普适性痰瘀互结证临床诊断条目的筛选与分析  

Screening and Analysis of Clinical Diagnosis Items of Universal Phlegm and Blood Stasis Mixture Syndrome

作　　者：王孟秋 张逸雯 江丽杰[2] 张佳乐 胡镜清[1,3] WANG Mengqiu;ZHANG Yiwen;JIANG Lijie;ZHANG Jiale;HU Jingqing(Hubei University of Traditional Chinese Medicine,Wuhan Hubei China 430065;Institute of Basic Theory of Traditional Chinese Medicine,Chinese Academy of Traditional Chinese Medicine,Beijing China 100700;China Science and Technology Development Center of Traditional Chinese Medicine,Beijing China 100700)

机构地区：[1]湖北中医药大学,湖北武汉430065 [2]中国中医科学院中医基础理论研究所,北京100700 [3]中国中医药科技发展中心,北京100700

出　　处：《中医学报》2023年第11期2406-2413,共8页Acta Chinese Medicine

基　　金：省部共建中医湿证国家重点实验室专项项目(SZ2021ZZ01,B202201);国家重点研发计划“中医药现代化研究”重点专项项目(2019YFC1708501);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)。

摘　　要：目的:筛选普适性痰瘀互结证临床诊断条目,为构建普适性痰瘀互结证临床诊断标准提供基础与参考。方法:以痰瘀互结证为研究对象,收集四大数据库中有关痰瘀互结及相关证候诊断标准研究文献。采用多种统计学方法结合焦点小组讨论法、专家共识会议法筛选诊断条目。结果:纳入文献111篇,使用多种统计方法建立条目池。焦点小组遵从初筛原则,初步筛选出疼痛、肿块、麻木等共19条诊断条目。经专家共识会议结合焦点小组讨论最终筛选出疼痛、麻木、肿块、肢体困重、肥胖或腹部肥软、面色晦暗或黧黑、口唇或齿龈紫暗、脘腹痞满、腻苔、舌有瘀斑或瘀点、舌质紫或暗、舌下脉络粗胀或曲张或色青紫或其他血管静脉曲张、弦脉、滑脉、涩脉等15条诊断条目。结论:通过主客观相结合的方法,筛选出普适性痰瘀互结证诊断条目,可以作为制定痰瘀互结证临床诊断标准的基础。Objective:To screen the items of universal clinical diagnosis of phlegm and blood stasis syndrome,and to provide basis and reference for the construction of universal clinical diagnosis standard of phlegm and blood stasis syndrome.Methods:Taking the syndrome of phlegm and blood stasis as the research object,the research literature on the diagnosis standard of phlegm and blood stasis and related syndromes in four databases was collected.Various statistical methods combined with focus group discussion and expert consensus meeting were used to screen diagnostic items.Results:111 articles were included,and a pool of items was established by using various statistical methods.The focus group followed the principle of primary screening,and initially screened out 19 items with reference to the above results:pain,lump,numbness,etc.After expert consensus meeting and focus group discussion,pain,numbness,mass,heavy limbs,obesity or fat abdomen,dull or dark complexion,purple lips or gums,fullness in the abdomen,greasy fur,ecchymosis or petechia on the tongue,purple or dark tongue,thick or varicose sublingual veins or blue or other vascular varicose veins,string pulse,slippery pulse.Conclusion:By combining subjective and objective methods,the universal diagnostic items of phlegm and blood stasis syndrome can be screened out,which can be used as the basis for formulating clinical diagnostic criteria of phlegm and blood stasis syndrome.

关 键 词：普适性痰瘀互结证 临床诊断条目 诊断标准 证候标准 证候客观化 证候诊断 

分 类 号：R241[医药卫生—中医诊断学]