基于"多维证据体"模式强直性脊柱炎患者督灸技术操作方案的构建  

Constructing Du-moxibustion technique operation scheme for patients with ankylosing spondylitis based on"multidimensional evidence body"model

作　　者：李丽[1] 王元红[1] 缪娇 徐庭 吴琳玲 顾婷 Li Li;Wang Yuanhong;Miao Jiao;Xu Ting;Wu Linling;Gu Ting(Department of Rheumatology,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing 210029,China)

机构地区：[1]江苏省中医院风湿科,南京210029

出　　处：《中国实用护理杂志》2025年第7期514-522,共9页Chinese Journal of Practical Nursing

基　　金：江苏省中医院院内课题(Y22043)。

摘　　要：目的基于"多维证据体"模式,构建适用于强直性脊柱炎患者的督灸技术操作方案,为临床督灸治疗强直性脊柱炎提供参考。方法依据"多维证据体"模式,综合现代文献、中医古籍和名医经验等证据,于2023年4—6月联合20例强直性脊柱炎患者的半结构式访谈形成操作方案初稿。2023年7—8月来自13个地区的20名中医专家通过2轮函询及专家共识会参与方案的评审和修订,形成操作方案终稿。结果20名专家中,男3名,女17名,年龄(42.70±6.57)岁。2轮函询专家积极指数分别为95%(19/20)和18/18,专家权威系数分别为0.80和0.81,各级条目变异系数分别为0.00~0.19和0.00~0.21,Kendall协调系数分别为0.179和0.344(均P<0.01)。最终方案包括"术语及定义""评估""操作要点""常见异外情况及处理措施""注意事项""效果评价"6个一级条目,27个二级条目和17个三级条目。结论基于"多维证据体"模式强直性脊柱炎患者督灸技术操作方案科学、可行且具有针对性,能为临床实践提供有效指导,确保治疗的全面性和有效性。Objective To construct a Du-moxibustion technique operation scheme suitable for patients with ankylosing spondylitis based on the"multidimensional evidence body"model,so as to provide a reference for clinical Du-moxibustion in the treatment of ankylosing spondylitis.MethodsThis study was based on the"multidimensional evidence body"model,integrating evidence such as modern literature,ancient Chinese medicine books,and the experience of famous doctors,and combined with semi-structured interviews of 20 patients to form a first draft of the operation plan from April to June 2023.Twenty traditional Chinese medicine experts from 13 regions participated in the review and revision of the plan through two rounds of consultation and expert consensus meetings from July to August 2023,forming the final draft of the operation scheme.ResultsAmong 20 experts,there were 3 males and 17 females,aged(42.70±6.57)years old.The effective response rates of the questionnaires in the two rounds of correspondence inquiries were 95%(19/20)and 18/18 respectively,and the expert authority coefficients were 0.80 and 0.81.The coefficients of variation were 0.00-0.19 and 0.00-0.21 respectively,and the Kendall harmony coefficients were 0.179 and 0.344 respectively(both P<0.01).The final scheme included 6 first-level items,including"terms and definitions""assessment""operation point""abnormal situations and handling measures""precautions""effect evaluation"and 27 second-level items and 17 third-level items.ConclusionsThe operation scheme of Du-moxibustion technique is scientific,feasible and targeted,which can provide effective guidance for clinical practice and ensure the comprehensiveness and effectiveness of treatment.

关 键 词：德尔菲技术 强直性脊柱炎 多维证据体 督灸 

分 类 号：R246.1[医药卫生—针灸推拿学]