《世界针灸杂志》针灸国际标准专刊

针灸是中医药学的重要组成部分，在中国已经有5 千年的历史，从5 世纪开始针灸已经开始走向世界，目前在196 个国家得到传播应用。2010 年11 月联合国教科文组织将“中医针灸”列入人类非物质文化代表作名录，中国针灸已经成为世界人类的针灸。中医药是中国古代科学的结晶，针灸的标准规范，是针灸发展、壮大以及传播应用的基础。早在2000 多年前《黄帝内经》中，已经有了针刺工具“九针”形状、大小以及150 个穴位归经和主治病症具体的记载。晋代《针灸甲乙经》更是对针灸相关的经络、腧穴、针刺工具等进行了更加系统、规范的描述，成为当今针灸标准的基础。宋朝名医王惟一考定《明堂针灸图》、撰写《新铸铜人腧穴针灸图经》、铸造针灸铜人模型并刻《图经》于石。完善了经穴理论、规范了腧穴部位，成为最早的政府制的针灸经络、腧穴标准和教学的模具；进入20 世纪，针灸标准、规范快速发展，世界卫生组织、世界标准化组织以及世界针灸学会联合会等国际性组织，成为针灸标准规范制定和宣贯的引领者，目前已经制定针灸相关标准57 项，成为针灸国际化发展的支撑。

世界针灸学会联合会成立于1987 年，目前拥有70 多个国家的270 个团体会员。世针联始终将针灸在世界各地安全、有效的传播推广应用作为重要的任务，成立了世界针灸学会联合会的标准化技术委员会、与世界卫生组织建立正式工作关系，并是国际标准化组织/中医药技术委员会的A 级联络组织，积极参与和组织针灸标准的制修订和宣贯。世针联特别关注与各国际组织在针灸标准制修订中的合作和协调，尽量避免同一标准的重复制定，强调高质量、合理有序地开展了针灸国际标准的建设。积极参与WHO 针灸相关标准的制定和宣贯、在ISO-TC249 上海书处建立了针灸标准联合研究室，与世界中医药学会联合会就相关标准共同发布的共识等。

2013 年，世界针联发布四项针灸国际标准；2023 年制、修订21 项针灸国际标准；目前，在研针灸国际标准25 项。本专辑将利用《世界针灸杂志》这一重要的平台，介绍世针联相关针灸标准制定的成果，宣传和鼓励更多的使用这些标准规范，同时也鼓励更多的针灸人参与标准的制修订。回眸痕履，文脉相承，以期弦歌不辍。

世界针灸学会联合已在构建“针灸标准体系表”对世针联标准化工作进行了顶层设计，制定系列“标准”的“标准”，如制定了“针灸临床实践指南制定和评估的规范”等，形成了世针联标准制定从申请、立项、起草、审定的全流程管理办法，同时还充分利用信息化技术搭建了世针联标准制修订的工作平台和标准展示平台。

山高路远，但见风光无限。标准化语言是世界语言，是针灸在世界各国传播应用的基础，也是文明互鉴、民心相通的重要载体，让我们携手共进，共同来推进针灸国际标准化的健康发展，产生出更多、高质量的针灸基础、应用、教育以及管理的标准规范，让针灸在构建人类卫生健康共同体中发挥更大的作用。诚挚地欢迎针灸同道给予的批评与指正，期盼更高质量的针灸国际标准促进科学、规范的针灸应用使更多世人受益。

Acupuncture, an essential component of traditional Chinese medicine (TCM), displays a 5,000-year history in China. Since the 5th century, acupuncture has spread globally and it is currently practiced in 196 countries. In November 2010, the United Nations Educational, Scientific, and Cultural Organization (UNESCO) included “Acupuncture and moxibustion of traditional Chinese medicine” in the Representative List of the Intangible Cultural Heritage of Humanity, signifying its relevance to the culture of humankind worldwide. TCM, as the culmination of ancient Chinese science, relies on standardized practices for acupuncture to ensure its development, growth, and widespread application. As early as two thousand years ago, the shapes and sizes of nine classical needles and 150 specific acupoints, along with their related treatment targets, have already been documented by the Yellow Emperor’s Inner Classic. Subsequently, the A-B Classic of Acupuncture and Moxibustion written during the Jin Dynasty(AD266-AD420), provided more systematic and standardized descriptions of the meridians, acupoints, and needles, establishing the foundations of current acupuncture standards. During the Song Dynasty(AD960-AD1279), the renowned physician Wei-yi WANG compiled the Mingtang Acupuncture-Moxibustion Illustration, wrote the Illustrated Classic of Acupoints on the Bronze Figure, casted the bronze acupuncture status, and carved the Illustrated Classic of Acupoints on the Bronze Figure on the stone. The bronze acupuncture status improved the theory of acupoints and standardized their locations, making it the earliest government-formulated model for standardization of meridians, acupoints and teaching. In the 20th century, acupuncture standards and regulations developed rapidly. International organizations such as the World Health Organization (WHO),International Standards Organization(ISO), and the World Federation of Acupuncture-Moxibustion Societies (WFAS) have become leaders in the formulation and promotion of acupuncture standards. To date, 57 acupuncture-related standards have been established, paving the way for the international development of acupuncture.

The WFAS was established in 1987 and currently encompasses 270 member organizations from over 70 countries. The safe and effective global dissemination and application of acupuncture has always been an important WFAS objective. Therefore, WFAS established its Standardization Technical Committee and formed official working relationships with WHO. In addition, as a Category A Organization in Liaison with the ISO/TC249 on TCM, the WFAS actively participates in and organizes the formulation, revision, and promotion of acupuncture standards. The WFAS pays particular attention to cooperation and coordination with various international organizations in the formulation and revision of acupuncture standards in order to avoid duplication and to emphasize the high-quality, rational, and orderly development of international acupuncture standards. The WFAS has also actively contributed to the development and promotion of the WHO acupuncture-related standards, establishing a collaborative research laboratory for acupuncture standards at the ISO/TC249 Shanghai Secretariat, and jointly issuing consensus standards with the World Federation of Chinese Medicine Societies.

In 2013, the WFAS released four international acupuncture-moxibustion standards and it formulated or revised 21 standards by 2023. Currently, 25 international acupuncture standards are under development. World Journal of Acupuncture-Moxibustion is the official journal of WFAS, it is one of the most important platform to showcase the achievements of WFAS in standardization, thereby promoting the adoption of these standards as well as encouraging more acupuncture professionals to participate in their formulation and revision. Reflecting on this journey and continuing the legacy, WFAS aims at maintaining a thriving tradition.

The WFAS has undertaken top-level design for its standardization by constructing a “Table of Acupuncture Standards System,” entailing the creation of a series of “standards for standards,” such as the Specification of the Formulation and Evaluation for the Clinical Practice Guideline of Acupuncture and Moxibustion. These activities resulted in the comprehensive management of WFAS standards, encompassing all aspects from application through project approval and drafting to review. In addition, information technology has been fully applied to build a development, revision, and display platform of WFAS standards.

Though the journey is long and challenging, the vistas are limitless. The standardization language is universal, laying the foundation for the global dissemination and application of acupuncture and serving as a vital medium for cultural exchange and mutual understanding. Let us work together to promote the healthy development of international acupuncture standardization and produce high-quality standards for acupuncture experimental research, application, education, and management, thereby allowing acupuncture to fulfill a more relevant role in contributing to a global health community. We sincerely welcome feedback and corrections from peer acupuncture professionals, and we look forward to higher-quality international acupuncture standards that could promote scientific and standardized acupuncture practices, ultimately benefiting more people worldwide.

《针灸临床实践指南：过敏性鼻炎》于2023年10月9日，经世界针灸学会联合会（WFAS）标准工作委员会审议通过、发布。这是首部由国际学术组织发布的过敏性鼻炎针灸临床实践指南（CPG），将为国际针灸临床从业者提供过敏性鼻炎的循证推荐意见及切实可行的推荐方案。本部指南的编研严格遵循《世界卫生组织指南制定手册》，采用GRADE方法，充分依靠指南制定小组（GDG）成员不同国家、不同专业的代表性。推荐意见是CPG的核心内容，亦是对临床问题的直接解答，故本文重点介绍本指南的推荐意见。本指南的推荐意见是根据最新的系统评价，通过改良德尔菲共识法和GRADE网格法制定的。针对15个临床问题提出了15条推荐意见，包括1条基于高质量证据的强推荐干预措施，3条基于极低质量证据的条件性推荐干预或对照措施，以及11条基于极低质量证据的条件性推荐干预措施。

Clinical Practice Guideline on Acupuncture and Moxibustion: Allergic Rhinitis was revised and released by the Standards Working Committee of World Federation of Acupuncture-Moxibustion Societies (WFAS) on October 9, 2023. This is the first clinical practice guideline (CPG) on acupuncture and moxibustion for allergic rhinitis approved by an international academic organization, which provides the evidence-based recommendations and the practical therapeutic protocols for acupuncture practitioners globally. This CPG was developed by following Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology, and the principles of the World Health Organization Handbook for Guideline Development. The members in the guideline development group (GDG) were from different countries, with different professions, and they played a critical role in the development of clinical questions, recommendations, and therapeutic regimens. Recommendations are the core of a CPG and the direct answers to clinical questions, due to which this article focuses on the recommendations of this CPG. The recommendations were developed by using the modified Delphi method and the GRADE grid rules, based on the updated systematic reviews of clinical evidence. A total of 15 recommendations for 15 clinical questions were developed in this CPG, including 1 strong recommendation for intervention based on high-quality evidence, 3 conditional recommendations for either the intervention or the comparison based on very low quality of evidence, and 11 conditional recommendations for the intervention based on very low quality of evidence. 

尿失禁（UI）在女性中很常见，严重影响患者的生活治疗，但缺乏足够的临床关注度和治疗方法。针灸疗法已被认为是极具潜力的女性尿失禁治疗方法。因此，世界针灸学会联合会（WFAS）启动了女性尿失禁针灸临床实践指南的编研工作。这部指南的编研遵循世界卫生组织（WHO）指南制定手册的规范，采用了GRADE方法，依据最新的系统评价结果，充分借助指南制定小组（GDG）不同国家、不同专业的代表性。本文重点介绍指南的推荐意见。本指南的推荐意见是根据最新的系统评价，通过改良德尔菲共识法和GRADE网格法制定的。针对10项临床问题提出了10条推荐意见，包括9条条件性推荐干预措施、1条条件性推荐干预措施或对照措施。此外，本指南还为目标用户提供了1项常规毫针治疗方案、2项毫针深刺腰骶部腧穴治疗(DPSLAT)方案、4项艾灸治疗方案。 

Urinary incontinence (UI) is common in women and affects the quality of life in female patients severely. But the clinical consideration and treatment are insufficient. Acupuncture and-moxibustion has been proposed as a potentially effective intervention for female UI. Hence, the World Federation of Acupuncture-moxibustion Societies (WFAS) have initiated a project to develop the clinical practice guideline (CPG) on acupuncture and moxibustion for female UI towards global acupuncture practitioners. The CPG was developed according to the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology, referring to the principles of the World Health Organization Handbook for Guideline Development. During the development of the CPG, the guideline development group (GDG) played an important role, which is composed of multi-national and multi-disciplinary experts. The clinical questions, recommendations and therapeutic protocols were all formulated by GDG using the modified Delphi method and basing on the results of the latest systematic review. This article focuses on the recommendations in the CPG. The CPG contains ten recommendations for ten clinical questions, including nine conditional recommendations for the intervention, one conditional recommendations for either the intervention or the comparison. The CPG also provides one conventional filiform needle therapy protocol, two deep puncturing stimulation on lumbosacral acupoints therapy (DPSLAT) protocols, and four moxibustion therapy protocols, extracted from the included clinical evidence of this CPG. 

《针灸临床实践指南：胃食管反流病》（WFAS 007.9-2023)是世界针灸学会联合会2023年10月9日正式发布的针灸临床实践指南，也是首个针灸治疗胃食管反流病的指南。本指南内容主要包含指南目的、范围、适用人群、适用环境；针灸治疗胃食管反流病概况；指南制定过程和推荐意见。本文重点介绍指南的推荐意见。本指南的颁布和实施将有利于规范针灸治疗胃食管反流病，对针灸在该病治疗中的推广应用将起到积极作用。

The Clinical Practice Guideline on Acupuncture and Moxibustion: Gastroesophageal Reflux Disease (GERD) (WFAS 007.9-2023), officially released by the World Federation of Acupuncture-Moxibustion Societies (WFAS) on October 9, 2023, represents the inaugural acupuncture and moxibustion clinical practice guideline dedicated to GERD globally. This guideline outlines its purpose, scope, target audience, and relevant environments, along with detailing the acupuncture and moxibustion treatment methodology for GERD, as well as the guideline development process and recommendations. This article specifically emphasizes the recommendations of the guideline, highlighting the crucial importance of both the dissemination and adherence to this guideline to standardize acupuncture and moxibustion treatments for GERD. Such standardization plays a pivotal role in the advancement and widespread utilization of acupuncture and moxibustion in the management of GERD. 

《针灸临床实践指南：偏头痛》（WFAS 007.8-2023)是世界针灸学会联合会2023年10月9日正式发布的针灸临床实践指南，也是首个针灸治疗偏头痛的国际指南。本指南的制定严格遵循循证方法学的流程及要求，包含指南目的、范围、适用人群、适用环境，针灸治疗偏头痛概况，指南制定过程和推荐意见。为帮助指南使用者更好地理解指南和应用本指南，最终能够更好地指导全球范围内针灸治疗偏头痛的临床决策，本文对指南共计18条推荐意见进行概述。

Clinical Practice Guideline on Acupuncture and Moxibustion: Migraine (WFAS 007.9-2023) is a clinical practice guideline officially released by the World Federation of Acupuncture-Moxibustion Societies (WFAS) on October 9, 2023, and is the first international guideline on the treatment of migraine with acupuncture. This international standard was developed under the guidance of rigorous evidence-based methodology, and it contains guideline purpose, scope, applicable population, applicable settings, overview of acupuncture for migraine, guideline development process and recommendations. For promoting the understanding and application of this guideline, this article summarizes a total of 18 recommendations in order to assist clinical decisions for migraine with acupuncture.

《针灸临床实践指南：非特异性腰痛》于2023年10月9日，经世界针灸学会联合会（WFAS）标准工作委员会审议通过、发布。这是首部由国际学术组织发布的非特异性腰痛针灸临床实践指南（CPG），将为国际针灸临床从业者提供非特异性腰痛的循证推荐意见及切实可行的推荐方案。这部指南的编研遵循了《世界卫生组织（WHO）指南制定手册》的规范，采用了推荐意见分级评估、制定和评价(GRADE)方法，充分借助了指南制定小组（GDG）成员不同国家、不同专业的代表性。推荐意见是CPG的核心内容，亦是对临床问题的直接解答，因此，本文重点介绍该指南的推荐意见。本指南的推荐意见是根据最新的系统评价，通过改良德尔菲共识法和GRADE网格法制定的。针对10个临床问题中的7个提出了7条推荐意见，包括6条基于极低质量证据的条件性推荐干预措施。1条基于极低质量证据的条件性推荐干预或对照措施。

Clinical Practice Guideline on Acupuncture and Moxibustion: Nonspecific low back pain was revised and released by the Standards Working Committee of World Federation of Acupuncture-Moxibustion Societies (WFAS) on October 9, 2023. This is the first clinical practice guideline (CPG) on acupuncture and moxibustion for nonspecific low back pain approved by an international academic organization, which provides the evidence-based recommendations and practical therapeutic protocols for international acupuncture practitioners. This CPG was developed by following Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology, and the Principles of the World Health Organization Handbook for Guideline Development. The guideline development group (GDG) from different countries, with different professions, played a critical role in the formulation of clinical questions, recommendations, and therapeutic protocols. Recommendations are the key content of a CPG and the direct answers to clinical questions. Hence, this article focuses on the recommendations of this CPG. The recommendations were formulated using the modified Delphi method and the GRADE grid rules, based on the updated systematic reviews of clinical evidence. A total of seven recommendations for ten clinical questions were formulated in this CPG, including one conditional recommendation for either the intervention or the comparison based on very low quality of evidence, and six conditional recommendations for the intervention based on very low quality of evidence. 

世界针灸学会联合会标准《针灸技术操作规范：拔罐》由天津中医药大学牵头完成，经世界针灸学会联合会审议通过，于2023年10月9日发布，2023年12月31日正式实施。主要内容包括范围、规范性引用文件、术语和定义、操作步骤与要求和安全性要求。本文主要对以上内容进行介绍，并对本操作规范的应用、推广及更新提出展望。

World Federation of Acupuncture-Moxibustion Societies (WFAS) Technical Benchmark of Acupuncture and Moxibustion: Cupping, developed under the leadership of Tianjin University of Traditional Chinese Medicine, was approved by WFAS. This technical benchmark was issued on October 9, 2023, and implemented on December 31, 2023. The main contents include the scope, normative references, terms and definitions, procedures and rules, and safety. This article focuses on the above contents, an outlook on the application, popularization, and update plan of this technical benchmark is proposed. 

世界针灸学会联合会标准《针灸技术操作规范：电针》由上海中医药大学牵头完成，经世界针灸学会联合会审议通过，于2023年10月9日发布，2023年12月31日正式实施。主要内容包括范围、规范性引用文件、术语和定义、操作步骤与要求和安全性要求。本文主要对以上内容进行介绍，并对本操作规范的应用、推广及更新提出展望。

World Federation of Acupuncture-Moxibustion Societies (WFAS) Technical Benchmark of Acupuncture and Moxibustion: Electroacupuncture, developed under the leadership of Shanghai University of Traditional Chinese Medicine, was approved by WFAS. This technical benchmark was issued on October 9, 2023, and implemented on December 31, 2023. The main contents include the scope, normative references, terms and definitions, acupuncture and moxibustion procedures and rules, and safety. This article focuses on the above contents. An outlook on the application, popularization, and update plan of this technical benchmark is proposed. 

2023年12月31日，世界针灸学会联合会在全球范围内正式发布了《针灸技术操作规范：毫针》。本规范明确了毫针技术操作的术语和定义、操作步骤与要求、安全性及注意事项等内容。规范的颁布和实施为针灸从业者在临床上使用毫针提供了奉行准则，对毫针技术的安全使用与推广将起到积极作用。

On December 31, 2023, World Federation of Acupuncture-Moxibustion Societies (WFAS) officially issued Technical Benchmark of Acupuncture and Moxibustion: Filiform Needle. This technical benchmark clarifies terms and definitions, operating procedures and requirements, safety requirements, etc. The promulgation and implementation of this technical benchmark would provide a standard for acupuncture practitioners to apply filiform needle in clinical practice, and may play a positive role in the safe use and promotion of filiform needle.

《针灸技术操作规范第一部分：艾灸》是由世界针灸学会联合会组织，安徽中医药大学牵头，在原标准《艾灸操作规范》基础上修订完成，其主要内容包括范围、规范性引用文件、术语与定义、操作步骤与要求、安全性要求，本文主要对以上标准内容进行介绍，说明此次修订的重难点内容，并对本标准的应用及推广提出展望。 

“Technical Benchmark of Acupuncture and Moxibustion: Moxibustion” was organized by the World Federation of Acupuncture-Moxibustion Societies and the revision was led by Anhui University of Chinese Medicine. This document was first issued in 2013, known as Moxibustion Manipulation. The technical benchmark of moxibustion include scope, normative reference, terms and definitions, operation and requirement and safety. This article introduces the above contents, explains the difficulties in the revision and give the suggestions for the application and popularization of this standard.

世界针灸学会联合会《针灸技术操作规范：头针》经世界针灸学会联合会审议通过，于2023年10月9日发布，2023年12月31日正式实施。本规范规定了头针操作的术语和定义、应用范围、操作步骤和要求及安全性等内容。在本规范的制定过程中，规范制定者充分考虑全球各国针灸临床的实际应用情况，确保本规范适用于世界范围内的针灸医疗机构。本规范的发布与应用有利于头针在临床实际中的规范使用，在一定程度上可促进头针疗法的国际传播与推广。

World Federation of Acupuncture-Moxibustion Societies (WFAS) Technical Benchmark of Acupuncture and Moxibustion: Scalp Acupuncture, was approved by WFAS, issued on October 9, 2023, and officially implemented on December 31, 2023. This technical benchmark specifies terms and definitions, scope of application, operation steps and requirements, security requirements, etc. In the development process, the actual clinical conditions of acupuncture and moxibustion in various countries have been fully considered. This technical benchmark is applicable to global acupuncture medical institutions, conducive to the standardized use of scalp acupuncture in clinical practice, and can promote the international dissemination of scalp acupuncture in a certain degree.

确定临床问题是临床实践指南形成的基础，在指南制定过程中起着承上启下的作用，是进行证据检索并形成推荐意见的关键环节。指南中临床问题确定方法的科学性和严谨性决定了指南实施和应用的前景。2020年世界针灸学会联合会对《针灸临床实践指南：成人轻中度抑郁症》进行立项，以期根据针灸治疗成人轻中度抑郁症所关注的临床及医疗决策中的实际问题，基于现有临床证据及患者价值观等多方因素，最终形成帮助决策者、临床医生、患者三方选择干预方案的系统指南意见。本文就该指南形成过程中临床问题的确定及其他相关环节进行讨论与分析，为针灸临床实践指南中临床问题的确定提供参考，并探索未来用于指南临床问题确定更具有科学性的工具及方法。

Determining clinical questions is fundamental to the development of clinical practice guidelines (CPGs), which bridges the initial phases and the final recommendations. It is essential for evidence retrieval and the formulation of recommendations. The scientific rigor and precision in determination of clinical questions directly influence the future implementation and applicability of guidelines. In 2020, the World Federation of Acupuncture-Moxibustion Societies initiated the project of clinical practice guideline on acupuncture and moxibustion for adult major depressive disorder (mild-moderate degree) to address clinical and medical decision-making issues in acupuncture treatment for adult mild to moderate major depressive disorder. This CPG provides systematic recommendations based on clinical evidence, patient values, and other factors, aiding decision-makers, clinicians, and patients in selecting appropriate interventions. This paper discusses and analyzes the determination process of clinical questions, and the related issues during the development of this guideline, aiming to provide a reference for determining clinical questions and developing CPGs in the field of acupuncture and exploring more scientific tools and methods for determining clinical questions in future CPGs.

推荐意见的形成是临床实践指南研制中的关键步骤，需要GRADE方法学提供工具。工具包括证据质量评价工具、证据总结工具和证据决策转化工具。临床实践指南中推荐意见的形成已有方法学指导的标准路径，然而，如何把“书上”的标准路径搬到实际推荐意见形成过程中来，推荐意见具体的形成步骤是什么等问题尚不完全清晰。故而本研究以世界针灸学会联合会《针灸临床实践指南：过敏性鼻炎》为例，详细介绍推荐意见形成的全过程，将临床实践指南推荐意见的形成归纳为“三步法”。第一步：搜集不同来源原始材料，形成证据决策表。第二步：发放并回收证据决策表，预收集推荐意见投票结果。第三步：组织召开“萨拉米切片式”指南制定小组共识会，形成推荐意见。临床实践指南推荐意见形成的“三步法”充分利用了GRADE证据决策表，从问题的重要性、利弊平衡、证据质量、资源消耗、价值观与偏好、健康公平性、可接受性、可实施性多个维度为指南制定小组提供了决策依据和参考，从而更好地提升了指南推荐意见的科学性和实用性。本研究为今后针灸临床实践指南推荐意见的形成提供了标准范例，以期形成针灸临床实践指南推荐意见形成的标准作业程序。

The formulation of recommendations is a crucial step in the development of clinical practice guidelines, which requires tools provided by the GRADE methodology. These tools include the evidence quality assessment tool, the evidence summary tool, and the evidence-to-decision (EtD) framework. Although there is a methodologically guided standard pathway for formulating recommendations in clinical practice guidelines, it remains unclear how to translate this theoretical pathway into the practical process for formulating recommendations and what the specific steps in this process entail. Therefore, this paper takes the World Federation of Acupuncture-Moxibustion Societies Clinical Practice Guidelines on Acupuncture: Allergic Rhinitis as an example to detail the full process of formulating recommendations and summaries it into a three-step method. Step one: Collect original materials from different sources to create EtD table. Step two: Distribute and collect EtD table, and preliminarily gather the recommendation voting results. Step three: Organize “salami-slicing pattern” guideline development group consensus meeting to formulate recommendations. The three-step method for formulating recommendations in clinical practice guidelines fully utilizes the GRADE EtD table to provide guideline development group with decision-making foundation and reference from multiple dimensions, including the importance of clinical questions, balance of benefits and harms, quality of evidence, resource required, values and preferences, health equity, acceptability, and feasibility. This approach enhances the scientific and practical nature of guideline recommendations. This paper provides a standard operating procedure to formulate recommendations for the incoming clinical practice guidelines, which aims to establish a standard pathway for the formulation of acupuncture clinical practice guideline recommendations. 

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