[骨质疏松症中医定性证度定量评价]。

Dong-tao Li, Jian Wang, Hong-yang Jiang, Feng-lei Shi, Fu-yu Li, Ji-hong Liu, Yong-mei Cheng, Nan Yan, Ai-hua Hu, Mei-zeng Zhang, Jie Li, Ling-bo Wei, Rong-qin Jiang
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引用次数: 0

摘要

目的:建立骨质疏松症中医证候诊断的定量估计模型。方法:通过查阅医学文献,收集骨质疏松症的症状、体征及与证候研究相关的方法学。根据100毫米视觉模拟量表将症状和体征定量分为三类、二类或一类。基于层次分析法建立中医定性证的模糊综合评价模型。随后召开了“综合工程研讨厅”专家研讨会,讨论了常用的证候量化方法和不同层次评价指标的权重,以建立常见的证候分析模型。为了临床验证,将所建立的模型应用于骨质疏松症患者进行辨证。并由8名骨质疏松症中西医结合专业专家对每位患者的证候进行鉴定,采用自制临床问卷进行符合率比较。结果:通过文献复习、证候量化和专家讨论,形成精虚、气虚、阴虚、阳虚、血瘀的估计模型。共纳入220例骨质疏松症患者并填写临床问卷。8名专家全部填写并返回问卷(1 760份),其中1 545份填写完整。611例专家的辨证意见与估计模型完全重合,639例几乎重合。总符合率达94.05%。结论:骨质疏松症辨证评价模型与专家模糊评价符合率高,具有较好的合理性和可行性,值得在临床研究中推广。
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[Quantitative evaluation of the degrees of traditional Chinese medicine qualitative syndromes of osteoporosis].

Objective: To establish a quantitative estimate model for diagnosing traditional Chinese medicine (TCM) syndromes of patients with osteoporosis.

Methods: Symptoms and signs of osteoporosis and methodology related to syndrome research were collected by reviewing medical literature. The symptoms and sighs were quantitatively classified into three, two or one category according to a 100-mm visual analog scale. Fuzzy comprehensive evaluation model of TCM qualitative syndromes was performed based on analytic hierarchy process. Then "Hall for Workshop of Metasynthetic Engineering" expert symposium was held on subjects of syndrome quantification method and weight of evaluation indices in different levels for developing the analysis model of common syndromes. For clinical verification, the created models were applied to patients with osteoporosis for discriminating syndromes. Syndrome of each patient was also identified by 8 experts major in integrative medicine treating osteoporosis for comparing the coincidence rate using a self-made clinical questionnaire.

Results: Through literature reviewing, symptoms and signs quantification and expert discussing, the authors formed estimate models of essence deficit, qi deficiency, yin deficiency, yang deficiency, and blood stasis. A total of 220 patients with osteoporosis were enrolled and filled the clinical questionnaire. All 8 experts completed and returned the questionnaire (1 760 cases), and 1 545 of them were filled in completely. Experts' opinion on syndrome differentiation was exactly coincidence to estimate model in 611 cases and almost coincidence in 639 cases. The total coincidence rate reached to 94.05%.

Conclusion: The estimate model for syndrome differentiation of osteoporosis has a high-coincidence rate with the fuzzy evaluation from experts, with good rationality and feasibility, and is worthy of promotion in the clinical study.

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