Evidence-based Chinese Medicine Clinical Practice Guideline for Stroke in Hong Kong
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Evidence‑based Chinese Medicine Clinical Practice Guideline for Stroke in Hong Kong Linda L. D. Zhong1,2* , Wai Kun1,2, Nannan Shi1,3, Tat Chi Ziea4, Bacon F. L. Ng4, Ying Gao5, Zhaoxiang Bian1,2 and Aiping Lu1,2*
Abstract Background: Stroke in Chinese Medicine (CM) includes the concepts of ischemic and hemorrhagic strokes from Western Medicine and is a common disease in Hong Kong. This clinical practice guideline (CPG) aims to evaluate and demonstrate CM treatment options for stroke, provide guideline for local CM practice, and act as a reference for decision makers on drafting CM related health policies. Methods: Based on the principle of multidisciplinary integration and evidence-based medicine, a steering committee oversaw the CPG development process in accordance with a published protocol. Clinical questions and evidences were identified, appraised, and synthesised through systematic literature reviews, text mining, and two rounds of Delphi surveys with a multidisciplinary panel of experts. Results: In this CPG, we defined stroke from the perspectives of both CM and Western Medicine, reported corresponding CM treatment options, and carried out evaluation based on levels of evidence and grade of recommendation. Suggested CM interventions include herbal medicine treatment based on pattern differentiation, acupuncture treatment, and nursing care. Conclusion: The target population is Hong Kong stroke patients with prodrome or sequela stage. This CPG is intended to help standardizing CM clinical practice and enhancing efficiency of clinical service in Hong Kong. Keywords: Chinese medicine, Clinical practice guideline, Stroke, Acupuncture, Evidence-based medicine Background Stroke is a neurological disease induced by cerebral infarction, intracerebral hemorrhage, or subarachnoid hemorrhage. It is a major cause of disability and death in the world. Concept of stroke in CM includes all the types of the above definition in Western Medicine. In 1986, the stroke professional group of internal medicine branch from China Association of Chinese Medicine (CACM) developed the “Criterion for CM Diagnosis and Efficacy of Stroke” [1]. From 1991–1996, a scientific research *Correspondence: [email protected]; [email protected] 2 School of Chinese Medicine, Hong Kong Baptist University, 4F, Jockey Club School of Chinese Medicine Building, 7 Baptist University Road, Kowloon Tong, Hong Kong SAR, China Full list of author information is available at the end of the article
group conducted a multi-center clinical investigation of CM syndromes of stroke. Based on the results, the collaborative group of cerebral emergency from the State Administration of Traditional Chinese Medicine of the People’s Republic of China developed the second version of the “Criteria for CM Syndromes and Efficacy of Stroke” [2] and “Standards of Syndrome-differentiated Diagnosis in Stroke (Trial) [3]. From 1996–2011, China completed the International Cooperation Project “The Traditional Chinese Medicine Reha
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