中医儿科标准化诊疗方案对比分析  

Comparison and Analysis of Standardized Diagnosis and Treatment Schemes in Pediatrics of Traditional Chinese Medicine

作　　者：周涛[1] 尤焱南 张成思 赵霞[1] ZHOU Tao;YOU Yannan;ZHANG Chengsi;ZHAO Xia(Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, 210029)

机构地区：[1]南京中医药大学附属医院

出　　处：《中医杂志》2018年第14期1198-1202,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81774367);国家中医药管理局中医药标准化项目(SATCM-2015-BZ061;SATCM-2015-BZ071);国家中医药管理局委托办事经费(GZY-KJS-2017-41)

摘　　要：目的对比分析中医儿科常见病相关标准化诊疗方案的一致性。方法检索《中医儿科常见病诊疗指南》《中医临床路径》《中医病证诊断疗效标准》《中医病证分类与代码》《中医临床诊疗术语》中与中医儿科相关的标准化诊疗方案,采集疾病病名术语、中医诊断、证候分类、方剂等信息建立数据库,采用Jaccard系数对比相同疾病的病名术语、中医诊断、证候、主方选择等方面的一致性。结果病名术语《中医儿科常见病诊疗指南》与其他方案相似性一般(矫正后0.50~0.57),其余四类之间相似度较高(矫正后0.50~1.00)。中医诊断《中医临床路径》多引用《中医病证诊断疗效标准》,《中医儿科常见病诊疗指南》与这两类方案相似性约为0.40。证候《中医临床路径》《中医病证诊断疗效标准》《中医儿科常见病诊疗指南》三者相似度矫正后在0.57~0.68之间。主方《中医儿科常见病诊疗指南》与《中医临床路径》相似性为0.26,矫正偏倚后为0.40,其中同证同方相似性为0.62。结论五类中医儿科标准化诊疗方案在病名术语、中医诊断、证候、主方选择等方面的一致性不高,证候分类、主方选择历史差异性较大。Objective To compare and analyze the consistency of standardized diagnosis and treatment protocols for common diseases of traditional Chinese medicine（ TCM） pediatrics. The standardized diagnosis and treatment programs of TCM pediatrics were searched in Guidelines for Diagnosis and Treatment of Common Diseases of Pediatrics in TCM,Clinical Pathways in TCM,Criteria of Diagnosis and Therapeutic Effect of Diseases and Syndromes in TCM,Clinic Terminology of TCM Diagnosis and Treatment,Classification and Codes of Diseases and Syndromes of TCM,to collect disease terminology,TCM diagnosis,syndromes classifications,prescriptions to establish database. The Jaccard index was used to compare the consistency of terminology,diagnoses,syndromes,and prescriptions. Results The terminology of Guidelines for Diagnosis and Treatment of Common Diseases of Pediatrics in TCM was similar to other plans（ 0. 50 to 0. 57 after correction）. The similarity between the other four categories was higher（ 0. 50 to1. 00 after correction）. The TCM diagnosis in Clinical Pathways in TCM quoted more frequently from Criteria of Diagnosis and Therapeutic Effect of Diseases and Syndromes in TCM. The similarity between Guidelines for Diagnosis and Treatment of Common Diseases of Pediatrics in TCM and these two types of programs was approximately 0. 40. In terms of syndromes,Clinical Pathways in TCM,Criteria of Diagnosis and Therapeutic Effect of Diseases and Syndromes in TCM,and Guidelines for Diagnosis and Treatment of Common Diseases of Pediatrics in TCM were corrected between 0. 57 and 0. 68 after correction. The similarity in prescriptions between Guidelines for Diagnosis and Treatment of Common Diseases of Pediatrics in TCM and Clinical Pathways in TCM was 0. 26,and 0. 40 after correction bias,of which the similarity of same syndrome with same prescription was 0. 62. The history of syndrome classification and prescription selection is quite different.

关 键 词：中医儿科学 中医标准化 诊疗方案 临床路径 病名术语 

分 类 号：R272[医药卫生—中医儿科学]