首页|浊毒证诊断量表的研制与权重赋值——基于德尔菲法及层次分析法

浊毒证诊断量表的研制与权重赋值——基于德尔菲法及层次分析法

The Development and Weight Assignment of the Diagnostic Scale of Turbid Toxin Syndrome:Based on Delphi and Hierarchical Analysis Process

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目的 初步构建浊毒证诊断量表,为中医证候标准化、规范化研究提供参考.方法 检索《中华医典》及中国知网(CNKI)、万方数据知识服务平台(WF)、维普数据库(VIP)各数据库建库之日至2022年9月1日浊毒证古籍条文及现代文献,初步筛选浊毒证四诊信息,建立条目池,开展横断面临床调查.运用离散趋势法、相关系数法、克朗巴赫系数法、因子分析法对条目进行客观筛选,通过三轮德尔菲法专家调查确定量表条目,采用层次分析法得到各条目判断矩阵分值及相对比重,一致性检验通过后等比扩大相对比重得到各条目权重并赋值,最终构建浊毒证诊断量表.结果 共纳入35篇文献,初筛后得到45个条目.经临床调查,离散趋势法中有12个条目不符合,相关系数法中有23个条目不符合,从内部一致性筛选有13个条目去掉后克朗巴赫α系数上升,因子分析法中有10个条目不符合,综合运用四种统计学方法客观筛选后保留22个条目.三轮德尔菲法专家咨询中专家积极系数均为96.67%,专家权威系数分别为0.834、0.856、0.867,协调系数为0.126、0.326、0.312,经咨询临床专家、三轮德尔菲法调查及层次分析法权重赋值后,最终确立浊毒证诊断量表条目,主症:舌质暗红或紫暗,苔黄腻或燥(10分);大便黏腻不爽(8分);口味不和(包括口臭、口黏腻、口干、口苦)(6分);小便不利或小便黄/赤(5分);面色晦暗(4分).次症:身体困重(3分);头昏蒙不清(3分);分泌物多、黏腻、臭秽(2分);脉弦滑,或滑或滑数(2分);腹部板硬感(1分).结论 采用德尔菲法联合层次分析法,定性与定量有机结合,初步研制出了浊毒证诊断量表.
Objective To construct traditional Chinese medicine(TCM)diagnostic scale of turbid toxin syn-drome in order to provide corresponding reference for the standardization of TCM syndromes and studies.Methods We systematically searched the Chinese Medical Dictionary(CMD),China Knowledge Network(CNKI),Wanfang Data Knowledge Service Platform(WF)and VIP database for TCM classics and modern literature on turbid toxin syn-drome,and initially screened the four diagnosis information of turbid toxin syndrome,established a pool of informa-tion entries,and conducted a cross-sectional clinical survey.Discrete trend method,correlation coefficient method,Cronbach's coefficient method,and factor analysis method were applied to objectively screen the entries.The diagnos-tic scale of turbid toxin syndrome were constructed through three rounds of Delphi method expert survey to determine the scale entries,using hierarchical analysis to get the judgement matrix scores and relative weight of each entry,after passing consistency test and then isometric expansion of the relative weight of the entries to get the weight of each en-try and assign the value.Results A total of 35 articles were included,45 entries were obtained after the initial screening.After the clinical investigation,12 entries were not suitable by the discrete trend method,23 entries not suitable by correlation coefficient method,13 entries by the internal consistency screening were removed with the Cronbach's alpha coefficient rising,and 10 entries not suitable by the factor analysis method.Twenty-two entries were retained after objective screening by the combined use of the four statistical methods.The positive coefficients of experts in the three rounds of Delphi method of expert consultation were 96.67%,the coefficients of expert authority were 0.834,0.856,and 0.867,and the coefficients of co-ordination were 0.126,0.326,and 0.312,respectively.After consulting with clinical experts,and three rounds of Delphi method survey and hierarchical analysis method weight assignment,the diagnostic scale entries of turbid toxin syndrome were finally established.Primary symp-toms:dark red or purple and dusky tongue,yellowish greasy or dry coating(10 points);sticky and unpleasant stools(8 points);disharmony of tastes including halitosis,sticky and greasy taste in the mouth,dry mouth and bitter taste in the mouth(6 points);unfavourable or yellowish or red urination(5 points);and dark complexion(4 points).Secondary symptoms:heavy body(3 points);dizziness(3 points);profuse,sticky,foul-smelling secretions(2 points);wiry and slippery,or slippery,or slippery and rapid pulse(2 points);feeling of hardness in the abdomen(1 point).Conclusion Using Delphi method combined with the hierarchical analysis method,combining qualita-tive and quantitative study,a diagnostic scale of turbid toxin syndrome was initially developed.

turbid toxin syndromediagnostic scaleDelphi methodhierarchical analysis method

刘晓雨、刘志华、李京璠、李润泽、王玉曼、薛滨清、张心千、杨倩、杜艳茹

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河北中医药大学,河北省石家庄市桥西区红旗街道新石南路326号,050020

河北省中医院

河北省浊毒证重点实验室

河北省中西医结合胃肠病研究重点实验室

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浊毒证 诊断量表 德尔菲法 层次分析法

国家中医药管理局项目河北省重点研发计划河北省中医药管理局科研计划河北省研究生创新资助项目

GZY-KJS-2023-01323377701D2023019XCXZZSS2023022

2024

中医杂志
中华中医药学会 中国中医科学院

中医杂志

CSTPCD北大核心
影响因子:1.464
ISSN:1001-1668
年,卷(期):2024.65(7)
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