冠心病中医证候要素特征性条目的专家调查  

Expert Survey on the Characteristic Items for Chinese Medicine Syndrome Elements of Coronary Artery Disease

作　　者：毕颖斐[1] 毛静远[1] 

机构地区：[1]天津中医药大学第一附属医院心血管科

出　　处：《中医杂志》2012年第18期1580-1584,共5页Journal of Traditional Chinese Medicine

基　　金：国家冠心病中医临床研究基地建设项目

摘　　要：目的对冠心病中医证候要素特征性条目进行专家调查,确定冠心病各种证候要素的诊断要点。方法在全国范围内遴选中医心血管病专家,运用Delphi法对冠心病中医证候要素特征性条目进行调查,对所选条目的敏感性与特异性进行量化评分,将两者的量化值予以求积处理,得到各种相关条目在证候要素判断过程中的权重值及重要性排序;并对专家积极系数、专家权威系数及专家意见的集中程度和协调程度等相关指标进行评价。结果共28名专家参加调查,专家积极系数为100%,平均权威系数为(0.94±0.06),协调系数为0.664。冠心病气虚证特征性条目为气短,乏力,动则尤甚,神疲懒言,淡白舌,弱脉;血虚证特征性条目为心悸,头晕,面色萎黄,唇甲色淡,淡白舌,细脉;阴虚证特征性条目为心悸,口干,手足心热,潮热,盗汗,舌红苔少,脉细数;阳虚证特征性条目为畏寒肢冷,气短,乏力,面色白,下肢水肿,胖大舌或伴齿痕舌,脉沉迟;寒凝证特征性条目为胸痛,畏寒肢冷,遇寒痛增,得温痛减,脉紧;热蕴证特征性条目为口干欲饮,口苦,大便燥结,小便短黄,舌红苔黄,脉数;痰浊证特征性条目为胸闷,体胖,头重如裹,身体困重,苔腻,脉滑;水饮证特征性条目为喘息,平卧困难,下肢水肿,或伴颜面浮肿,小便短少,渴不欲饮,苔滑;气滞证特征性条目为胸胁胀满,嗳气或矢气则舒,善太息,情志不遂易发,脉弦;血瘀证的特征性条目为胸痛,面色晦暗,口唇紫暗,舌暗淡或紫暗,或伴有瘀点、瘀斑,舌下络脉瘀滞,脉涩。结论专家调查结果确定了规范、简明的冠心病中医证候要素判断标准,具有一定的临床实用价值。Objective To take an expert survey on the characteristic items for Chinese medicine syndrome elements of coro- nary artery disease （CAD） and determine the key point of diagnosis of different syndrome elements. Methods A nationwide expert survey was carried out on the characteristic items for Chinese medicine syndrome elements of CAD with Delphi method. The sensitivity and specificity of the selected items was quantified and then both quantity scores were multiplied to get the weight and the importance of the selected items in the process of syndrome elements judgment. The positive coefficient and au- thority degree of experts and the concentration and coordination of their advice were evaluated. Results Twenty-eight experts participated in the survey. The positive coefficient of experts was 100%, the average authority coefficient was （0.94 ± 0.06） and the coordination coefficient was 0. 664. The characteristic items of qi deficiency syndrome were shortness of breath, fa- tigue, aggravation after activity, mental exhaustion and less words, pale tongue and weak pulse. The characteristic items of blood deficiency syndrome were palpitation, dizziness, pale complexion, pale lips and fingernails, pale tongue and thin pulse. The characteristic items of yin deficiency syndrome were palpitations, dry mouth, feverish palms and soles, hectic fever, night Sweats, red tongue and less coating of tongue and rapid and thin pulse. The characteristic items of yang deficiency syndrome were cold intolerance, shortness of breath, fatigue, pale and swollen complexion, lower extremity edema, fat and large tongue or with the traces of the teeth and slow and deep pulse. The characteristic items of cold coagulation syndrome were chest pain, cold intolerance, pain increase or reduction with temperature and tight pulse. The characteristic items of fire-heat syndrome were dry mouth, bitter mouth, dry stool, short and yellow urine, red tongue and yellow coating and rapid pulse. The charac- teristic items of phlegm retention syndrome

关 键 词：冠心病 证候要素 特征性条目 专家调查法 

分 类 号：R259[医药卫生—中西医结合]