高血压病肝火上炎证诊断规范化探究.pdf

提 要 目的：作为教育部新世纪优秀人才支持计划（No.NECT-07-0522）高血压病中医 证候研究的一项重要基础性工作，建立高血压病肝火上炎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：在文献调研、临床流行病学调查、专家咨询的基础上，建立高血压病肝火 上炎证宏观诊断量表，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，建立高血压病肝火上炎证的宏观 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：编制了高血压病肝火上炎证宏观诊断量表，综合测评表明该量表信度、效 度及反应度良好。在此基础上建立了高血压病肝火上炎证量化诊断标准，诊断阈值为 230。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 的规范的高血压病肝火上炎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。本研究成果将为高血压病肝火上炎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。 关键词 高血压病；肝火上炎证；辨证规范化；量化诊断；量表 Research on the Diagnostic Standardization of Liver Fire Flaming Upward Syndrome of Hypertensive Disease Speciality: cardiovascular disease of TCM Author: Zhao Hao Tutor: Prof. Ji Zhong-qiang Abstract Objective: To establish the macroscopic quantitative diagnostic standard of liver fire flaming upward syndrome of hypertensive disease 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 hypertensive disease were respectively carried first. The macroscopic diagnostic scale of liver fire flaming upward of hypertensive disease was constituted according to literature research, clinical epidemiological investigation and expert consultation.Then, the re1iability, validity and responsiveness of the scale were evaluated. The macroscopic quantitative diagnostic model and standard of liver fire flaming upward of hypertensive disease were established by determining item weights according to epidemiological investigation. Clinical diagnostic experiment