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基于共识法的湿证诊断标准研究

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目的 通过科学、规范的研究方法建立湿证诊断标准。方法 通过文献研究运用结构化工具全面集成湿证辨证依据，并通过问卷调查及共识会议法就湿证内涵及外延、判定依据以及标准构建等开展深入调查，达成共识。结果 经过文献研究获得湿证辨证依据36项。通过问卷调查有专家建议应探索更贴近临床实际的湿证诊断模式，据此本研究就"如何确立诊断"这一关键问题深入思考。分析发现，湿证存在特异性/敏感性指标;经深入调查，在文献研究基础上确定了11项特异性及19项敏感性指标，并根据专家建议将特异性指标以湿性特征分为3类。同时，本研究系统梳理了证候标准的诊断属性并相应归纳为4种模式，据此经调查决定湿证标准宜采用特异性模式和相似度/一致性模式，并进一步明确了符合湿证诊断属性的判定形式。结论 本标准可为湿证临床诊断提供依据;同时，本研究探索了证候的诊断属性，可为其他证候标准的研制提供参考。
Research on the Diagnostic Criteria for Dampness Syndrome Based on Consensus Method
Objective To establish diagnostic criteria for dampness syndrome through scientific and normative research methods.Methods The basis for syndrome differentiation of dampness syndrome was comprehensively integrated through literature research and structured tools,and in-depth investigation was carried out on the connotation and extension of dampness syndrome,judgment basis and criteria construction through questionnaire surveys and consensus conference method.Results Thirty-six items for syndrome differentiation of dampness syndrome were obtained through literature research.Through the questionnaire surveys,some experts suggested that the diagnosis mode of dampness syndrome should be in line with the clinical practice requirements.Accordingly,we were deep in thought about the key issue of"how to establish accurate diagnostic criteria".After in-depth investigation,we found that the dampness syndrome had specific and sensitive indicators.And 11 specific and 19 sensitive indicators were determined.Furthermore,according to the experts'suggestions,the specific indicators were classified into three categories based on dampness characteristics.Meanwhile,we investigated the diagnosis attributes of Chinese medicine syndromes and summarized them into four corresponding modes.Based on this,specificity mode and similarity/consistency mode should be adopted for diagnostic criteria for dampness syndrome.In addition,the judgment form in accord with the diagnostic attributes of dampness syndrome was determined.Conclusion This diagnostic criteria can provide a basis for the clinical diagnosis of dampness syndrome.Besides,this study explored the diagnostic attributes of Chinese medicine syndromes,which could provide reference for the development of other Chinese medicine syndrome criteria.

Dampness syndromeDiagnostic criteriaConsensus methodLiterature researchSelf-administered questionnaires method

李倩、吴文珍、艾芷萱、周砾磊、刘书君、杨小波

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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

广州中医药大学第二临床医学院 广州 510405

湿证 诊断标准 共识法 文献研究 自填问卷法

广州市科学技术局广州市科技计划项目省部共建中医湿证国家重点实验室重点项目省部共建中医湿证国家重点实验室重点项目广东省卫生健康委员会广东省医学科学技术研究基金项目

2024A03J0722SZ2021ZZ05SZ2021ZZ0501B2021437

2024

10.11842/wst.20230531007

世界科学技术-中医药现代化
中科院科技政策与管理科学研究所，中国高技术产业发展促进会

世界科学技术-中医药现代化

CSTPCD北大核心
影响因子：1.175
ISSN：1674-3849
年,卷(期)：2024.26(6)
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