慢性乙型肝炎常见证候要素辨识依据分析  

Analysis on the Identification Evidence of TCM Syndromes of Chronic Hepatitis B

作　　者：邓华亮[1,2] 王天芳[1] 赵燕[1] 薛晓琳[1] 吴秀艳[1] 王庆国[1] 

机构地区：[1]北京中医药大学基础医学院 [2]山东中医药大学

出　　处：《中医杂志》2011年第19期1661-1664,共4页Journal of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划("973"计划)资助项目(2003CB517101;2003CB517106)

摘　　要：目的通过专家咨询问卷调查,探讨慢性乙型肝炎(CHB)常见证候要素的辨识依据。方法在前期研究工作基础上制订专家咨询问卷,对全国8个中心17家中医药机构长期从事慢性肝病中医研究工作且具有副高及以上职称的专家进行问卷调查,通过分析专家对该疾病常见证候要素辨识中辨识依据重要性程度评价的累积百分比、变异系数,获取与本病常见证候要素的辨识依据。结果将同时满足累积百分比≥60%及变异系数≤0.25条件的症状(体征)初步确定为诊断慢性乙型肝炎常见证候要素的辨识依据。病位类证候要素中,"肝"有"胁肋胀满"等12条症状/体征,"脾"有"腹胀"等17条,"肾"有"腰膝酸软"等11条,"胆"有"身目俱黄"等8条,"胃"有"恶心"等13条;病性类证候要素中"湿(浊)"有"头身困重"等19条,"热(火)"有"黄疸黄色鲜明如橘皮"等18条,"气滞"有"精神抑郁"等15条,"阴虚"有"胁肋隐痛"等17条,"血瘀"有"舌有瘀斑瘀点"等16条,"阳虚""有"面色挑(白光)白"等"19条,"气虚"有"神疲"等17条。结论通过发挥专家的集体效应,初步明确了慢性乙型肝炎常见证候要素的辨识依据,为后期建立该病基于证候要素的辨证规范奠定了基础。Objective To study the identification evidence for the common syndrome elements of chronic hepatitis B through the questionnaire of expert consultation. Methods The expert consultation questionnaire was worked out on the basis of earlier researches. The questionnaire was used in the survey for the experts from 17 hospitals or organizations of 8 centers in China. All of these experts engaged in the TCM researches on chronic hepatic diseases for a long time were with the title of deputy director or higher. The identification evidence for the commonly seen syndromes of hepatitis B was obtained through the cumulative percentage and variation coefficient of the evaluation from the experts. Results The identification evidence for diagnosing the common syndromes of chronic hepatitis B were initially determined as that the symptoms （signs） met the condition of cumulative percentage ≥60% and variation coefficient ≤0.25. Of the disease location elements, the ＂liver＂ had 12 symptoms and signs including ＂distension and fullness of hypochondriac region＂, the ＂spleen＂ had 17 items including ＂abdominal distension＂, the ＂kidney＂ had 11 items including ＂soreness and weakness of lumbus and knees＂, the ＂gallbladder＂ had 8 items including ＂yellow skin and eyes＂, and the ＂stomach＂ had 13 items including ＂nausea＂. Of the disease nature elements, the ＂damp （turbidity）＂ had 19 items including ＂tiredness and heaviness of head and body＂, the ＂heat （fire）＂ had 18 items including ＂jaundice color bright as orange skin＂, the ＂qi stagnation＂ had 15 items including ＂depression＂, the ＂yin deficiency＂ had 17 items including ＂dull pain in hypochondrium＇, the ＂blood stasis＂ had 16 items including ＂tongue having ecchymosis or blood spots＂, the ＂yang deficiency＂ had 19 items including ＂pale complexion＂, and the ＂qi deficiency＂ had 17 items including ＂listlessness＂ . Conclusion From the collective standpoints of experts, the identification e

关 键 词：慢性乙型肝炎 专家咨询问卷调查 证候要素 辨识依据 

分 类 号：R259[医药卫生—中西医结合]