基于德尔菲法和层次分析法的气滞证诊断条目筛选及权重确定

Selection and Weight Determination of Diagnostic Items for Qi Stagnation Syndrome Based on Delphi Method and Analytic Hierarchy Process

目的 运用德尔菲法和层次分析法筛选气滞证诊断条目并确定其权重,为研发气滞证诊断量表提供参考。方法 检索中国知网(CNKI)、万方数据知识服务平台(WF)、维普数据库(VIP)、中国生物医学文献服务系统(SinoMed)各数据库建库至2020年10月31日收录的气滞证相关文献。通过文献系统评价、专家讨论方式,规范中医四诊信息并构建条目池。采用德尔菲法筛选条目指标,结合层次分析法明确各条目权重。用均数、满分比、等级和、不重要百分比、变异系数等统计方法进行条目筛选,并用层次分析法计算条目权重。结果 共纳入文献235篇,构建的条目池包含16个条目。三轮德尔菲法专家咨询共回收有效问卷84份,总专家积极系数为99%,专家权威程度分别为0.86、0.84、0.83,肯德尔协调系数分别为0.45、0.49、0.29。经统计分析,筛选出胀满(闷)或胀痛或窜痛、脉弦、情志抑郁、太息、脉沉弦、急躁易怒、舌质淡红、苔薄白8个气滞证诊断条目。层次分析法确定的一级指标权重由高到低为临床症状、脉象、舌象;二级指标权重由高到低为胀满(闷)或胀痛或窜痛、脉弦、情志抑郁、太息、脉沉弦、急躁易怒、舌质淡红、苔薄白。结论 通过德尔菲法和层次分析法对气滞证诊断条目进行分析和评估,筛选出气滞证诊断条目并确定其权重,为气滞证诊断量表的开发奠定基础。

Objective Using the Delphi method and analytic hierarchy process(AHP)to screen diagnostic items for qi stagnation syndrome and determine their weights,providing a reference for the development of a diagnostic scale of qi stagnation syndrome.Methods Literature related to qi stagnation syndrome were screened from databases including CNKI,Wanfang,VIP,SinoMed(from inception to October 31,2020).Through systematic review of literature and expert discussions,the information on the four examinations of traditional Chinese medicine were organized and an item pool was constructed.The Delphi method was used to screen the item indicators,while the AHP was employed to determine their weights.Statistical methods such as mean value,full score ratio,rank sum,unimportant percentage,and coefficient of variation were used for item screening,with the weights calculated by AHP serving as the item weights.Results A total of 235 articles and books were included for analysis,resulting in an item pool of 16 items.After three rounds of expert consultation,a total of 84 valid questionnaires were collected,with a total expert enthusiasm coefficient of 99%and authority coefficient of 0.86,0.84,0.83,respectively,and the coordination coefficients were 0.45,0.49,and 0.29,respectively.Through the statistics analysis,8 diagnosis items were screened out,including distension(stuffi-ness)or distending pain or scurrying pain,wiry pulse,depressed emotions,frequent sighing,deep and wiry pulse,irritability,pale red tongue,and thin white coating.The AHP showed that the order of weights of the first-level indicators from high to low was clinical symptoms,pulse manifestation,and tongue manifestation;the order of weights of the second-level indicators from high to low was distension(stuffiness)or distending pain or scurrying pain,wiry pulse,depressed emotions,frequent sighing,deep and wiry pulse,irritability,pale red tongue,and thin white coating.Conclusion By applying the Delphi method and AHP to analyze and evaluate the diagnostic items for qi stagnation syndrome,key diagnostic items were screened and their weights determined,laying the foundation for the development of a diagnostic scale for qi stagnation syndrome.