中医证候诊断标准研制现状与思考

Current status and considerations for the development of diagnostic criteria for traditional Chinese medicine syndrome

对中医证候诊断标准的研究现状进行回顾,并探讨未来发展思路。在发展模式上,中医证候诊断标准是“证诊断标准”和“病证结合诊断标准”并行发展的两种模式。在制定方法上,运用到德尔菲法、层次分析法等多种循证医学研究方法。在应用模式上,以病证结合诊断标准应用较为广泛,操作性强,更适于临床推广和使用。总体来说,中医证候诊断标准研究呈现出由浅入深、由点到面、由定性到定量的发展趋势,为中医临床诊断提供了较为客观、标准化的工具。未来中医证候诊断标准的发展主线或将以病证结合诊断标准为主,同时建立中医证候诊断标准的方法学规范,强化诊断性试验的应用;重视中医证候诊断标准中名词术语的规范化研究;随着诊断技术的进步,探索并构建微观诊断指标体系或是未来中医证候诊断标准的突破口。

This paper reviews the research status of traditional Chinese medicine(TCM)syndrome diagnostic criteria,and discusses the future development ideas.In terms of development mode,the diagnostic criteria of TCM syndrome are two parallel development modes of‘syndrome diagnostic criteria’and‘diagnostic criteria of combination of disease and syndrome’.In the formulation of methods,Delphi method,analytic hierarchy process and other evidence-based medicine research methods are used.In the application mode,the combination of disease and syndrome with diagnostic criteria is widely used and has strong operability,which is more suitable for clinical promotion and use.In general,the study of TCM syndrome diagnostic criteria shows a development trend from shallow to deep,from point to surface,and from qualitative to quantitative,which provides a more objective and standardized tool for TCM clinical diagnosis.In the future,the main development line of TCM syndrome diagnostic criteria may focus on the combination of disease and syndrome,establish methodological norms of TCM syndrome diagnostic criteria,and strengthen the application of diagnostic tests;Pay attention to the standardization of terms in the diagnostic criteria of TCM syndromes.With the progress of diagnosis technology,exploring and constructing micro diagnosis index system or the breakthrough of TCM syndrome diagnosis standard in the future.