quality of EB guideline was higher than those of CB and CB-EB CPGs in CM for hypertension and CM should be prescribed alone or combined with Western medicines based on the grade of hypertension.

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Authors and Affiliations

  1. Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China

    Ya Yuwen, Xue-jie Han, Xue-yao Zhao, Yu-qi Liu, Da-sheng Liu, Yan-ping Wang & Ai-ping Lu

  2. Institute of Clinical Pharmacology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China

    Wei-liang Weng

  3. Chinese Medicine College, Ningxia Medical University, Yinchuan, 750004, China

    Wei-qiang Li

  4. School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China

    Ai-ping Lu

Authors
  1. Ya Yuwen
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  2. Xue-jie Han
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  3. Wei-liang Weng
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Corresponding author

Correspondence to Yan-ping Wang.

Additional information

Supported by the National Natural Science Foundation of China (No. 81202846), the State Administration of Traditional Chinese Medicine [No.ZYYBZ-2013(PJ85)], China Academy of Chinese Medical Sciences (No. Z0292)

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Yuwen, Y., Han, Xj., Weng, Wl. et al. Appraisal of the Quality and Contents of Clinical Practice Guidelines for Hypertension Management in Chinese Medicine: A Systematic Review. Chin. J. Integr. Med. 24, 545–550 (2018). https://doi.org/10.1007/s11655-016-2277-8

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