骨质疏松症常见中医定性证候轻重程度量化评价

目的：构建骨质疏松症中医定性证候轻重程度量化评价模型。方法：整理归纳国内有关骨质疏松症症状与证候的相关研究文献，以100mm刻度法结合症状轻重分级赋分法对症状轻重程度进行初步量化，再用综合评价层次分析法确立骨质疏松症中医常见定性证候量化评价目标树层次。然后应用“综合集成研讨厅”专家研讨的方法，组织专家对该模型进行研讨。研讨内容包括确立每个症状轻重量化方法，对定性证候轻重程度层次分析模型中的各层次评价指标进行权重估计，初步构建定性证候轻重程度量化评价层次分析模型。最后在临床上选择220例患者，将该模型运算结果与专家模糊判断结果进行比较。结果：通过以上程序，构建了骨质疏松症精亏证、气虚证、阴虚证、阳虚证、血瘀证的轻重程度量化评价模型，并将其用于220例骨质疏松症患者证候判断。统计1545份骨质疏松症专家判断表结果与量化评价模型判定结果发现，两者完全拟合加基本拟合率为80．91％（1250／1545），如果加上部分拟合，则拟合率达到94．05％。结论：骨质疏松症常见定性证候轻重程度量化评价模型与专家模糊判断有较高的符合率，操作性强，值得在临床上推广应用。如果加上部分拟合，则拟合率达到94．05％。结论：骨质疏松症常见定性证候轻重程度量化评价模型与专家模糊判断有较高的符合率，操作性强，值得在临床上推广应用。

Quantitative evaluation of the degrees of traditional Chinese medicine qualitative syndromes of osteoporosis

OBJECTIVE： To establish a quantitative estimate model for diagnosing traditional Chinese medicine （TCM） syndromes of patients with osteoporosis. METHODS： Symptoms and signs of osteoporosis and methodology related to syndrome research were collected by reviewing medical literature. The symptoms and sighs were quantitatively classified into three, two or one category according to a lO0-mm visual analog scale. Fuzzy comprehensive evaluation model of TCM qualitative syndromes was performed based on analytic hierarchy process. Then ＂Hall for Workshop of Metasynthetic Engineering＂ expert symposium was held on subjects of syndrome quantification method and weight of evaluation indices in different levels for developing the analysis model of common syndromes. For clinical verification, the created models were applied to patients with osteoporosis for discriminating syndromes. Syndrome of each patient was also identified by 8 experts major in integrative medicine treating osteoporosis for comparing the coincidence rate using a self-made clinical questionnaire. RESULTS： Through literature reviewing, symptoms and signs quantification and expert discussing, the authors formed estimate models of essence deficit, qi deficiency, yin deficiency, yang deficiency, and blood stasis. A total of 220 patients with osteoporosis were enrolled and filled the clinical questionnaire. All 8 experts completed and returned the questionnaire （1 760 cases）, and 1 545 of them were filled in completely. Experts＇ opinion on syndrome differentiation was exactly coincidence to estimate model in 611 cases and almost coincidence in 639 cases. The total coincidence rate reached to 94.05%. CONCLUSION, The estimate model for syndrome differentiation of osteoporosis has a high-coincidence rate with the fuzzy evaluation from experts, with good rationality and feasibility, and is worthy of promotion in the clinical study.