基于共识法的湿证诊断标准研究  

Research on the Diagnostic Criteria for Dampness Syndrome Based on Consensus Method

作　　者：李倩 吴文珍 艾芷萱 周砾磊 刘书君 杨小波 LI Qian;WU Wenzhen;AI Zhixuan;ZHOU Lilei;LIU Shujun;YANG Xiaobo(State Key Laboratory of Dampness Syndrome of Chinese Medicine,the Second Afiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,China;The Second Clinical College of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]省部共建中医湿证国家重点实验室、广州中医药大学第二附属医院,广州510120 [2]广州中医药大学第二临床医学院,广州510405

出　　处：《世界科学技术-中医药现代化》2024年第6期1660-1667,共8页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：广州市科学技术局广州市科技计划项目(2024A03J0722):基于共识方法的湿证诊断标准研制及其方法学研究,负责人:李倩;省部共建中医湿证国家重点实验室重点项目(SZ2021ZZ05,SZ2021ZZ0501):湿证队列关键技术平台的构建,负责人:杨小波;广东省卫生健康委员会广东省医学科学技术研究基金项目(B2021437):国际量表IBS-SSS中文版在肠易激综合征中的应用及其信度和反应度调查研究,负责人:李倩。

摘　　要：目的通过科学、规范的研究方法建立湿证诊断标准。方法通过文献研究运用结构化工具全面集成湿证辨证依据,并通过问卷调查及共识会议法就湿证内涵及外延、判定依据以及标准构建等开展深入调查,达成共识。结果经过文献研究获得湿证辨证依据36项。通过问卷调查有专家建议应探索更贴近临床实际的湿证诊断模式,据此本研究就“如何确立诊断”这一关键问题深入思考。分析发现,湿证存在特异性/敏感性指标;经深入调查,在文献研究基础上确定了11项特异性及19项敏感性指标,并根据专家建议将特异性指标以湿性特征分为3类。同时,本研究系统梳理了证候标准的诊断属性并相应归纳为4种模式,据此经调查决定湿证标准宜采用特异性模式和相似度/一致性模式,并进一步明确了符合湿证诊断属性的判定形式。结论本标准可为湿证临床诊断提供依据;同时,本研究探索了证候的诊断属性,可为其他证候标准的研制提供参考。Objective To establish diagnostic criteria for dampness syndrome through scientific and normative research methods.Methods The basis for syndrome differentiation of dampness syndrome was comprehensively integrated through literature research and structured tools,and in-depth investigation was carried out on the connotation and extension of dampness syndrome,judgment basis and criteria construction through questionnaire surveys and consensus conference method.Results Thirty-six items for syndrome differentiation of dampness syndrome were obtained through literature research.Through the questionnaire surveys,some experts suggested that the diagnosis mode of dampness syndrome should be in line with the clinical practice requirements.Accordingly,we were deep in thought about the key issue of"how to establish accurate diagnostic criteria".After in-depth investigation,we found that the dampness syndrome had specific and sensitive indicators.And 11 specific and 19 sensitive indicators were determined.Furthermore,according to the experts′suggestions,the specific indicators were classified into three categories based on dampness characteristics.Meanwhile,we investigated the diagnosis attributes of Chinese medicine syndromes and summarized them into four corresponding modes.Based on this,specificity mode and similarity/consistency mode should be adopted for diagnostic criteria for dampness syndrome.In addition,the judgment form in accord with the diagnostic attributes of dampness syndrome was determined.Conclusion This diagnostic criteria can provide a basis for the clinical diagnosis of dampness syndrome.Besides,this study explored the diagnostic attributes of Chinese medicine syndromes,which could provide reference for the development of other Chinese medicine syndrome criteria.

关 键 词：湿证 诊断标准 共识法 文献研究 自填问卷法 

分 类 号：R441[医药卫生—诊断学]