痛经中医证候的德尔菲法专家咨询研究
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摘要
目的应用德尔菲法,对痛经的中医证候进行问卷分析,探讨痛经的中医证候特点。方法根据德尔菲法的原理,依据《中医基础理论》《中医诊断学》《中医妇科学》《中药新药临床研究指导原则》,结合课题组的临床诊治经验制定了"痛经中医证候专家咨询表"。中医妇科专家独立评定后收回,进行统计分析。根据第一轮专家咨询结果,以及专家增补信息,再制定第二轮专家问卷,仍请以上专家进行了第二轮咨询,对专家第二次评定结果再进行统计分析。若专家两轮咨询意见还未一致,将进行更多轮的咨询,直至意见趋于一致。结果第一轮调查发出专家咨询表30份,收回30份,回收率为100%。第二轮调查发出30份,收回30份,回收率为100%。说明专家积极配合调查咨询。经两轮专家问卷咨询,专家意见趋于一致,认为痛经最"常见"中医证候是气滞血瘀、阳虚内寒和寒湿凝滞;"比较常见"中医证候是湿热下注、肾虚血瘀、阴虚血瘀;专家普遍认为"不常见"中医证候是气血虚弱、肝肾亏虚和阴虚内热。同时获得了各证候的症状、体征在诊断中的权重,即诊断各证候的主症和次症。结论德尔菲法专家咨询法对于痛经的证候诊断具有重要参考意义,其测量结果具有数理统计特性,能获得较为客观、符合临床实际的信息,期望能为痛经诊断治疗方案标准化、规范化,提供客观有效的借鉴。
Objective To conduct the questionnaire analysis on TCM syndromes of dysmenorrhea based on Delphi method and explore the characteristics of TCM syndromes of dysmenorrhea. Methods According to the principle of Delphi method,in reference to Basic Theory of Traditional Chinese Medicine,Diagnosis of Traditional Chinese Medicine,Gynecology of Traditional Chinese Medicine and Guide on Clinical Research of New Drugs of Chinese Medicine,in combination with the clinical diagnostic and treatment experiences of the project team,the Expert questionnaire on TCM syndromes of dyemenorrhea was developed. The experts of TCM gynecology made the evaluation independently and the questionnaire was collected for statistical analysis. Based on the first-round consultation results and the supplementation information from the experts,the second-round questionnaire was developed and consulted among the same group of experts.The statistical analysis was done afterwards. The more consultations would be provided if the results were not consistent between the two rounds until the results were consistent. Results A total of questionnaire forms were delivered and all of them were returned( 100%) in the first-round investigation. 30 forms were delivered and all of them retuned( 100%) in the second-round one. It showed the experts cooperated actively with the investigation. After two rounds of investigation,the comments were consistent in tendency. It was believed that the most common TCM syndromes of dysmenorrhea included qi and blood stagnation,yang deficiency and internal cold,and stagnation of cold and damp. The common symptoms included downward flowing of damp heat,kidney deficiency and blood stagnation,yin deficiency and blood stagnation. The uncommon syndromes were qi and blood deficiency,liver and kidney deficiency,and yin deficiency and internal heat. The weights for the symptoms and physical signs in diagnosis were obtained,referring to the primary symptoms and the secondary symptoms. Conclusion Delphi method is significant in the syndrome diagnosis of dysmenorrhea and its results present the mathematical statistical feature provide objective and practical information. It is anticipated that the results can provide the effective references of the normalization of the diagnosis and treatment of dysmenorrhea.
Objective To conduct the questionnaire analysis on TCM syndromes of dysmenorrhea based on Delphi method and explore the characteristics of TCM syndromes of dysmenorrhea. Methods According to the principle of Delphi method,in reference to Basic Theory of Traditional Chinese Medicine,Diagnosis of Traditional Chinese Medicine,Gynecology of Traditional Chinese Medicine and Guide on Clinical Research of New Drugs of Chinese Medicine,in combination with the clinical diagnostic and treatment experiences of the project team,the Expert questionnaire on TCM syndromes of dyemenorrhea was developed. The experts of TCM gynecology made the evaluation independently and the questionnaire was collected for statistical analysis. Based on the first-round consultation results and the supplementation information from the experts,the second-round questionnaire was developed and consulted among the same group of experts.The statistical analysis was done afterwards. The more consultations would be provided if the results were not consistent between the two rounds until the results were consistent. Results A total of questionnaire forms were delivered and all of them were returned( 100%) in the first-round investigation. 30 forms were delivered and all of them retuned( 100%) in the second-round one. It showed the experts cooperated actively with the investigation. After two rounds of investigation,the comments were consistent in tendency. It was believed that the most common TCM syndromes of dysmenorrhea included qi and blood stagnation,yang deficiency and internal cold,and stagnation of cold and damp. The common symptoms included downward flowing of damp heat,kidney deficiency and blood stagnation,yin deficiency and blood stagnation. The uncommon syndromes were qi and blood deficiency,liver and kidney deficiency,and yin deficiency and internal heat. The weights for the symptoms and physical signs in diagnosis were obtained,referring to the primary symptoms and the secondary symptoms. Conclusion Delphi method is significant in the syndrome diagnosis of dysmenorrhea and its results present the mathematical statistical feature provide objective and practical information. It is anticipated that the results can provide the effective references of the normalization of the diagnosis and treatment of dysmenorrhea.
引文
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[6]张晓宁,杜冬青,马海洋,等.隔药灸脐法对原发性痛经患者下腹部疼痛及额外卧床时间的影响[J]. 2015,31(6):528-531.
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[8]荆晶.温经汤合失笑散加味治疗原发性痛经87例观察[J].实用中医药杂志,2016,32(4):318-319.
[2]孙广仁.中医基础理论[M].北京:中国中医药出版社,2002:45
[3]朱文峰.中医诊断学[M].北京:中国中医药出版社,2002:56
[4]张玉珍.中医妇科学[M].北京:中国中医药出版社,2002:137-139.
[5]郑筱萸.中药新药临床研究指导原则试行[M].北京:中国医药科技出版社,2002:245-247.
[6]张晓宁,杜冬青,马海洋,等.隔药灸脐法对原发性痛经患者下腹部疼痛及额外卧床时间的影响[J]. 2015,31(6):528-531.
[7]李毛措,仁青东智.口服藏药结合熨敷疗法治疗原发性痛经23例疗效观察[J].中国民族民间医药,2016,25(14):10-12.
[8]荆晶.温经汤合失笑散加味治疗原发性痛经87例观察[J].实用中医药杂志,2016,32(4):318-319.