【作者】 戴霞；

【导师】 郭伟星；

【作者基本信息】 山东中医药大学 ， 中医内科学， 2010， 博士

【摘要】 目的：建立老年高血压病肾气亏虚证的宏观量化诊断标准,探索中医证候诊断规范化研究的思路与方法。方法：首先进行老年高血压病中医证候分布规律的现代文献对照研究和临床回顾性研究。在文献调研、临床流行病学调查、专家咨询的基础上,建立老年高血压病肾气亏虚证宏观诊断量表,并从信度、效度、反应度等方面对量表进行考评。以该量表为测量工具,在流行病学调查基础上,经过指标赋权,建立老年高血压病肾气亏虚证的宏观量化诊断模型和标准。最后对该标准进行临床诊断性试验。结果：研究揭示了肾气亏虚证是老年高血压病临床常见中医证型之一。编制了老年高血压病肾气亏虚证宏观诊断量表,综合测评表明该量表信度、效度及反应度良好。在此基础上建立了老年高血压病肾气亏虚证量化诊断标准,诊断阂值为220。临床诊断性试验结果显示,该标准具有较高的灵敏度、特异度、准确度及阳性似然比。结论：通过文献研究、临床流行病学调查、量表研制、统计分析及临床验证建立的规范的老年高血压病肾气亏虚证宏观量化诊断标准具有良好的可行性、准确性和实用价值。本研究成果将为老年高血压病肾气亏虚证的进一步深入研究和临床证候疗效的客观评价提供标准化尺度,为其它病证的证候规范化研究提供规范的可供借鉴的研究思路与方法。更多还原

【Abstract】 Objective:To establish the macroscopic quantitative diagnostic standard of kidney qi deficiency syndrome of elderly hypertension and explore a new method of standardization of TCM syndrome differentiation.Methods:Control study of modern literature and clinical retrospective study on distribution rule of TCM syndromes of elderly hypertension were respectively carried first. The macroscopic diagnostic scale of kidney qi deficiency of elderly hypertension was constituted according to literature research, clinical epidemiological investigation and expert consultation.Then, the reliability, validity and responsiveness of the scale were evaluated. The macroscopic quantitative diagnostic model and standard of kidney qi deficiency syndrome of elderly hypertension were established by determining item weights according to epidemiological investigation. Clinical diagnostic experiments were performed on the standard finally.Results:This research revealed that kidney qi deficiency was one of the most common TCM syndromes of elderly hypertension.The diagnostic scale of kidney qi deficiency of elderly hypertension was compiled and proved to have good reliability, validity and responsiveness. The quantitative diagnostic standard of kidney qi deficiency syndrome of elderly hypertension was established, whose lowest critical value was 220. Clinical diagnostic experiment showed that it had high sensitivity, specificity, accuracy and positive likelihood ratio.Conclusion:The diagnostic scale of kidney qi deficiency of elderly hypertension established through literature research, clinical epidemiological investigation, scale compilation, statistical analysis and clinical verification has good feasibility, accuracy and clinical practical value. The results of this research will offer standardized scale for further research of kidney qi deficiency syndrome of elderly hypertension and provide ideas and methods for standardization study on other syndromes.更多还原