类风湿关节炎痰湿证素量化诊断标准的探索性研究  

Exploratory research on establish quantitative diagnosis criteria of syndrome element about phlegm-dampness of rheumatoid arthritis

作　　者：姜小帆[1] 李娟娥[2] 雷鹏[2] 吉海旺[2] 王颖 白琳 JIANG Xiao-fan;LI Juan-e;LEI Peng;JI Hai-wang;WANG Ying;BAI Lin(Shaanxi Provincial People’s Hospital,Xi’an 710068,China;Xi’an No.5 Hospital,Xi’an 710082,China)

机构地区：[1]陕西省人民医院中医科,西安710068 [2]陕西省人民医院,西安710068 [3]西安市第五医院,西安710082

出　　处：《中华中医药杂志》2020年第1期392-395,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：陕西省科技厅社发项目(No.2017SF0189);陕西省中医药管理局项目(No.15-LC038)。

摘　　要：目的:建立类风湿关节炎痰湿证素量化诊断标准。方法:运用最大似然判别分析法确定痰湿证素评定量表中各条目下属二级指标的权重,即计算各证素中"是"与"非"两类患者各个指标的条件概率,再将条件概率换算成指数,依此建立各证素的量化诊断指数表。将待判患者对各个条目(一级指标)的选择结果(二级指标)代入诊断指数表,分别将两列中所选数字纵向相加,求出"是"和"非"两类指数和,以较大者判断其诊断为该证素或不诊断为该证素。根据临床流行病学诊断性试验的评价原则,通过计算敏感度、特异度、准确度、阳性预测值、阴性预测值等指标对建立的各证素量化诊断标准进行前瞻性检验。结果:前瞻性检验结果表明,本研究建立的类风湿关节炎痰湿证素量化诊断标准具有较高的灵敏度和特异度,相应的漏诊率和误诊率均较低,其准确度、阳性预测值、阴性预测值结果均比较理想。结论:建立的痰湿证素量化诊断标准具有较好的诊断效能。Objective:To establish the quantitative diagnosis criteria of syndrome element about phlegm-dampness of rheumatoid arthritis.Methods:Maximum likelihood discriminatory analysis method was used to assure the weight of second order which belongs to the items of syndrome element scale,that is,to calculate the conditional probability of each indicator of ‘yes’ and ‘no’ patients in each syndrome element,and then convert the conditional probability into an index,and then establish the quantitative diagnosis index table of each syndrome element.The results of the patient’s selection of each item (primary indicator) (secondary indicator) will be substituted into the diagnostic index table,and the selected numbers in the two columns will be added longitudinally,as ‘yes’ or ‘no’ according to the maximum.Implement quantitative diagnosis of syndrome through their combination which syndrome elements had been diagnosed.The standard of quantitative diagnosis about each syndrome element should be checked by prospective study through evaluating the indexes such as sensitivity,specificity,accuracy,positive predictive value,and negative predictive value.Results:The prospective study showed that quantitative diagnosis standard of phlegm dampness syndrome element had high sensitivity and specificity,the corresponding missed diagnosis rate and misdiagnosis rate were low,and the accuracy,positive predictive value and negative predictive value results were ideal.Conclusion:The established quantitative diagnostic standard of phlegm dampness syndrome element has better diagnosis efficacy.

关 键 词：类风湿关节炎 痰湿 证素 最大似然判别分析法 计量诊断 

分 类 号：R259[医药卫生—中西医结合]