基于德尔菲法的《中医治未病实践指南——慢性腰痛易发人群》第2轮专家问卷调查和结果分析

Result of the second round Delphi-based expert questionnaire of TCM preventive treatment practical guideline for chronic low back pain prone group

目的通过德尔菲法(Delphi method)对专家问卷调查的分析,制订出《中医治未病实践指南—慢性腰痛易发人群》(以下简称《指南》)发病因素,进行干预调理(四季调摄、生活起居干预、饮食指导、运动干预、中药、中医适宜技术等),以期改善或纠正偏颇体质,增强腰部肌群力量,从而使体质趋于平和健康。方法采用德尔菲法,在第1轮专家问卷的基础上,编制《指南》第2轮专家问卷,向全国30名专家进行问卷调查。回收有效问卷30份,从《指南》的范围、慢性腰痛易发人群常见易发因素及体质、慢性腰痛易发人群生活方式及习性干预措施、慢性腰痛易发人群中医特色疗法干预等方面进行统计分析。结果通过德尔菲法得出第2轮专家问卷调查共识:(1)慢性腰痛易发因素为腰椎长期受到反复劳损及过度活动等不良因素的刺激、长期姿势不正确和重体力劳动、阳虚体质等11项。(2)在生活方式干预中,有顺应四季气候变化、调整起居习惯、注意保暖等15项。(3)在加强腰背肌锻炼中,有仰卧起坐和飞燕点水等。(4)在中医特色疗法的干预中,有保健按摩、针灸、拔罐、中药外敷等。结论在开展问卷调查的同时结合循证医学开展文献研究,将循证医学与德尔菲法结合起来相互参照、对比,最后形成科学、客观、系统的中医治未病实践指南。

Objective To formulate the risk factors of traditional Chinese medicine （TCM） preventive treatment practical guideline for chronic low back pain prone group through the Delphi - based expert questionnaire, and then conduct intervention and regulation including recuperating of four seasons, life intervention, dietary guidance, exercise intervention traditional Chinese medicine and TCM appropriate technology, etc. Expecting to improve or correct biased constitution, strengthen the waist muscles, thereby making the constitution tend to mild and healthy. Methods Based on the first round Delphi - based expert questionnaire, the second round （30 nationwide experts questionnaire） was compiled. Finally acquired 30 effective questionnaires, then the statistical data was analyzed from scope of the ＂guide＂, common risk factors, constitution, lifestyle and habits intervention, TCM characteristic therapy intervention and the other aspects of chronic low back pain prone group. Results The second round expert question- naire had been reach a consensus that firstly there were 11 risk factors of chronic low back pain including the stimulation of long - term repeated strain and hyperactivity and the other negative factors, long - termincorrect body posture, hard physical labour and yang - deficiency constitution, etc. Secondly, there were 4 items of lifestyle interventionsinclud- ing adapted to the climate changes of four seasons, adjusted the living habits, and paid attention to staying warm, etc. Thirdly, the exercises for strengthening the low back muscles including sit - ups and swallow flying to touch water, etc. Finally, the TCM characteristic therapy interventions including keepfit massage, acupuncture and moxibustion, cupping, external application of TCM, etc. Conclusion Combined the questionnaire and document research, the results are contrast between Evidence - based medicine and Delphi method, eventually forming a scientific, objective and systematic practical guideline guideline for TCM preventive treatment of disease.