多指标综合评价法在高血压病中医证候分类研究中的应用  

Application of Multi-index Comprehensive Evaluation Method to TCM Syndrome Classification of Hypertension

作　　者：申春悌[1] 王忠[2] 陈炳为[3] 陈启光[3] 张华强 钱刘兰 

机构地区：[1]南京中医药大学常州附属医院,江苏常州213003 [2]中国中医科学院中医临床基础医学研究所,北京100700 [3]东南大学公共卫生学院,江苏南京210009 [4]江苏省卫生和计划生育委员会,江苏南京210008 [5]南京医科大学附属常州第二人民医院,江苏常州213003

出　　处：《南京中医药大学学报》2017年第1期4-7,共4页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：国家基础研究发展计划("973"计划)(2003CB517101);国家自然科学基金(81273190)

摘　　要：目的获得高血压病相对科学、客观的证候及证候要素,并对证候要素所对应的指标进行重要性评价。方法以肝火亢盛证为例来说明多指标综合评价法在高血压病证候分类研究中的应用。采用多指标综合评价法,评价高血压病在传统流行病学调查以及专家咨询中所获得的证候及证候要素所对应的各指标的重要性。结果高血压病肝火亢盛证包含18个指标,经综合评价后部分指标的重要性发生了改变,如舌红、黄苔、急躁易怒、口苦目眩、半身麻木等。该证候包含2证候要素,其分别对应的指标经综合评价后,大部分的重要性与之前的研究结果一致,少数指标的重要性发生轻微改变,如舌红、弦脉等。结论多指标综合评价法可以将临床流行病学调查的统计分析结果以及专家经验有机地结合起来,既避免了纯统计分析脱离临床的弊端,又解决了专家经验过于主观的问题。OBJECTIVE To obtain the scientific and objective syndrome and syndrome factors for hypertension and to evalu- ate the importance of corresponding indexes of each syndrome factors. METHODS Overabundant liver-fire syndrome was ci- ted as the example to illustrate the syndrome factors of hypertension and the analysis and evaluation of its indexes. Multi-index comprehensive evaluation method was applied to evaluate the hypertension syndromes obtained under the structural equation model and through expert consultation, with importance of each indexes being analyzed. RESULTS 18 indexes were included in the hypertension of overabundant liver-fire syndrome. Among which, the importance of partial indexes like red tongue, yellow tongue coating, prone to lose temper, bitter sensation in the mouth, dizziness, hemianesthesia experienced changes based on comprehensive evaluation. Two syndrome factors were included in this syndrome. It was proved that the majority of index importance through comprehensive evaluation was almost the same as the previous study results, except for some small index changes like red tongue and wary pulse. CONCLUSION Multi-index comprehensive evaluation method can be used to analyze the statistical results of both clinical epidemiological investigation and expert experience, which not only avoids the dis- advantages of pure statistical estimation, but also solves the problem of subjective bias induced by expert experience.

关 键 词：多指标综合评价 高血压病 中医证候分类 肝火亢盛证 证候要素 

分 类 号：R2-03[医药卫生—中医学]