不同职称中医师评判肾阳虚证的一致性

Assessing Diagnostic Agreement of Kidney-yang Deficiency Syndrome Among Chinese Medicine Physicians with Different Professional Titles

目的:评价不同职称中医师对肾阳虚证诊断的一致性。方法:选择职称分别为主任医师、主治医师、医师的3名中医师,运用自编的肾阳虚证调查表对受试者作调查;采用Kappa统计方法分析3位医生的总体辨证结果及各项辨证因子的诊断一致性。结果:医师1和2、1和3、2和3对肾阳虚证诊断的一致性kappa值分别为0.66、0.42及0.57。3名医师诊断一致性较好的症状主要为腰痛酸软、四肢发冷、面目水肿、下肢水肿、五更泄泻、久病咳喘和夜尿频多。结论:不同职称中医师对肾阳虚证诊断的一致性较好,职称层次越接近,诊断一致性越好。

Objective ： To assess the diagnostic agreement of kidney - yang deficiency syndrome among Chinese medi- cine physicians with different professional titles. Methods： Three Chinese medicine physicians whose professional titles are chief physician, attending physician and physician were selected to diagnose subjects with self - compiled question- naire of kidney - yang deficiency syndrome. The kappa statistical analysis was employed to assess the diagnose agreement in differentiation results of both kidney - yang deficiency and each symptoms and signs. Results ： The kappa value of physi- cian 1 and 2, 1 and 3, 2 and 3 was 0.66, O. 42 and 0.57 respectively. Aching in back, coldness of extremities, edema of face, edema of lower extremity, diarrhea before dawn, chronic cough and dyspnea and frequent night urination were generally in good agreement in diagnosing kidney - yang deficiency syndrome between any two of the three physicians, and the kappa value was above 0.4. Conclusion ： Chinese medicine physicians with different professional titles are in good agreement in diagnosing kidney -yang deficiency syndrome.