《儿童过敏性紫癜中医诊疗指南》济南地区适用性评价研究

Evaluation of Applicability of Diagnosis and Treatment Guideline of Traditional Chinese Medicine for Children Allergic Purpura in Jinan Area

目的：配合国家中医药管理局中医诊疗标准化研究工作，对《儿童过敏性紫癜中医诊疗指南草案》在济南地区的适用性进行回顾性评价调查。方法：制定《中医临床诊疗指南应用评价病例调查表》，随机收集2012年4月-2014年4月就诊于山东中医药大学附属医院儿科的过敏性紫癜患儿病例，对入选病例的临床资料进行统计分析。结果：①儿童过敏性紫癜病名诊断符合率为100％。其中过敏性紫癜中医证型符合率为90．91％，紫癜性肾炎中医证型符合率为39．48％。②过敏性紫癜中医治则治法符合率为81．82％，方药符合率61．04％；紫癜性肾炎中医治则治法符合率为34．21％，方药符合率为39_47％。③儿童过敏性紫癜中医诊疗临床愈显率86．96％；安全性评价很好占72．17％，较好占27．83％；经济性评价很好占69．56％，较好占21．74％，一般8．70％。结论：该指南基本适用于临床，可作为临床医师治疗本病的规范方案，但需进一步完善；过敏性紫癜辨证分型论治建议增加瘀血阻络型，紫癜性肾炎建议增加湿热夹瘀型、瘀血阻络型、脾肾阳虚型；建议增加调摄与预防内容。

Objective：Cooperating with the standardization of diagnosis and treatment of traditional Chinese medicine（TCM） carried out by the state administration of TCM,to evaluate the applicability of the Draft of Diagnosis and Treatment Guideline of TCM for Children Allergic Purpura in Jinan Area retrospectively. Methods：Children with allergic purpura who visited the affiliated hospital of shandong university of TCM from April 2012 to April 2014 were randomly selected for the study. Their clinical data was filled in the Case Questionnaire for Application Evaluation of Diagnosis and Treatment Guideline of TCM. And then the clinical data was statistically analyzed. Results：①The coincidence rate of the name of children allergic purpura in diagnosis was 100% ,in which the coincidence rate of TCM syndrome of allergic purpura was 90.91% and that of TCM syndrome of purpura nephritis was 39.48%. ②The coincidence rate of TCM thera- peutic principles and methods of allergic purpnra was 81.82% and that of the prescriptions and medicines was 61.04%. The coincidence rate of TCM therapeutic principles and methods of purpura nephritis was 34.21% and that of the prescriptions and medicines was 39.47%. ③The effective and curative rate of TCM diagnosis and treatment for children allergic purpura was 86.96% For security evaluation, ＂terrific＂ accounted for 72.17% and ＂better＂ accounted for 27.83%. For economic evaluation,＂terrific＂ accounted for 69.56%, ＂better＂ accounted for 21.74% and ＂good＂ accounted suitable for clinical application and can be used as the for 8.70%. Conclusion：The guideline was generally standard for treatment of this disease,but it needs further improvement. Suggestions for syndrome differentiation：syndrome of blood stasis in the collateral should be added to the allergic purpura syndrome differentiation. Syndrome of dampness-heat with blood stasis,blood stasis in the collateral and deficiency of spleen and kidney Yang should be added to purpura nephritis syn- drome differentiation. Contents about nursing and prevention should be added.