阿片类戒断综合征的中医辨证计量诊断  

Measurable Diagnosis of Opioid Withdrawal Syndrome by theory of Traditional Chinese Medicine

作　　者：白晓菊[1] 高学敏[1] 徐国柱[2] 郑继旺[2] 

机构地区：[1]北京中医药大学,北京100029 [2]北京大学中国药物依赖性研究所,北京100083

出　　处：《中国药物滥用防治杂志》2004年第2期63-67,共5页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:探讨阿片类戒断综合征的中医辨证计量诊断。方法:在对423例阿片依赖戒断者调查的基础上,进行了阿片类戒断综合征计量诊断研究,采用最大似然法判别分析模型,建立阿片类戒断综合征中医辨证计量诊断的指数表,继而运用DME方法,对毒瘀内阻寒热错杂证、毒瘀热阻证和毒瘀寒阻证进行了诊断效能的评价,在此基础上又进一步对毒瘀寒热互阻虚证、毒瘀虚热证和毒瘀虚寒证进行了诊断效能的评价。结果:毒瘀寒热互阻虚证评价结果为:灵敏度87.32%,特异度96.88%,误诊率3.13%,漏诊率12.68%,诊断指数184.2%,Youden指数84.2%,阳性预告值84.93%,阴性预告值97.43%,粗符合率95.27%,阳性似然比2.7898,阴性似然比0.1309;毒瘀虚热证评价结果为:灵敏度96.00%,特异度98.74%,误诊率1.26%,漏诊率40.00%,诊断指数194.74%,Youden指数94.74%,阳性预告值82.76%,阴性预告值99.75%,粗符合率98.58%,阳性似然比79.1905,阴性似然比0.4051;毒瘀虚寒证评价结果为:灵敏度95.00%,特异度99.01%,误诊率0.99%,漏诊率5.00%,诊断指数108.01%,Youden指数8.01%,阳性预告值82.61%,阴性预告值99.75%,粗符合率98.82%,阳性似然比95.9596,阴性似然比0.0005。结论:阿片类戒断综合征中医辨证计量诊断指数表具有良好的诊断效能,该方法有一定的推广使用价值。Objective: To explore the measurable diagnosis and syndrome differentiation of opioid withdrawal. Methods: Make the measurable diagnostic index forms for the syndrome of opium abstinence, on the basis of investigating 423 cases of opium abstinence, with the maximum likelihood method. And then make an evaluation to the diagnostic efficiency on the syndromes of opium stagnation complicated with heat and coldness, opium and heat stagnation, opium and coldness stagnation,and further on excessive opium stagnation complicated with deficient heat and coldness,excessive opium stagnation complicated with deficient heat and excessive opium stagnation complicated with deficient coldness with DME method. Results: The evaluated results of the syndrome of excessive opium stagnation complicated with deficient heat and coldness were as follows: sensitivity (Se) was 87.32%, specificity (Sp) was 96.88%, Wrong Diagnostic Rate (e Likelihood Ratio (-LR) was 0.1309. The evaluated results of the syndromes of excessive opium stagnation complicated with deficient heat were as follows:Se was 96.00%, Sp was 98.74%, -PV was 99.75%,CAR was 98.58%, +LR was 79.1905,-LR was 0.4051. The evaluated results of the syndromes of excessive opium stagnation complicated with deficient coldness were as follows:Se was95.00%, Sp was 99.01%, J was 8.01%, +PV was 82.61%,-PV was 99.75%, CAR was 98.82%, +LR was 95.9596,-LR was 0.0005. Conclusion: The DI for the syndrome of opium abstinence showed good diagnostic efficiency and the diagnostic method is practical.

关 键 词：阿片类戒断综合征 中医辨证 计量 病理学 毒瘀虚热证 

分 类 号：R277.7[医药卫生—中医学]