冠心病常见中医定性证候轻重程度量化评价

Quantitative evaluation of the degrees of qualitative syndromes commonly encountered in patients with coronary heart disease

目的:构建冠心病中医定性证候轻重程度量化评价模型。方法:整理归纳国内有关冠心病症状与证候的相关研究文献,以"综合集成研讨厅"专家研讨的方法,在首先以100mm刻度法结合症状轻重分级赋分法完成对症状轻重程度量化的基础上,以综合评价层次分析法为证候量化评价的数学工具,组织专家对定性证候的各层次评价指标进行权重估计,构建定性证候轻重程度量化评价层次分析模型,然后在临床上将该模型的运算结果与专家模糊判断进行验证。结果:共收集287例次冠心病患者的临床观察表,排除填写不规范的表格,可用的观察表167份。模型运算与专家判断的拟合率为68.26%(114/167),如果加上部分拟合,则可以达到88.62%(148/167)。结论:该模型与专家模糊判断有较高的符合率,具有较好的合理性与可行性,是值得在临床上推广的冠心病常见定性证候轻重程度量化评价模型。

Objective：To establish a quantitative model for evaluating the degree of traditional Chinese medicine （TCM） syndromes often seen in patients with coronary heart disease （CHD）.Methods：Medical literature concerning clinical investigation of TCM syndromes of CHD was collected and organized,and the ＂Hall for Workshop of Metasynthetic Engineering＂ expert symposium method was applied.First,the 100 millimeter scaling was used for combining with scoring on degree of symptoms to establish a quantitative criterion for classification of symptom degree in CHD patients,and the model was established by using comprehensive analytic hierarchy process as the mathematical tool to estimate the weight of the criterion for evaluating qualitative syndromes in various layers by specialists.Then the model was verified in clinical practice and the outcomes were compared with fuzzy evaluation from the specialists.Results：A total of 287 clinical observation forms on CHD cases were collected,and 167 forms were available after excluding any irregular forms.The results showed that basic coincidence rate between the outcomes derived from specialists and those from the model was 68.26% （114/167）,and part coincidence rate was 88.62% （148/167）.Conclusion：This model,with good rationality and feasibility,has a high coincidence rate with fuzzy evaluation from specialists,and can be promoted in clinical practice.It is a good quantitative model for evaluating the degree of TCM syndromes of CHD.