气滞证辨证核心条目筛选研究  

Research on the screening of core items of qi stagnation syndrome differentiation

作　　者：吴珊 王传池 杨燕 江丽杰[1] 陈南杰 汪锦城 张佳乐 林明欣[1] 胡镜清[1,3] WU Shan;WANG Chuanchi;YANG Yan;JIANG Lijie;CHEN Nanjie;WANG Jincheng;ZHANG Jiale;LIN Mingxin;HU Jingqing(Institute of Basic Theory for Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Xin-Huangpu Joint Innovation Institute of Chinese Medicine,Guangzhou 510000,China;China Science and Technology Development Center for Chinese Medicine,Beijing 100027,China)

机构地区：[1]中国中医科学院中医基础理论研究所,北京100700 [2]广东省新黄埔中医药联合创新研究院,广州510000 [3]中国中医药科技发展中心,北京100027

出　　处：《中华中医药杂志》2023年第7期3376-3382,共7页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家重点研发计划(No.2019YFC1708501);中国中医科学院基本科研业务费优秀青年科技人才培养专项(No.ZZ15-YQ-069);中国中医科学院中医基础理论研究所基本科研业务费自主选题项目(No.YZ-202051);佛山市科技创新项目中医药领域先行先试科技攻关专项(No.202000100558);中国中医科学院广安门医院结余经费课题(No.2022068)。

摘　　要：目的:筛选气滞证辨证核心条目,为气滞证的临床诊疗和科学研究提供参考。方法:检索中国知网全文数据库(CNK I)、维普全文数据库(CQVI P)、万方全文数据库和读秀数据库发表的涉及气滞证诊断标准的文献,归纳气滞证辨证条目池并制定问卷,通过专家咨询对气滞证辨证核心条目进行优化。结果:文献分析最终纳入1984年至2021年气滞证诊断标准29个,涵盖辨证条目35个;出现频率最高的前5位条目依次为:“局部胀闷疼痛”(100.0%)、“脉弦”(75.9%)、“胀痛可因叹息、嗳气、或矢气而减轻”(69.0%)、“疼痛时轻时重,时作时止”(65.5%)、“疼痛随情绪变化增减”(62.1%)。来自全国25位专家响应调查(专家积极程度92.6%,正高级职称占80.0%),最终确定气滞证辨证核心条目为:“情志抑郁”“急躁易怒”“喜叹息”“胸、胁、腹、背部胀闷疼痛,痛无定处,时轻时重”“症状变化与情志有关”“身体有异常感觉,部位不定(冷、热、麻、蚁行感等)”“脉弦”。结论:位置不固定且可随情志变化的胀、闷、痛是气滞证诊断的核心要点。Objective:To screen the core items of qi stagnation syndrome differentiation,and to provide reference for clinical diagnosis,treatment and scientific research of qi-stagnation syndrome.Methods:The diagnostic criteria of qi-stagnation syndrome published in CNKI Full-text database(CNKI),VIP Full-text database(CQVIP),Wanfang and other databases were searched,and the entry pool of qi-stagnation syndrome differentiation was summarized and questionnaires were formulated.The core items of qi-stagnation syndrome differentiation were optimized through expert consultation and investigation.Results:Twenty-nine diagnostic criteria for qi-stagnation syndrome were included in the literature analysis from 1984 to 2021,including 35 syndrome differentiation items;The occurrence frequency of the top five items were:‘local distension and pain’(100.0%),‘pulse string’(75.9%),‘distension and pain can be relieved by sighing,belching,or sagittal gas’(69.0%),‘pain is sometimes light,sometimes heavy,sometimes intermittent’(65.5%),‘pain increases and decreases with emotional changes’(62.1%).Twenty-five experts from 7 districts across the country responded to the survey(92.6%positive degree of experts,80.0%senior titles),and finally determined the core items of qi stagnation syndrome differentiation as follows:‘Emotional depression’‘irritable’‘happy sigh’‘chest,flank,abdomen,back distension pain,pain is not fixed,when light when heavy’‘symptom changes and emotion related’‘the body has abnormal feelings,indefinite parts(cold,heat,hemp,ant feeling,etc.)’‘pulse string’.Conclusion:Distension,distress and pain,which are not fixed and vary with emotion,are the key points in the diagnosis of qi stagnation syndrome.

关 键 词：气滞证 诊断标准 辨证 文献分析 专家咨询 

分 类 号：R255[医药卫生—中医内科学]