| 标题： | 扩张型心肌病中西医结合诊疗指南 |
| title： | Guidelines for the diagnosis and treatment of dilated cardiomyopathy with integrated traditional Chinese and Western medicine |
| 版本： | 原创版 |
| version： | Original |
| 分类： | 中医药指南 |
| classification： | Traditional Chinese Medicine guideline |
| 领域： | 诊疗 |
| field： | Diagnosis and Treatment |
| 国家和地区： | 中国 |
| Country and region： | China |
| 指南使用者： | 中医院、中西医结合医院、综合医院、基层医院等接诊扩张型心肌病患者的临床医生。 |
| Guide users： | Clinicians who receive patients with dilated cardiomyopathy in traditional Chinese medicine hospitals, integrated traditional Chinese and Western medicine hospitals, comprehensive hospitals, and grassroots hospitals. |
| 证据分级方法： | GRADE证据质量分级及定义: 高(A) 非常有把握观察值接近真实值 中(B) 对观察值有中等把握；观察值有可能接近真实值，但也有可能差别很大 低(C) 对观察值的把握有限：观察值可能与真实值有很大差别 极低(D) 对观察值几乎没有把握：观察值与真实值可能有极大差别 |
| Evidence grading method： | GRADE Evidence Quality Grading and Definition: High (A) is very confident that the observed value is close to the true value Medium (B) has moderate confidence in the observed values; The observed values may be close to the true values, but there may also be significant differences Low (C) Limited grasp of observed values: observed values may differ significantly from true values Extremely low (D) with almost no confidence in observed values: there may be significant differences between observed and true values |
| 制定单位： | 河南中医药大学第二附属医院/河南省中医院 |
| Formulating unit： | Henan Province Hospital Of Tcm |
| 注册时间： | 2024-06-11 |
| Registration time： | |
| 注册编号： | PREPARE-2024CN778 |
| Registration number： | |
| 指南制订的目的： | 扩张型心肌病（Dilated cardiomyopathy，DCM）是一种以心室扩大和心肌收缩功能降低为特征的异质性心肌病，心室持续扩大导致心室功能下降引起心力衰竭，继而出现传导系统异常、室性心律失常、血栓栓塞，甚至猝死。本病在我国发病率13/10万-84/10万，家族性者占2.25%-8.8%，52个月病死率为42.24%。近几年临床证据显示中西医结合治疗DCM在改善患者临床症状、逆转心室重构、改善心肌能量代谢，增强免疫调节、降低病死率和再住院率方面发挥了重要作用，这些研究越来越多地被用来指导临床。因为至今国内尚未见到DCM中西医结合诊疗的专家共识或临床应用指南，所以基于《世界卫生组织指南制定手册》的指南制定流程以及GRADE方法学制定《扩张型心肌病中西医结合诊疗指南》对于提高心血管疾病的防治水平具有重要意义。本指南紧密结合我国医疗现状和卫生经济学需求，推荐DCM中医和西医协同治疗方法，针对不同证型的DCM患者推荐不同治疗方案，体现病证结合动态诊疗模式，围绕常见并发症，发挥中西医结合综合干预优势，推荐具有一定证据或共识较高的治疗方法，为临床医生提供安全有效的治疗手段，具有较好适用性、经济性和临床操作性。 |
| Purpose of the guideline： | Dilated cardiomyopathy (DCM) is a heterogeneous cardiomyopathy characterized by ventricular enlargement and decreased myocardial contractile function. Prolonged ventricular enlargement leads to decreased ventricular function and heart failure, followed by conduction system abnormalities, ventricular arrhythmias, thromboembolism, and even sudden death. The incidence rate of this disease in China is 13 to 84 per 100000 people, and the familial ones account for 2.25 to 8.8%. The 52 month mortality rate is 42.24%. In recent years, clinical evidence has shown that the combination of traditional Chinese and Western medicine in the treatment of DCM has played an important role in improving clinical symptoms, reversing ventricular remodeling, improving myocardial energy metabolism, enhancing immune regulation, reducing mortality and readmission rates. These studies are increasingly being used to guide clinical practice. Due to the lack of expert consensus or clinical application guidelines for the integrated diagnosis and treatment of DCM in China, the development process of guidelines based on the World Health Organization Guidelines and the GRADE methodology for the integrated diagnosis and treatment of dilated cardiomyopathy is of great significance for improving the level of prevention and treatment of cardiovascular diseases. This guide closely combines the current medical situation and health economic needs in China, recommends the collaborative treatment methods of traditional Chinese medicine and Western medicine for DCM, recommends different treatment plans for DCM patients with different syndrome types, reflects the dynamic diagnosis and treatment model of disease syndrome integration, focuses on common complications, and leverages the advantages of integrated intervention of traditional Chinese and Western medicine. It recommends treatment methods with certain evidence or high consensus, providing clinical doctors with safe and effective treatment methods, which have good applicability, economy, and clinical operability. |
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