基于专家咨询问卷调查的慢性肾功能衰竭常见中医证候要素的研究

Common syndrome factors of traditional Chinese medicine in chronic renal failure based on the questionnaire investigation among experts

目的:运用专家咨询问卷调查的方法提取慢性肾功能衰竭的常见中医证候要素。方法:在前期研究结果的基础上,制订专家咨询问卷,对全国8个中心15家医院中长期从事肾病临床工作且具有副高级及以上职称的专家进行调查。在分析专家对该疾病证候要素常见程度评价的均数、累积百分比、变异系数基础上,获取慢性肾功能衰竭的常见证候要素。结果:本次调查共发放问卷114份,收回114份,回收率为100%,其中有效问卷为113份。按照专家给予的证候要素的常见程度评价情况,将同时满足变异系数≤0.35、累积百分比≥60%的结果作为慢性肾功能衰竭的常见证候要素,病位类证候要素有肾、脾、胃、心、肺;病性类证候要素中属实者为湿、浊毒、血瘀、水、痰;属虚者为气虚、阴虚、血虚、阳虚、精亏。结论:通过专家问卷的咨询调查,进一步确定了代表专家共识意见的慢性肾功能衰竭常见中医证候要素,与以往文献研究比较,临床专家在疾病认识方面有了更深层次的认识,同时该结果为后期建立该病基于证候要素的中医证候诊断标准提供了依据。

Objective： To screen common traditional Chinese medicine （TCM） syndrome factors of chronic renal failure （CRF） via questionnaire investigation among experts. Methods： A questionnaire was developed based on the results of our previous researches. The investigation was carried out with the questionnaire among experts who are engaged in clinical research and treatment of nephrosis with the title of chief or associate chief physician from 15 hospitals in China. Common TCM syndrome factors of CRF were obtained based on the data analysis of the mean value on general evaluation, cumulative percentage and coefficient of variation. Results： A total of 114 sets of the questionnaire were sent out and all of them were returned back, 113 of which were effective. The recovery rate was 100 %. The TCM syndrome factors were regarded as common factors of CRF syndrome if the cumulative percentage was more than or equal to 60% and the coefficient of variation was less than or equal to 0. 35. The syndrome factors related to the disease location were the kidney, spleen, stomach, heart, and lung; the syndrome factors related to the disease type were dampness, turbid toxin, blood stasis, water retention, and phlegm which belong to excess type, and qi deficiency, yin deficiency, yang deficiency, blood deficiency, and essence deficiency which belong to deficiency type. Conclusien： The common TCM syndrome factors of CRF were obtained from the representative experts through the questionnaire investigation among the experts. The results enable us to have a deeper understanding of the disease in view of TCM compared with the previous literature data and may contribute to the establishment of TCM syndrome diagnosis criteria of the disease in the future.