基于德尔菲法建立类风湿关节炎寒湿痹阻证诊断标准的初步研究  

Preliminary study on establishing diagnostic criteria for cold-dampness syndrome in rheumatoid arthritis based on Delphi method

作　　者：萧韵婷 吴晓东 王茂杰[2,3,4] 高恺昕 梅丽艳 黄闰月 陈秀敏[2,3,4,5] Xiao Yunting;Wu Xiaodong;Wang Maojie;Gao Kaixin;Mei Liyan;Huang Runyue;Chen Xiumin(The Second Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou 510120,China;The Second Affiliated Hospital,Guangzhou University of Chinese Medicine(Guangdong Provincial Hospital of Chinese Medicine),Guangzhou 510120,China;State Key Laboratory of Dampness Syndrome of Chinese Medicine,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,China;Guangdong-Hong Kong-Macao Joint Lab on Chinese Medicine and Immune Disease Research,Guangzhou 510120,China;Guangdong Provincial Key Laboratory of Chinese Medicine for Prevention and Treatment of Refractory Chronic Diseases,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二临床医学院,广州510120 [2]广州中医药大学第二附属医院(广东省中医院),广州510120 [3]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 [4]粤港澳中医药与免疫疾病研究联合实验室,广州510120 [5]广东省中医药防治难治性慢性病重点实验室,广州510120

出　　处：《国际中医中药杂志》2024年第11期1393-1400,共8页International Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82274421);省部共建中医湿证国家重点实验室专项项目(SZ2021ZZ0202、SZ2021ZZ35、SZ2021KF16);青年岐黄学者培育项目(国中医药人教函〔2022〕256号);广州中医药大学学科后备人才培育项目(A1-2601-22-415-013)。

摘　　要：基于德尔菲法,结合前期文献研究和专家访谈结果,进行3轮专家咨询,从算术平均数、满分比(Ki)、等级和(Si)3个方面评价专家意见集中程度及其重要性,构建类风湿关节炎(RA)寒湿痹阻证诊断量表。本研究第1轮发放专家调查问卷30份,回收问卷30份,专家协调系数为0.309;第2轮发放专家调查问卷30份,回收问卷30份,专家协调系数为0.320;第3轮发放专家调查问卷30份,回收问卷29份,专家协调系数为0.387。3轮专家变异系数最大值为0.27、最小值为0.09,提示专家对寒湿痹阻证候条目重要性评价的一致性及可信程度均较高。本研究最终获得17个条目,其均值及权重排名前5位的有关节冷痛(4.793,0.0666)、遇寒加重(4.586,0.0637)、苔白(4.552,0.0632)、阴雨天加重(4.448,0.0618)、疼痛关节皮肤触之不热(4.379,0.0608)。本研究完成了相关条目筛选并进行初步探索,为构建RA寒湿痹阻证诊断量表、形成最终诊断标准奠定基础。本研究方法科学、可靠,可为RA寒湿痹阻证诊断标准提供借鉴,但仍需进一步临床实践研究。Based on the Delphi method,combined with the results of the previous literature study and expert interviews,3 rounds of expert consultation were conducted to evaluate the degree of concentration of expert opinions and their importance from 3 aspects:arithmetic mean,full score ratio(Ki),and rank sum(Si),to construct a diagnostic scale for rheumatoid arthritis(RA)cold-dampness syndrome.In this study,30 expert questionnaires were distributed in the 1st round,30 questionnaires were recovered,and the expert coordination coefficient was 0.309;30 expert questionnaires were distributed in the 2nd round,30 questionnaires were recovered,and the expert coordination coefficient was 0.320;and 30 expert questionnaires were distributed in the 3rd round,29 questionnaires were recovered,and the expert coordination coefficient was 0.387.The maximum value of the coefficient of variation of the experts of the 3 rounds was 0.27,and the minimum value was 0.09,suggesting that the consistency and credibility of the experts'evaluation of the importance of the entries of cold-dampness syndrome were high.In this study,the mean values and weights of 17 entries were finally obtained,of which the top 5 entries were cold pain in joints(4.793,0.0666);aggravated by cold(4.586,0.0637);white tongue coating(4.552,0.0632);aggravated in cloudy and rainy days(4.448,0.0618);and painful joints that are not warm to the touch(4.379,0.0608).This study completed the screening of relevant entries and conducted preliminary discussions,laying the foundation for constructing a diagnostic scale for RA cold-dampness syndrome and forming the final diagnostic criteria.The research method is scientific and reliable,which can provide reference for the diagnostic standard of RA cold-dampness syndrome,but further clinical practice research is still needed.

关 键 词：类风湿关节炎 寒湿痹阻证 德尔菲法 证候诊断 

分 类 号：R259[医药卫生—中西医结合]