论定性研究方法在中医方案优化中的应用  

Application of Qualitative Research Method in Optimization of Traditional Chinese Medicine Protocol

作　　者：张梓寒 徐敏杰 刘孟宇[2] 李颖[1] 黄佳钦 雷晓菁 周雨帆 谭逸海 赵蕊 唐璐[1] 崔方圆[1] 董兴鲁[1] 白晶 史楠楠[2] 常静玲[1] ZHANG Zihan;XU Minjie;LIU Mengyu;LI Ying;HUANG Jiaqin;LEI Xiaojing;ZHOU Yufan;TAN Yihai;ZHAO Rui;TANG Lu;CUI Fangyuan;DONG Xinglu;BAI Jing;SHI Nannan;CHANG Jingling(Department of Neurology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院神经内科,北京100700 [2]中国中医科学院中医临床基础医学研究所,北京100700

出　　处：《世界中医药》2022年第20期2930-2935,共6页World Chinese Medicine

基　　金：国家自然科学基金项目(81973790);中医药国际合作专项(基地类项目)(0610-2140NF020630);北京中医药大学重点攻关项目(2020-JYB-ZDGG-110-2);北京市自然科学基金项目(7181005)。

摘　　要：目的:在定量研究“益髓醒神”针刺方案取得疗效证据的基础上,率先开展结合定性研究的方法,以优化“益髓醒神”中医针刺方案,取得综合循证证据,促进中医方案临床应用与推广。方法:采用半结构化访谈的定性研究方法,进一步对医师个人技能和经验、患者的价值观和选择以及中医治疗方案潜在的干预成分进行研究,运用主题分析法分析访谈资料。结果:共访谈10名医师和8例患者。访谈结果显示:医师认为本方案选穴常规,操作简单容易上手,无不良反应,是治疗失语的一个基础处方,在临床上可根据辨证或患者症状加减使用;治疗效果除改善患者语言外,还对改善认知、情绪、构音功能有治疗效果。患者对于本方案接受度高、依从性好,认为方案除了改善语言症状外,还对认知、精神状态有改善效果。结论:运用定性研究方法进一步深化了对“益髓醒神”中医针刺方案干预措施影响因素的认识,完善了方案的结局指标,为中医方案的进一步优化提供了依据。Objective:On the basis of quantitative research evidence of the acupuncture protocol of “enlivening brain and replenishing marrow”,the qualitative research method was applied to optimize the acupuncture protocol of “enlivening brain and replenishing marrow” to obtain comprehensive evidence and promote the clinical application and promotion of traditional Chinese medicine(TCM) protocols.Methods:The qualitative research method of the semi-structured interview was adopted to further study physicians′ skills and experience, patients′ values and choices, and potential intervention factors of the protocol.The interview materials were analyzed by the thematic analysis method.Results:Ten physicians and eight patients were interviewed.The interview results showed that the physicians believed that the acupuncture in this protocol was characterized by routine acupoint selection and easy manipulation, without adverse reactions, and it served as a basic prescription for the treatment of aphasia, which should be modified according to syndrome differentiation or symptoms of patients.In addition to the improvement in the patient′s language, the therapeutic efficacy was also embodied in the improvement in cognition, emotion, and articulation.The patients had a high degree of acceptance and good compliance with this protocol.They believed that this protocol not only improved the language symptoms but also improved the cognitive and mental state.Conclusion:Qualitative research method was used to further deepen the understanding of the influencing factors of acupuncture protocol of “enlivening brain and replenishing marrow”,improve the outcome indicators, and provide a basis for the further optimization of TCM protocols.

关 键 词：定性研究 半结构化访谈法 中医方案 优化 中风后失语 针刺方案 益髓醒神 

分 类 号：R259[医药卫生—中西医结合]