基于层次分析法的高血压病肝阳上亢证疗效评价体系的构建  

Establishment of the Efficacy Evaluation System for Hypertension of Liver-yang Hyperactivity Type by Using Analytic Hierarchy Process

作　　者：张传文 朱羽硕 李坤[1] 李运伦[1] ZHANG Chuan-Wen;ZHU YuShuo;LI Kun;LI Yun-Lun(Shandong University of Traditional Chinese Medicine,Jinan 250014 Shandong,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014 Shandong,China)

机构地区：[1]山东中医药大学,山东济南250014 [2]山东中医药大学附属医院,山东济南250014

出　　处：《广州中医药大学学报》2021年第6期1077-1085,共9页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(编号:81774242);山东省泰山学者工程专项经费资助项目(编号:ts201712042)。

摘　　要：【目的】通过德尔菲法与层次分析法相结合,建立高血压病肝阳上亢证疗效评价体系。【方法】在本课题组研究基础上确立高血压病肝阳上亢证疗效评价的基础指标,通过专家问卷调查,根据专家意见的集中程度和协调程度筛选出疗效评价指标。将Satty评分法和层次分析法相结合,构建矩阵,确立层次结构,然后通过运算矩阵确立各个指标的权重系数,从而建立起高血压病肝阳上亢证疗效评价体系。【结果】(1)向全国中医药防治高血压病的专家发放咨询表20份,回收专家咨询表20份,有效咨询表20份。(2)在二级指标重要性意见的集中程度和协调程度方面,专家对二级指标重要性赋值均≥4,且专家意见的变异系数均<0.2,表明中医证候指标、理化指标、安全性指标、生活质量指标、治疗结果及预后指标均可作为疗效评价指标。(3)在三级指标的专家意见集中程度和协调程度方面,各二级指标下的各项三级指标重要性赋值均≥4,且专家意见的变异系数均<0.2,故均可作为疗效评价指标。(4)二级指标的权重系数排序为:中医证候指标=治疗结果及预后指标>安全性指标>生活质量指标>理化指标。(5)三级指标的权重系数排序为:高血压病肝阳上亢证诊断量表>血压控制情况>再住院率>杜氏高血压生活质量量表>不良事件发生率=不良事件严重程度>花生四烯酸>世界卫生组织(WHO)生活质量量表>血栓素B2>前列腺素E2。(6)高血压病肝阳上亢证疗效评价模型:G=0.377x1+0.059x2+0.101x3+0.087x4+0.377x5。其中x1、x2、x3、x4、x5分别代表中医证候指标、理化指标、安全性指标、生活质量指标、治疗结果及预后指标5个维度。【结论】该疗效评价体系的建立可为高血压病肝阳上亢证的临床诊疗提供新思路,也可为其他疾病及证候的标准化研究提供参考。Objective By using the Delphi method combined with analytic hierarchy process(AHP),the efficacy evaluation system for hypertension of liver-yang hyperactivity type was established. Methods On the basis of previous study of our team,we established the basic indexes for the efficacy evaluation of hypertension of liver-yang hyperactivity type. And after the expert questionnaire survey,we screened out the efficacy evaluation indexes according to the degree of concentration and coordination of the expert opinions. By combining Satty weight method and analytic hierarchy process, a matrix was constructed to establish the hierarchical structure, and then the weight coefficient of each index was determined by the operation matrix,so as to establish the efficacy evaluation system for hypertension of liver-yang hyperactivity type. Results(1)A total of 20 questionnaires were distributed to the national experts specialized in the prevention and treatment of hypertension with traditional Chinese medicine(TCM),and all of the 20 questionnaires were effectively responded.(2)The results of the degree of concentration and coordination of the expert opinions for the second-level indexes showed that the value assignment for the importance was equal to or was over 4,and the coefficient of variation was less than 0.2,indicating that TCM syndrome indexes, physiochemical indexes, safety indexes, quality of life indexes, efficacy outcomes and prognostic indexes can be used as the efficacy evaluation indexes.(3)The results of the degree of concentration and coordination of the expert opinions for the third-level indexes showed that the value assignment for the importance was equal to or was over 4,and the coefficient of variation was less than 0.2,indicating that the third-level indexes can be used as the efficacy evaluation indexes.(4)The ranking of the weight coefficient of the second-level indexes was as follows: TCM syndrome indexes = efficacy outcomes and prognostic indexes > safety indexes > quality of life indexes > physiochemical i

关 键 词：高血压病 肝阳上亢证 疗效评价体系 层次分析法 中医证候指标 理化指标 安全性指标 

分 类 号：R259.441[医药卫生—中西医结合]