基于德尔菲法的四弯风中医临床诊疗指南专家问卷调查研究

The TCM diagnosis and treatment guideline of the wind of four fossae： a Delphi concensus study

目的通过问卷调查，筛选和评价四弯风常见证型及其治法方药，为四弯风中医诊疗指南的制定提供参考。方法采用德尔菲法，住文献研究基础上制定《四弯风中医诊疗指南专家调查问卷》，对全国25位专家分别进行2次问卷调查，并将训查结果建立数据库。采用SAS6.12软件进行均数、变异系数、满分比及等级和统计分析，筛选和评价四弯协l常见证型及其治法方药。结果第1、2轮训查回收有效问卷分别为2l、23份，专家积极系数分别为84％、92％。四弯风常见证型中，以胎热、湿热蕴结、脾虚血燥、风湿蕴肤和血虚风燥5个证型的专家意见集中和协训程度最高，均数依次为1．67、1．90、1．83、1．7l、1．90，等级和依次为37、40、42、36、40，满分比依次为0．8l、0．90、0．87、0．71、0．90，变异系数依次为0．32、0．16、0．27、0．27、0．16。治法方药中，胎热证治宜清心导赤，方用三心导赤饮；湿热蕴结证治宜清热利湿，方用龙艄泻盯汤；风湿蕴肽证治宜祛风除湿，方用消风散；血虚风燥证治宜养血润燥，方用当归饮子；脾虚血燥证治宜益气健脾、养血祛风，方用参苓白术散合当归饮子。结论问卷训查可将专家意见量化，为四弯风中医诊疗指南的制定提供参考。

Objective To evaluate the common traditional Chinese medicine syndrome types, therapies and formulas of the wind of four Ibssae. This will provide reference for the formulation of the guideline for the diagnosis and treatment of traditional Chinese medicine in the wind of four tbssae. Methods Delphi method using questionnaires were developed based on literature about TCM syndromes and treatment of the wind of four fossae. The questionnaire were sent to 25 experts nationwide for 2 rounds. The database of the collected data was established. The mean, full score ratio, rank sum and coefficient of variation were described and by SAS 6.12 statistical software. Results A total of 21 valid questionnaires were recovered in the first round and 23 valid questionnaires in the second round. The active coefficient of the experts was 84% and 92%, respectively. The results showed that syndromes of newborn beat, damp heat retention, spleen deficiency and blood dryness, wind dampness accumulating skin, blood deficiency and wind dryness demonstrated high concensus. The consistency scores＇ mean of 5 syndromes were 1.67, 1.90, 1.83, 1.71 and 1.90. The sum of degrees of 5 syndromes were 37, 40, 42, 36 and 40. The ratio of full scores of 5 syndromes were 0.81, 0.90, 0.87, 0.71 and 0.90. The coefficient of variations of 5 syndromes were 0.32, 0.16, 0.27, 0.27 and 0.16. The therapy of syndrome of newborn heat was clearing away the heart-fire and inducing diuresis by the sanxin daochi decoction; The therapy of syndrome of damp heat retention was clearing heat and removing dampness by longdan xiegan decoction; The therapy of syndrome of wind dampness accumulating skin was dispelling wind and eliminating dampness by xiaofeng san; The therapy of syndrome of spleen deficiency and blood dryness was enriching blood and moistening dryness by danggui decoction; The therapy of syndrome of blood deficiency and wind dryness was replenishing qi to invigorate the spleen and enriching blood to calm endogenous wind by shenling baizhu power and danggui decoction. Conelusion Questionnaire survey could quantify the opinions of experts, and provide reference for the establishment of guideline for the diagnosis and treatment of traditional Chinese medicine in the wind of four fossae.