梅核气诊断标准的应用现状分析与思考

Analysis of the Application Status of the Diagnostic Criteria for Plum-stone Qi(Globus Hystericus)

目的调查当前梅核气诊断标准的应用现状,分析梅核气诊断标准的演变与制定思路,为梅核气的诊断标准制定及相关研究提供依据。方法检索1981年1月1日至2020年12月31日国内发表的引用梅核气诊断标准的临床研究文献,归纳诊断标准的名称、制定时间、组织(制定者)、内容及被引频次,分析各梅核气诊断标准的异同点。结果共检索出临床研究文献60篇,得到梅核气中医诊断标准11个,其中2个为"郁证"诊断标准;9篇临床研究文献同时设置了西医诊断标准,其中1篇参考"癔球症"诊断标准,8篇参考"咽异感症"诊断标准。各诊断标准在梅核气症状方面认识较为一致,但在体征描述方面存在差异。现有梅核气诊断标准存在临床实用性差,与梅核气现代研究结果不符等问题。结论当前梅核气诊断缺乏统一的标准,通过梅核气理论溯源及现代研究明确该病的内涵及外延,在局部体征描述形成共识,逐步完善诊断标准的框架及内涵,是梅核气诊断统一标准的关键。

Objective To investigate the current application status of the diagnostic criteria for plum-stone qi(globus hystericus),and to analyze its evolution discipline and development idea,thereby providing a basis for future related researches.Methods Clinical researches published in China from January 1st,1981 to December 31st,2020,which cited the diagnostic criteria of plum-stone qi were included,and the data on the names,issuing time,issuing organization,contents and citation frequency of diagnostic criteria were summarized for analysis on the similarities and differences between different diagnostic criteria.Results A total of 60 clinical research papers were included,and 11 diagnostic criteria were obtained,of which two were the diagnostic criteria of"constraint syndrome";nine clinical research papers also cited the diagnostic criteria of western medicine,one of which referred to the diagnostic criteria of“globus hystericus”while others referred to the diagnostic criteria of“paraesthesia pharynx”.All the diagnostic criteria had the same understanding in the symptoms of plum-stone qi,but there were differences in the description of signs.The existing diagnostic criteria of plum-stone qi had certain problems,such as poor practicality and inconsistency with the modern research results.Conclusion At present,there is no unified criteria for the diagnosis of plum-stone qi.Through tracing the origin of the theory and exploring the connotation and extension of plum-stone qi,the consensus on the description of local signs may be obtained,and the framework and connotation of the diagnostic criteria can be gradually perfected,which is the key to unify the diagnostic standard of plum-stone qi.