类风湿关节炎血瘀证素量化诊断标准探索性研究  

Exploratory Study on Quantitative Diagnostic Criteria for Syndrome Elements of Rheumatoid Arthritis of Blood Stasis Pattern

作　　者：姜小帆[1] 李娟娥[1] 吉海旺[1] 雷鹏[1] JIANG Xiaofan;LI Juane;JI Haiwang;LEI Peng Shaanxi(Provincial People’s Hospital,Xi’an 710068,China)

机构地区：[1]陕西省人民医院,陕西西安710068

出　　处：《西部中医药》2021年第9期138-142,共5页Western Journal of Traditional Chinese Medicine

基　　金：陕西省自然科学基础研究计划项目(2021JM-544);陕西省中医药管理局中医药科研课题(15-LC038);中国博士后科学基金会资助项目(2019M663752)。

摘　　要：目的:建立类风湿关节炎(rheumatoid arthritis,RA)血瘀证素量化诊断标准。方法:运用最大似然判别分析法确定血瘀证素评定量表中各条目下属二级指标的权重,依此建立各证素量化诊断指数表。将待判患者对各条目(一级指标)的选择结果(二级指标)代入诊断指数表,分别纵向相加两列中所选数字,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:建立的各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、阴性预测值结果均较理想。结论:建立的RA血瘀证素量化诊断标准具有较好的诊断效能。Objective:To establish the quantitative diagnostic criteria for syndrome elements of rheumatoid arthritis(RA)of blood stasis pattern.Methods:Maximum likelihood discriminant analysis was used to determine the weight of subordinate secondary indexes of each item in blood stasis syndrome element rating scale,based on this,to establish quantitative diagnostic index of each syndrome element.Substitute the selection result(secondary index)of each item(primary index)of the patients to be judged into the diagnostic index table,add the selected numbers in the two columns vertically respectively,and calculate the sum of“yes”and“non”indexes,so as to judge whether the patient is diagnosed as the syndrome element or not.According to the evaluation principle of clinical epidemiological diagnostic test,the established quantitative diagnostic criteria of each syndrome element were prospectively tested by calculating the sensitivity,specificity,accuracy,positive predictive value and negative predictive value.Results:The established quantitative diagnostic criteria of each syndrome element possessed higher sensitivity and specificity,the corresponding miss rate and misdiagnosis rate were lower,and the results of accuracy,positive predictive value and negative predictive value were ideal.Conclusion:The established quantitative diagnostic criteria of blood stasis syndrome elements in RA owns better diagnostic efficiency.

关 键 词：类风湿关节炎 血瘀证 证素 最大似然判别分析法 量化诊断标准 

分 类 号：R287[医药卫生—中药学]