建立胃肠气滞证诊断量表的评价体系

Establishment the Evaluation System of the Diagnostic Scale for Gastrointestinal Qi Stagnation Syndrome

目的初步构建胃肠气滞证评价体系。方法在课题组前期医学文献系统评价的基础上,采用德尔菲法,将24个高频条目通过3轮专家咨询确定条目指标,结合层次分析法明确指标比重值,初步构建胃肠气滞证评价体系。结果3轮专家德尔菲法共收回有效问卷84份,其中,第1轮15份,第2轮32份,第3轮37份。经统计,筛选出胀满(闷)或胀痛或窜痛(胃脘部、腹部等)、嗳气、肠鸣、矢气等16个条目。层次分析法得到一级指标的比重由高到低的排序分别为:临床症状、脉象、舌象;二级指标的比重由高到低的排序分别为:胀满(闷)或胀痛或窜痛(胃脘、腹部等)、脉弦、苔腻、苔薄白、脉弦滑、脉沉弦、舌质淡红、矢气、肠鸣、嗳气、遇情志不遂时易诱发或加重、呃逆、腹部时聚包块、纳呆、呕吐、嗳腐吞酸。结论以德尔菲法和层次分析法对胃肠气滞证进行研究,初步形成了评价体系,且指标结构合理,针对性强,具有较强的临床实用性。

Objective To establish a preliminary evaluation system for gastrointestinal qi stagnation syndrome.Methods On the basis of the systematic evaluation of medical literature in the early stage of the research group,24 high-frequency items were subjected to Delphi method,the item indexes were determined through three rounds of expert consultation,and the proportion value of the indexes was determined by AHP,and the evaluation system of gastrointestinal qi stagnation syndrome was initially constructed.Results A total of 84 valid questionnaires were collected by three rounds of Delphi method,including 15 in the first round,32 in the second round and 37 in the third round.According to the statistics,16 items including distention(stuffy)or distending pain or moving pain(epigastric,abdominal,etc.),belching,borborygmus,flatus,etc.were selected.The order of the proportion of the first level indexes obtained by the analytic hierarchy process from high to low is:clinical symptoms,pulse,tongue;The proportion of secondary indicators from high to low is as follows:distention(stuffy)or distending pain or moving pain(epigastric,abdominal,etc.),pulse string,greasy fur,thin white fur,slippery pulse string,pulse sinking string,light red tongue,flatus,borborygmus,belching,induced or aggravated in case of emotional distress,hiccup,abdominal mass,anorexia,vomiting,belching and swallowing acid.Conclusion Delphi method and analytic hierarchy process have been used to study gastrointestinal qi stagnation syndrome,and an evaluation system has been preliminarily formed.The index structure is reasonable,targeted and has strong clinical practicability.