气滞血瘀证诊断量表的研制

目的:研制气滞血瘀证诊断量表,为临床诊断气滞血瘀证提供依据。方法:通过101部古代文献与1 121篇现代文献研究,归纳气滞血瘀证相关症状体征,构建专家咨询调查问卷;对45名高级职称医师及研究者进行相关咨询,明确诊断量表研制的形式及内容,并据此设计了气滞血瘀证患者临床研究调查表;通过调查表收集1 076例患者临床信息数据,采用聚类分析,频数分析,因子分析,相关性分析,Spearman相关系数,主成分分析,Logistic逐步回归,区分度,受试者工作特征曲线(ROC曲线)等统计学分析结合专家咨询的方法筛选量表条目,并通过界值与赋权形成气滞血瘀证诊断量表。结果:本量表包涵10个条目,分别为疼痛、情志不遂、胀痛、窜痛、胸闷、肿块和包块、舌上瘀斑或瘀点、舌质紫暗、脉涩和脉沉,最高诊断分数达到51.5分,当分数≥20分时,即可诊断为气滞血瘀证。本量表的特异度81.91%,敏感度80.35%,判断准确率80.94%。结论:气滞血瘀证诊断量表具有一定的普适性,其特异度、敏感度及判断准确率均达到了预期目标,可为气滞血瘀证的临床诊断提供参考依据。

Constructing Diagnosis Scale for Qi Stagnation and Blood Stasis Syndrome

Objective:To construct the diagnosis scale for Qi stagnation and blood stasis syndrome (QSBSS), and provide the basis for clinical diagnosis of QSBSS. Method:Through the ancient and modern literature analysis, we summarized the symptoms and signs of QSBSS and constructed an expert consultation questionnaire.After consulting 45 senior professional doctors and researchers, we made clear the form and content of the development of the diagnostic scale and designed a clinical research questionnaire for QSBSS patients.Then, we investigated 1 076 patients and collected their clinical data.Through several statistical analysis methods, including cluster analysis, principal component analysis, factor analysis, discrimination analysis, Spearman correlation coefficient, Logistic stepwise regression, receiver operating characteristic (ROC) curve, and expert consultation, we screened the scale items.Finally, we made the diagnosis scale by determining the boundary value and empowering. Result:The diagnosis scale contained 10 items, which were pain, emotional frustration, distending pain, scurry pain, chest distress, lumps in body, petechia in the tongue, purplish tongue, unsmooth pulse and deep pulse.The maximum score was 51.5 points and a score of 20 points could be diagnosed as QSBSS.The sensitivity of the scale was 80.35%, the specificity was 81.91%, and the accuracy rate was 80.94%. Conclusion:The diagnosis scale for QSBSS is universally suitable, and its sensitivity, specificity and accuracy rate reach the expected target, which can provide the basis for clinical diagnosis of QSBSS.