肠癌血瘀证量化辨证标准的研究

Study on Quantified Standard of Blood-block Syndrome of Large Intestine Cancer

目的:建立肠癌血瘀证量化辨证标准。方法:在对311例肠癌患者进行临床流行病学调查的基础上,组织专家组对其进行辨证,根据各相关中医症状在血瘀证组和非血瘀证组中出现状况的差异对这些症状进行赋分;应用ROC曲线的方法选择最佳诊断阈值从而建立量化辨证标准;以专家组统一辨证作为"金标准"对建立的量化标准进行回顾性检验。结果:胁刺痛、少腹刺痛、唇紫暗、舌紫、舌青、舌晦暗、舌瘀点瘀癍为肠癌血瘀证的相关中医症状,分别赋为18、16、26、20、20、13、23分;量化辨证标准为≥13分;回顾性检验的敏感度、特异度、准确度均在80%以上,阳性似然比60.60。结论:建立的量化标准的特点是:①较符合肠癌的临床特点;②符合中医辨证的临床实际;③数理统计方法的运用比较合理。

Objective To set a quantified standard on blood-block syndrome of large intestine cancer. Methods Identify blood-block syndrome by experts on the basis of clinical epidemiological investigation on 311 patients suffer- ing from Large intestine cancer and evaluate its correlative factors on the basis of difference of their appearance between blood-block syndrome ans no-blood-block syndrome, and set its quantified diagnosis standard and test it retrospectively. Results flank-bite, lower abdomen-bite, purple lip, purple tongue, blue tongue, tarnish tongue, tongue with petechia are its relative symptoms which is endowed with 18, 16, 26, 20, 20, 13, 23 points respectively; the diagnosis standard of blood-block syndrome of large intestine cancer is 13 points; the Sen, Spe and ACC of retrospective examination are all over 80% and its ＋ LR is 60. 60. Conclusions the quantified standard on blood-block syndrome of large intestine cancer has its characteristics： （1）accordance with clinical characteristic of large intestine cancer ; （2）accordance with characteristic of TCM syndrome diagnosis; （3）rigorous statistical methods.