基于德尔菲专家咨询法对肿瘤异常黑胆质病证异常体液成熟、清除标准的研究

 为建立肿瘤异常黑胆质病证异常体液成熟、清除诊断标准,采用德尔菲专家咨询法进行分两个阶段的专家咨询研究.第1阶段,编制肿瘤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,睡眠增多,多梦、噩梦减少,精神气色逐步好转,目光有神等频率大于70%的10个肿瘤异常黑胆质病证异常体液成熟证侯特征;精神气色明显好转、心情温和,睡眠质量明显提高,舌苔滋润、接近薄白(趋于正常)等频率大于70%的8个清除时的证侯特征.共进行一轮.第2阶段,根据筛选结果再次编制咨询表,并进行对肿瘤异常黑胆质病证异常体液成熟、清除证候特征权重系数的研究.共进行两轮咨询,每轮均回收有效问卷30份,回收率均为100%.专家平均权威系数为0.825,提示专家权威度高.经分析各证侯特征权重系数,得出判断肿瘤异常黑胆质病证异常体液成熟的主症为5个,次症为5个;判断肿瘤异常黑胆质病证异常体液清除的主症为4个,次症为4个.专家集中程度和协调程度均高,肿瘤异常黑胆质型异常体液成熟证侯特征一致性系数为(χ²=0.261,P=0.000),两轮相等;肿瘤异常黑胆质型异常体液清除证侯特征一致性系数为(χ²=0.248,P=0.000),两轮相等;由此得出结论,通过改良德尔菲咨询法建立的肿瘤异常黑胆质病证异常体液成熟、清除标准对肿瘤有效、规范诊治提供客观量化依据.

The Matured and Removed Syndrome Characteristics Criteria of Abnormal Hilit for Abnormal Savda Type Tumor with Uighur Medicine Based on Delphi Method

Two-stage expert consulting research is conducted in order to set up diagnostic criteria for abnormal hilit matured and removed from body with abnormal savda type tumor with traditional Uighur medicine based on Delphi method. At the first stage, an enquiry form including key syndrome characteristics which were identified by the past research results from our research group is formulated, and then sent to 30 experts who are located in the Xinjiang Uygur Autonomous Region and have rich experience in this field. Round one Delphi technique is conducted at this stage. Then 10 kinds of syndrome characteristics, such as sleeping increasing, doing more dream, nightmare reducing, mental color gradually improving, and having a pair of sparkling eyes are selected as diagnostic criteria for abnormal hilit matured from body with abnormal savda type tumor. And eight kinds of syndrome characteristics, such as mental color significantly improving, moderative mood, sleeping quality significantly improving, tongue fur is damp and closes to the original state, are selected as diagnostic criteria for abnormal hilit removed from body with abnormal savda type tumor in accordance to expert high consensus that frequency is greater than 70% (21 out of 30 experts). At the second stage, a new enquiry form based on screening results of the first stage is formulated, and the weight coefficients of each selected syndrome characteristics are studied, Round two Delphi technique is conducted at this stage and 30 copies of valid questionnaire are responded for each round. Expert authority coefficient is 0.825 on average and is considered to be high authority degree. By analyzing the weight coefficients of each selected syndrome characteristics, five kinds of syndrome characteristics are considered as major symptoms and other five kinds of syndrome characteristics are considered as subsequent symptoms for diagnosing abnormal savda type tumor abnormal hilit already matured or not. Four kinds of major symptoms and other four kinds of subsequent symptoms are selected for diagnosing abnormal savda type tumor abnormal hilit already removed from body or not. Both expert concentration and coordinate degrees are high. The consistency coefficients for abnormal savda type tumor abnormal hilit matured syndrome criteria are (χ²=0.261, P=0.000) and two around are same, for diagnostic criteria for abnormal savda hilit removed from body is (χ²=0.248, P=0.000), and two around are also same. The establishment of diagnostic criteria for abnormal hilit matured and removed from body with abnormal savda type tumor with traditional Uighur medicine based on modified Delphi method would provide an objective and quantitative basis for the effective, standardized diagnosis and treatment of the tumor.