Quality evaluation and content analysis of guidelines and consensus statements on oral mucosa management in patients with autoimmune bullous disease

doi:10.3877/cma.j.issn.1674-0785.2026.01.007

Abstract

Abstract:

Objective

To conduct a quality evaluation and content analysis of guidelines and consensus statenments on oral mucosa management for patients with autoimmune bullous disease, aiming to provide evidence for clinical nursing interventions.

Methods

Based on the "6S" evidence model, systematic searches were conducted in domestic and international guideline websites, professional society websites, and Chinese-English databases for literature on oral mucosa management in patients with autoimmune bullous diseases, with the period spanning from the database establishment to June 30,2025. The included literature was independently evaluated by two researchers who had received systematic training in evidence-based nursing, while the guidelines were independently assessed by four researchers. The guideline evaluation was performed using the "Appraisal of Guidelines for Research and Evaluation II" (AGREE II). The quality assessment of expert consensus was conducted using the evaluation criteria of the Australian JBI Evidence-Based Healthcare Centre (2016 edition).

Results

A total of ten articles were ultimately included. Of these, four were clinical guidelines, of which three received a Grade A recommendation and one received a Grade B recommendation according to the AGREE Ⅱ instrument. The remaining five articles were consensus statements. A total of 22 pieces of evidence on oral mucosa management in patients with autoimmune bullous diseases were synthesized, covering six categories: oral assessment, oral hygiene management, mucosal healing medication management, pain management, nutritional management, comprehensive management, and follow-up.

Conclusion

Current guidelines and consensus on oral mucosa management for patients with autoimmune bullous diseases require quality enhancement. It is recommended that relevant organizations refine oral mucosa care in future guidelines, drawing on tools like AGREE Ⅱ and the WHO Guidelines Development Manual. This study synthesizes the best evidence for oral mucosa management in autoimmune bullous disease patients. Healthcare providers should implement personalized care based on mucosal conditions and these evidence-based recommendations to promote mucosal recovery.

Key words: Autoimmune bullous disease, Oral mucosa, Guideline, Consensus

Yingxin Wang, Xinyuan Hu, Xie Guo, Yu Zhao, Fei Liu, Miao Cao. Quality evaluation and content analysis of guidelines and consensus statements on oral mucosa management in patients with autoimmune bullous disease[J]. Chinese Journal of Clinicians(Electronic Edition), 2026, 20(01): 41-48.

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Figures/Tables 6

References 27

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编号	指南名称	发表年份	发表机构/作者	国家/区域	制定方法
1	黏膜类天疱疮的诊断和治疗-欧洲指南（S3）第一部分^[9]	2021	Rashid等欧洲皮肤病与性病学会（EADV）	欧洲	指南循证制定
2	黏膜类天疱疮诊断和治疗-欧洲指南（S3）第二部分^[10]	2021	Schmidt等欧洲皮肤病与性病学会（EADV）	欧洲	指南循证制定
3	天疱疮患者健康教育共识（2023版）^[19]	2023	晋红中、王刚等中国医师协会皮肤科医师分会	中国	专家共识
4	寻常型天疱疮管理指南^[11]	2017	Harman等英国皮肤科医生协会（BJD）	英国	指南循证制定
5	关于寻常型天疱疮和落叶型天疱疮管理的最新S2K指南^[4]	2020	Joly等欧洲皮肤病与性病学会（EADV）	欧洲	指南循证制定
6	中国天疱疮诊疗指南（2024版）^[20]	2024	晋红中、王刚等中国医师协会皮肤科医师分会	中国	指南循证制定
7	日本类天疱疮（包括获得性大疱性表皮松解）治疗指南^[12]	2019	Ujiie等日本皮肤病协会（JDA）	日本	指南循证制定
8	天疱疮中医诊疗指南^[21]	2017	周冬梅、杨志波等中华中医药学会皮肤科分会	中国	指南循证制定
9	副肿瘤性天疱疮诊疗中国专家共识^[22]	2025	晋红中、王刚等中华医学会皮肤性病学分会中国医师协会皮肤科医师分会	中国	专家共识
10	自身免疫性表皮下大疱病诊疗共识^[3]	2022	晋红中、王刚等中华医学会皮肤性病学分会中国医师协会皮肤科医师分会	中国	专家共识

编号	指南名称	发表年份	发表机构/作者	国家/区域	制定方法
1	黏膜类天疱疮的诊断和治疗-欧洲指南（S3）第一部分^[9]	2021	Rashid等欧洲皮肤病与性病学会（EADV）	欧洲	指南循证制定
2	黏膜类天疱疮诊断和治疗-欧洲指南（S3）第二部分^[10]	2021	Schmidt等欧洲皮肤病与性病学会（EADV）	欧洲	指南循证制定
3	天疱疮患者健康教育共识（2023版）^[19]	2023	晋红中、王刚等中国医师协会皮肤科医师分会	中国	专家共识
4	寻常型天疱疮管理指南^[11]	2017	Harman等英国皮肤科医生协会（BJD）	英国	指南循证制定
5	关于寻常型天疱疮和落叶型天疱疮管理的最新S2K指南^[4]	2020	Joly等欧洲皮肤病与性病学会（EADV）	欧洲	指南循证制定
6	中国天疱疮诊疗指南（2024版）^[20]	2024	晋红中、王刚等中国医师协会皮肤科医师分会	中国	指南循证制定
7	日本类天疱疮（包括获得性大疱性表皮松解）治疗指南^[12]	2019	Ujiie等日本皮肤病协会（JDA）	日本	指南循证制定
8	天疱疮中医诊疗指南^[21]	2017	周冬梅、杨志波等中华中医药学会皮肤科分会	中国	指南循证制定
9	副肿瘤性天疱疮诊疗中国专家共识^[22]	2025	晋红中、王刚等中华医学会皮肤性病学分会中国医师协会皮肤科医师分会	中国	专家共识
10	自身免疫性表皮下大疱病诊疗共识^[3]	2022	晋红中、王刚等中华医学会皮肤性病学分会中国医师协会皮肤科医师分会	中国	专家共识

指南编号	指南名称	ICC值	95%CI	F值
1^[9]	黏膜类天疱疮的诊断和治疗-欧洲指南（S3）第一部分	0.921	0.851~0.963	12.404
2^[10]	黏膜类天疱疮诊断和治疗-欧洲指南（S3）第二部分	0.921	0.851~0.963	12.404
3^[11]	寻常型天疱疮管理指南	0.953	0.912~0.978	20.630
4^[4]	关于寻常型天疱疮和落叶型天疱疮管理的最新S2K指南	0.964	0.932~0.983	27.167
5^[20]	中国天疱疮诊疗指南（2024版）	0.971	0.964~0.987	33.396
6^[12]	日本类天疱疮（包括获得性大疱性表皮松解）治疗指南	0.979	0.961~0.990	47.897
7^[21]	天疱疮中医诊疗指南	0.978	0.959~0.990	45.075

指南编号	指南名称	ICC值	95%CI	F值
1^[9]	黏膜类天疱疮的诊断和治疗-欧洲指南（S3）第一部分	0.921	0.851~0.963	12.404
2^[10]	黏膜类天疱疮诊断和治疗-欧洲指南（S3）第二部分	0.921	0.851~0.963	12.404
3^[11]	寻常型天疱疮管理指南	0.953	0.912~0.978	20.630
4^[4]	关于寻常型天疱疮和落叶型天疱疮管理的最新S2K指南	0.964	0.932~0.983	27.167
5^[20]	中国天疱疮诊疗指南（2024版）	0.971	0.964~0.987	33.396
6^[12]	日本类天疱疮（包括获得性大疱性表皮松解）治疗指南	0.979	0.961~0.990	47.897
7^[21]	天疱疮中医诊疗指南	0.978	0.959~0.990	45.075

指南编号	各领域标准化百分比（%）						标准化得分≥60%的领域数	标准化得分≥30%的领域数	推荐级别
指南编号	范围和目的	相关参与人员	制定严谨性	清晰性	应用性	编辑独立性	标准化得分≥60%的领域数	标准化得分≥30%的领域数	推荐级别
1^[9]	100	87.50	89.58	88.89	85.42	100	6	6	A
2^[10]	100	87.50	89.58	88.89	85.42	100	6	6	A
3^[11]	100	100	68.23	91.67	72.92	100	6	6	A
4^[4]	76.39	81.94	77.08	58.33	54.17	75.00	4	6	B
5^[20]	100	70.83	95.31	88.89	84.38	79.17	6	6	A
6^[12]	98.61	70.83	69.27	91.67	55.21	100	5	6	B
7^[21]	94.44	84.72	86.98	93.06	64.58	37.50	5	6	B
平均得分	95.63	83.33	82.29	85.91	71.73	84.52	5.43	6

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