冠心病痰湿证临床诊断标准诊断效能评价与阈值修订  

Diagnostic Efficacy Evaluation and Threshold Revision of Clinical Diagnostic Criteria for Phlegm-dampness Syndrome of Coronary Heart Disease

作　　者：周聪慧 杨燕[2] 王传池 江丽杰[2] 张新淼 赵福海[4] 张松峰[5] 陈智龙[6] 王昃睿 胡镜清 ZHOU Cong-hui;YANG Yan;WANG Chuan-chi;JIANG Li-jie;ZHANG Xin-miao;ZHAO Fu-hai;ZHANG Song-feng;CHEN Zhi-long;WANG Ze-rui;HU Jing-qing(Nanjing University of Chinese Medicine,Nanjing 210023,China;Institute of Basic Theory for Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350004,China;Huangshi Hospital of Traditional Chinese Medicine,Hubei Huangshi 435000,China;XiangYang Hospital of Traditional Chinese Medicine,Hubei Xiangyang 441000,China)

机构地区：[1]南京中医药大学,南京210023 [2]中国中医科学院中医基础理论研究所,北京100700 [3]中国中医科学院中医临床基础医学研究所,北京100700 [4]中国中医科学院西苑医院,北京100091 [5]福建中医药大学附属人民医院,福州350004 [6]黄石市中医医院,湖北黄石435000 [7]襄阳市中医医院,湖北襄阳441000

出　　处：《中国中医基础医学杂志》2021年第7期1114-1118,共5页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：国家重点研发计划(2019YFC1708501)-冠心病痰瘀互结病因病机与诊治方案创新研究;科学技术部国家重点基础研究发展计划“973计划”(2014CB542903)-基于冠心病痰瘀互结证辨证方法的创新研究;中国中医科学院中医基础理论研究所自主选题项目(YZ-1910)-两种冠心病痰瘀互结证诊断标准的质量比较研究;佛山市科技创新项目(中医药领域先行先试科技攻关专项)(2020001005585)-痰瘀互结相关慢病社区防控关键共性技术与应用研究。

摘　　要：目的:评价冠心病痰湿证临床诊断标准的诊断效能并修订诊断阈值,为临床实践提供诊断依据。方法:采用诊断性试验研究方法,通过计算敏感度、特异度、准确度等评价冠心病痰湿证临床诊断标准的诊断效能,同时绘制受试者工作特征曲线(receiver operator characteristic curve,ROC),根据约登指数获取最佳诊断阈值。结果:冠心病痰湿证临床诊断标准ROC曲线下面积为0.835,95%置信区间为0.724~0.946。根据约登指数最大值(0.62)将诊断阈值修订为“≥5分”后,该标准的敏感度、特异度和准确度分别为90%、72%和86.4%。结论:调整诊断阈值后的冠心病痰湿证临床诊断标准反映出更好的诊断效能。Objective:To evaluate the diagnostic efficacy of the clinical diagnostic criteria of phlegm-dampness syndrome with coronary heart disease,revise the diagnostic threshold,and provide diagnostic basis for clinical practice.Methods:The diagnostic test method is used to evaluate the diagnostic efficacy of the criteria by calculating sensitivity,specificity and accuracy.At the same time,the Receiver Operator Characteristic Curve(ROC)is drawn,and the best diagnostic threshold is obtained according to Youden index.Results:The area under the ROC curve of the diagnostic criteria is 0.835,95%confidence interval is 0.724~0.946.After the diagnostic threshold is revised to"≥5 points"according to the maximum value of Youden index(0.62),the sensitivity,specificity and accuracy of the criteria are 90%,72%and 86.4%,respectively.Conclusion:The clinical diagnostic criteria of phlegm-dampness syndrome with coronary heart disease reflects better diagnostic efficiency after adjusting the diagnostic threshold.

关 键 词：冠心病 痰湿证 诊断标准 诊断性试验 敏感度 特异度 诊断效能 阈值 

分 类 号：R541.4[医药卫生—心血管疾病]