基于德尔菲法对冠心病痰瘀互结证辨证依据的研究

Assessing for syndrome differentiation basis of intermingled phlegm-blood stasis syndrome in coronary heart disease based on Delphi method

[目的]基于德尔菲法专家咨询明确冠心病中医痰瘀互结证的辨证依据。[方法]在课题前期循证医学文献系统评价基础上,经过多次讨论修正,初步拟定《冠心病痰瘀互结证德尔菲法专家咨询问卷》,在全国范围内,先后开展了两轮德尔菲法专家咨询,共计88位专家参与。第1轮与第2轮咨询问卷的回收率及每位专家对各个问题的应答率,均为100%。[结果]冠心病痰瘀互结证德尔菲法专家咨询问卷的总信度为0.589 0,效度为71.724%,提示所拟定的专家咨询问卷稳定性及有效性尚可。对两轮咨询问卷条目的重要性、集中度、变异度及其排序进行分析,结果表明冠心病痰瘀互结证辨证依据的关键条目为胸闷、胸痛,苔腻,舌质暗(黯)紫,重要条目为舌有瘀斑、瘀点,肢体困重,唇青紫,备选条为脉弦涩,面色晦暗,体胖。[结论]该研究冠心病痰瘀互结证辨证依据的结果可作为临床辨证时的参考。

[Objective] To evaluate the relative importance of syndrome differentiation basis of intermingled phlegm-blood stasis syndrome in coronary heart disease. [Methods] On the basis of the literature evaluation system,expert consultation questionnaire for intermingled phlegm-blood stasis syndrome differentiation of traditional Chinese medicine(TCM) was formulated. two rounds of the modeling symptom quantitative evaluation of the importance of syndrome differentiation basis of intermingled phlegm-blood stasis syndrome in coronary heart disease was constructed. A total of 88 experts were participated. The recovery rate and each question response rate were 100% in two expert consultation questionnaires. [Results] The reliability and validity of two rounds of consultation total were0.5890 and 71.724%,which suggested that stability and validity of the questionnaire were acceptable. The key items for diagnosis of intermingled phlegm-blood stasis syndrome in coronary heart disease were chest tightness/pain,greasy coating,tongue dark purple. The important items were tongue with petechia or bruise,heaviness of limbs,bluish lips. The optional items were wiry and choopy pulse,dim complexion,obesity. [Conclusion] The results of this research could serve as a reference for diagnosis of intermingled phlegm-blood stasis syndrome in coronary heart disease.