原发性高血压肝气郁结证诊断量表阈值的建立
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摘要
目的:建立原发性高血压肝气郁结证诊断量表的阈值。方法:随机选取200例原发性高血压病诊断标准的患者进行调查,通过专家咨询确定主观权重系数,利用因子分析法确定量表条目的客观权重系数,然后将主、客观赋权权数相乘得到某一指标的综合权重数,并通过受试者工作特征曲线确定证候最佳诊断阈值。结果:受试者工作特征曲线的最佳临界点即高血压肝气郁结证的诊断界值为253. 5,灵敏度为90. 6%,特异度为93. 0%。结论:原发性高血压肝气郁结证诊断量表阈值的证候积分Y≥253. 5,即高血压病患者的中医证候积分Y≥253. 5时,肝气郁结证诊断成立。
Objective: To establish diagnostic scale threshold of essential hypertension with liver-qi stagnation syndrome. Methods:200 patients with diagnostic criteria of essential hypertension were randomly selected for investigation. Subjective weight coefficients were determined through expert consultation. The objective weight coefficients of the items of the scale were determined by factor analysis. Then we multiplied the subjective and objective weights to get the comprehensive weights of a certain index,and determined the optimal diagnostic scale threshold of syndromes through the receiver operating characteristic curve. Results: The optimal critical point of the receiver's operating characteristic curve,namely,the diagnostic scale threshold of hypertensive of liver-qi stagnation syndrome was 253. 5,the sensitivity was 90. 6%,and the specificity was 93. 0%. Conclusion: The syndrome score of the threshold of the diagnosis of primary hypertensive liver-qi stagnation syndrome is Y≥253. 5,that is,the TCM syndrome score of patients with hypertension is Y≥253. 5,and the diagnosis of liver-qi stagnation syndrome is established.
Objective: To establish diagnostic scale threshold of essential hypertension with liver-qi stagnation syndrome. Methods:200 patients with diagnostic criteria of essential hypertension were randomly selected for investigation. Subjective weight coefficients were determined through expert consultation. The objective weight coefficients of the items of the scale were determined by factor analysis. Then we multiplied the subjective and objective weights to get the comprehensive weights of a certain index,and determined the optimal diagnostic scale threshold of syndromes through the receiver operating characteristic curve. Results: The optimal critical point of the receiver's operating characteristic curve,namely,the diagnostic scale threshold of hypertensive of liver-qi stagnation syndrome was 253. 5,the sensitivity was 90. 6%,and the specificity was 93. 0%. Conclusion: The syndrome score of the threshold of the diagnosis of primary hypertensive liver-qi stagnation syndrome is Y≥253. 5,that is,the TCM syndrome score of patients with hypertension is Y≥253. 5,and the diagnosis of liver-qi stagnation syndrome is established.
引文
[1]孟凡波,李运伦,杨传华.原发性高血压肝阳上亢证诊断量表阈值的建立[J].山东中医药大学学报,2013,37(1):12-15.
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[14]杜丽新,李书清,李凤莲,等. ROC曲线确定最佳临界点的方法探讨[J].标记免疫分析与临床,2015,22(8):823-824.
[15]王晓刚,宗序平. ROC曲线区分度与最优阈值[J].扬州职业大学学报,2015,19(1):37-40.
[2]刘伟涛,顾鸿,李春洪.基于德尔菲法的专家评估方法[J].计算机工程,2011,37(S1):189-191,204.
[3]游家兴.如何正确运用因子分析法进行综合评价[J].统计教育,2003(5):10-11.
[4]魏艳华,王丙参,田玉柱.主成分分析与因子分析的比较研究[J].天水师范学院学报,2009,29(2):13-15.
[5]贾振华.“脉络—血管系统病”辨证诊断标准制定——中医辨证诊断标准定量方法学研究[J].疑难病杂志,2009,8(5):259-261.
[6]姜君.中医证候量化诊断标准研究方法概况[J].中医学报,2010,25(1):94-96.
[7]刘自远,刘成福.综合评价中指标权重系数确定方法探讨[J].中国卫生质量管理,2006,13(2):44-46,48.
[8]陈伟,夏建华.综合主、客观权重信息的最优组合赋权方法[J].数学的实践与认识,2007,22(1):17-22.
[9]王晖,陈丽,陈垦,等.多指标综合评价方法及权重系数的选择[J].广东药学院学报,2007,23(5):583-589.
[10]邹莉玲,余小金,闵捷,等. ROC曲线在医学诊断中的应用与进展[J].东南大学学报(医学版),2003,22(1):67-70.
[11]季聪华. ROC分析方法在中医辨证诊断量表研制过程中的应用[J].中华中医药学刊,2013,33(3):550-551.
[12]徐林发,汪素珍,王柏省.应用ROC曲线求解最佳切点的方法介绍[J].中国卫生统计,2011,28(6):701-702,705.
[13]陈卫中,倪宗瓒,潘晓平,等.用ROC曲线确定最佳临界点和可疑值范围[J].现代预防医学,2005,32(7):729-731.
[14]杜丽新,李书清,李凤莲,等. ROC曲线确定最佳临界点的方法探讨[J].标记免疫分析与临床,2015,22(8):823-824.
[15]王晓刚,宗序平. ROC曲线区分度与最优阈值[J].扬州职业大学学报,2015,19(1):37-40.