基于德尔菲专家咨询法对哮喘异常黑胆质病证异常体液成熟、清除标准的研究

 为建立哮喘异常黑胆质病证异常体液成熟、清除标准,采用改良德尔菲专家咨询法进行两个阶段的专家咨询研究.第一阶段,编制哮喘异常黑胆质病证异常体液成熟、清除的入选指标专家咨询问卷,并向全疆30位维吾尔医学专家发送,通过频数计算筛选出精神气色逐步好转,小便色清、量多,脉象呈粗和(或)波浪状等频率大于70%的11个哮喘异常黑胆质病证异常体液成熟的证侯特征;睡眠质量明显提高,舌苔滋润,恢复原气质时的状态,大便颜色略黑呈铁锈色,随后变成淡黄色或土黄色等频率大于70%的10个哮喘异常黑胆质病证异常体液清除的证侯特征,共进行一轮.第二阶段,根据筛选结果再次编制咨询表,并进行对哮喘异常黑胆质病证异常体液成熟、清除证侯特征权重系数的研究,共进行两轮咨询.每轮回收有效问卷均30份,回收率均100%.专家平均权威系数为0.87,提示专家权威度高.经分析各证侯特征权重系数,得出判断哮喘异常黑胆质病证异常体液成熟的主症为6个,次症为5个;判断哮喘异常黑胆质病证异常体液清除的主症为5个,次症为5个.专家集中程度和协调程度均高,各证侯特征变异系数均小于0.3,哮喘异常黑胆质病证异常体液成熟证侯特征一致性系数为χ²=0.275,P=0.000,两轮相等;哮喘异常黑胆质型异常体液清除证侯特征一致性系数为χ²=0.270,P=0.000,两轮相等.由此得出,通过改良德尔菲法建立的哮喘异常黑胆质病证异常体液成熟、清除标准,为哮喘异常黑胆质病证异常体液成熟、清除的正确诊断、规范用药、提高疗效提供客观量化依据.

The Syndrome Characteristics Criteria of Matured and Removed Abnormal Hilit of Abnormal Savda Type Asthma in Uyghur Medicine Based on Delphi Method

The two-stage expert consulting research is carried out to set up the diagnostic criteria for the abnormal hilit matured and removed from the body on the abnormal savda type asthma in traditional Uighur medicine based on the Delphi method. In the first stage, an enquiry form is formulated to include key syndrome characteristics identified from the past research results of our research group, and is sent to 30 experts in this field from all around the Xinjiang province. One round Delphi technique is conducted in this stage. Then, 11 kinds of syndrome characteristics, such as the gradual improvement of the mental color, the clear urine in large amount, thick and (or) wavy pulse, are selected as the diagnostic criteria for the abnormal hilit matured on the abnormal savda type asthma and 10 kinds of syndrome characteristics, such as the significant improvement of the sleep quality, the tongue moisture and restore the state of original temperament, a little black and rust-colored stool first, then pale yellow or kaki,are selected as the diagnostic criteria for the abnormal hilit removed from the body on the abnormal savda type asthma in accordance with a high expert consensus of frequency greater than 70% (21 out of 30 experts). In the second stage, a new enquiry form is formulated based on the screened results of the first stage, and the weight coefficients of the selected syndrome characteristics are studied, and the two-round Delphi technique is used in this stage. 30 copies of valid questionnaires were responded each round. The expert authority coefficient is 0.87 on average, which would be considered as a high authority degree. By analyzing the weight coefficients of each selected syndrome characteristics, 6 kinds of syndrome characteristics are considered as the chief symptoms and other 5 kinds of syndrome characteristics are considered as the subsequent symptoms for diagnosing the abnormal savda type asthma abnormal hilit ( matured or not). 5 kinds of the chief symptoms and other 5 kinds of the subsequent symptoms are selected for diagnosing the abnormal savda type asthma abnormal hilit ( removed from body or not). The experts enjoy a high concentrated and coordinate degree, the variation coefficients of each syndrome characteristics are less than 0.3. The consistency coefficients for the abnormal savda type asthma abnormal hilit matured diagnostic criteria is χ²=0.275, P=0.000 and the same with the second round; for the diagnostic criteria of the abnormal savda hilit removed from body, it is χ²=0.270, P=0.000, and the same with the second round. The establishment of the diagnostic criteria for the abnormal hilit matured and removed from the body on the abnormal savda type asthma in the traditional Uighur medicine based on the modified Delphi method is shown to provide an objective and quantitative basis for the effective, standardized diagnosis and treatment of asthma.