Diagnosis And Treatment Of Rotator Cuff Injury With Traditional Chinese And Western Medicine Based On Ancient And Modern Literature And Clinical Research

ObjectiveAs a part of the development project of TCM diagnosis and treatment guidelines for rotator cuff injury,the diagnostic criteria of traditional Chinese medicine and Western medicine,TCM syndrome differentiation,curative effect evaluation criteria and other parts of rotator cuff injury were scientifically formulated to form the first draft of the guidelines,so as to provide the basis for further scientific and standardized formulation of the guidelines.MethodsEvidence based evidence acquisition:Domestic databases mainly include.HowNet,VIP,CBM,Wanfang,TCM literature database,TCM diagnosis and treatment standard database,SFDA database;foreign databases mainly include:PubMed,Cochrane Library,EMBASE database.We also searched the clinical trials registered in China clinical trial registry and the United States clinical trial registry;we searched the databases related to the guidelines,such as the national guidelines database NGC,the National Institute of Clinical Excellence nice and the Scottish inter hospital guidelines collaboration network(sign).The retrieval time starts from the establishment of major databases and ends on June 31,2020.The quality of the literature screened strictly according to the inclusion and exclusion criteria was evaluated.According to the different types of literature(clinical randomized controlled trials,non randomized clinical trials,systematic review/meta analysis),the literature with different evaluation tools(Cochrane bias risk assessment tool(modified Jadad scale score>3),minors items(≥ 13),amstar scale(≥5))can be used as the literature evidence for the treatment part of the guideline.The clinical studies were classified according to the "classification standard of TCM literature basis",and finally included in the first draft of rotator cuff injury guidelines.Expert questionnaire and clinical consistency evaluation of TCM syndromes and symptoms based on Delphi method.According to the principle of Delphi method,the expert questionnaire of "TCM syndromes and symptoms of rotator cuff injury" was developed.The questionnaire is provided to 80 experts from all over the country in the form of Star online questionnaire.On this basis,the experts’ opinions are collected and integrated to form a new round of questionnaire,and the answers are collected again.The expert opinions were summarized and modified to form the expert opinion draft of TCM syndrome differentiation and symptoms of rotator cuff injury.By integrating the previous literature research and expert questionnaire,we collected the research results of another researcher who was responsible for rotator cuff injury treatment and rehabilitation program in this guide project,formed the first draft,and then conducted the consistency evaluation.The evaluation objects were 200 cases of rotator cuff injury diagnosed from the outpatient and inpatient departments of Guangdong Provincial Hospital of traditional Chinese medicine.Finally,the clinical consistency evaluation opinions were summarized and fed back to the first draft of the guideline for further improvement and revision.ResultsThe survey results show that the common syndrome types of rotator cuff injury are:Qi stagnation and blood stasis syndrome,liver and kidney deficiency syndrome,cold dampness obstruction syndrome and Qi blood deficiency syndrome.Collect the research results of another member of the guideline working group responsible for the treatment and rehabilitation of rotator cuff injury to form the first draft of the guideline,and further improve the first draft after the clinical consistency evaluation.Through the clinical consistency evaluation of 200 cases of rotator cuff injury in the outpatient and inpatient departments of Guangdong Provincial Hospital of traditional Chinese medicine,the consistency rate of each index is more than 70%,and satisfactory results can be obtained.Completed the "diagnosis and curative effect standard of traditional Chinese and Western medicine for rotator cuff injury based on ancient and modern literature and clinical research",and finally completed the draft of the guideline,which realized the preliminary improvement and standardization of TCM diagnosis and treatment scheme for rotator cuff injury.ConclusionAs an important part of the rotator cuff injury guideline project,Delphi based expert questionnaire and clinical consistency evaluation of TCM syndromes and symptoms are the pre investigation of the guideline project.The results further confirm the feasibility of formulating TCM clinical diagnosis and treatment guideline of rotator cuff injury supported by evidence-based medicine.And this topic highlights the characteristics and advantages of traditional Chinese medicine in the diagnosis and treatment of rotator cuff injury,and provides suggestions and guidance for clinical diagnosis and treatment combined with the latest modern medical research,which is conducive to the further standardization and standardized development of traditional Chinese medicine clinical diagnosis and treatment of rotator cuff injury.However,there are still some deficiencies in this topic,which need to be further improved,such as:Although the first draft has been formed,there is no further Delphi expert investigation for more controversial items,no expert meeting has been held to demonstrate,and the selection mechanism of clinical consistency evaluation cases is not extensive enough,so the guideline research group will strictly follow the group standard system in the following formal formulation process of the guideline It is necessary to establish the criterion and perfect it further.