火热证诊断条目筛选与构建  

Screening and Construction of Diagnostic Items for Fire-heat Syndrome

作　　者：张佳乐 吴珊 杨燕 陈南杰 汪锦城 胡镜清[1,2] ZHANG Jiale;WU Shan;YANG Yan;CHEN Nanjie;WANG Jincheng;HU Jingqing(Institute of Basic Theory for Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,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]中国中医药科技发展中心,北京100027

出　　处：《世界科学技术-中医药现代化》2024年第2期511-516,共6页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家科学技术部国家重点研发计划中医药现代化研究重点专项(2019YFC1708501):冠心病痰瘀互结病因病机与诊治方案创新研究,负责人:胡镜清;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,负责人:胡镜清;中央级公益性科研院所中国中医科学院中医基础理论研究所自主选题项目(YZ-202218):冠心病热结血脉证危险因素分析及微观指标探索研究,负责人:胡镜清,张佳乐。

摘　　要：目的通过对既往火热证相关诊断规范和火热证临床研究中的四诊信息进行系统分析,总结火热证四诊临床表征,为构建火热证临床诊断标准条目池提供基础。方法检索PubMed、CNKI、WANFANG、CQVIP、CBM等数据库发表的火热证临床研究及相关辨识规范,描述火热证的症状、舌脉四诊基本信息,并通过名义小组法结合专家咨询法对临床表征进行分析。结果检索火热相关证临床研究文献193条,通过规范化处理后,筛选出63个条目,主要症状为发热、大便秘结、脉数、小便短黄、躁扰不安、舌苔黄、面红、口渴。通过名义小组法,对条目进行优化处理,纳入火热证条目池的11个条目的组成为8个症状、3个舌脉。症状:怕热、面赤、大便秘结、局部红肿热痛(齿龈、咽喉肿痛,口腔溃疡等)、烦躁、口苦、口渴喜冷饮、近期病情波动。舌脉:舌质红、舌苔黄、脉数。结论火热证条目池重点突出“近期病情波动、局部红肿热痛(齿龈、咽喉肿痛,口腔溃疡等)”两个核心症状,在舌脉上以舌质红、舌苔黄、脉数为主,火热证条目池的筛选与构建,可作为未来火热证临床诊断标准研制的依据。Objective By systematically analyzing the four consultation pieces of information from previous diagnostic norms and clinical studies related to the fire-heat syndrome,we summarized the four diagnostic clinical representations and provided a basis for constructing a clinical diagnostic criteria items pool for the fire-heat syndrome.Methods The clinical studies of the fire-heat-related syndrome and identification norms published in PubMed,CNKI,WANFANG,CQVIP,CBM,and other databases were retrieved to describe the basic information of the four diagnoses of symptoms,tongue,and pulse of the fire-heat syndrome,and the clinical symptoms were analyzed by the Nominal Group Technique(NGT)combined with expert consultation.Results 193 entries of clinical studies of the fire-heat syndrome were retrieved,and 63 entries were screened by normalization,and the main symptoms were fever,constipation,rapid pulse,short yellow urine,restlessness,yellow tongue coating,blush,and thirst.Through the NGT method,the entries were optimized,and the 11 entries included in the pool of fire-heat syndrome were composed of eight symptoms with three tongues and pulses.Symptoms:fear of heat,flushing,constipation,local redness and heat pain(gingingival pain,sore throat,mouth ulcers,etc.),dysthesia,bitter taste,thirst for cold drinks,and recent illness fluctuations.Tongue and pulse:red tongue,yellow tongue coating,and rapid pulse.Conclusion The items pool of fire-heat syndrome focuses on the two core symptoms of"recent illness fluctuations,local redness and heat pain(gingingival pain,sore throat,mouth ulcers,etc.)"and on the tongue and pulse,the red tongue,yellow fur,and rapid pulse are the main symptoms.

关 键 词：火热证 诊断 证候 诊断标准 条目池 

分 类 号：R241.2[医药卫生—中医诊断学]