胰腺癌湿证量化诊断标准探索性研究

Preliminary study on the quantitative diagnostic criteria of the damp syndrome in patients with pancreatic cancer

目的:探索建立胰腺癌湿证量化诊断标准的方法。方法:2017年12月—2019年2月中国中医科学院广安门医院肿瘤科收集临床诊断为胰腺癌的患者133例,填写临床观察表,依据中医诊断标准进行辨证分组,应用χ;检验筛选相关因素,条件概率法实现条目赋分,极大似然法确定量化诊断阈值,并对建立标准进行回顾性检验。结果:研究建立标准的诊断条目包括身体困重、皮肤瘙痒、口黏腻等15项,诊断阈值为23,回顾性检验显示该标准敏感度为66.7%,特异度为87.0%,准确度为76.0%,阳性似然比为5.11,阴性似然比为0.38。结论:本研究应用病证结合模式初步建立胰腺癌湿证量化诊断标准,可为胰腺癌证候量化研究提供参考。

Objective: To explore the method of establishing quantitative diagnostic criteria for pancreatic cancer damp syndrome. Methods: A total of 133 pancreatic cancer patients form Oncology Department, Guang’ anmen Hospital, China Academy of Chinese Medical Sciences were collected from December, 2017 to February, 2019, fill out the case observation, group the syndromes according to the diagnostic criteria of traditional Chinese medicine. χ;test was used to screen the diagnosis items,conditional probability method to assign the diagnostic items, maximum likelihood to establish diagnostic threshold and the study was examined retrospectively. Results: The standard diagnostic items established by the study included 15 items such as weighted body, cutaneous pruritus, and sticky mouth. The diagnostic threshold was 23. The results of the retrospective examination showed that the sensitivity, specificity, accuracy, positive likelihood ratio and negative likelihood ratio were 66.7%, 87.0%, 76.0%, 5.11 and 0.38 respectively. Conclusion: Applying the disease-syndrome combination model, this study establishes the quantitative diagnostic criteria for pancreatic cancer damp syndrome, which can provide a reference for quantitative research of pancreatic cancer syndrome.