摘要
目的:通过《产后腹痛中医诊疗指南》的临床应用性评价和诊断内容细化研究,评价该指南诊断内容的临床应用一致性,探讨中医妇科诊疗指南诊断内容的评价方法。方法:按照国家中医药管理局《中医诊疗指南临床应用评价实施方案》要求,开展《产后腹痛中医诊疗指南》应用性评价,重点评价指南的中医疾病诊断、西医疾病诊断、证候分类内容;引入量化表及分级评分法,提高判断的准确性和客观性;引入疼痛分级标准,评估产后腹痛的疼痛程度。结果:中、西医疾病诊断和证候分类符合率分别为100%、100%、87.3%,但完全符合率分别为100%、86.7%、17.3%;符合指南中证候分类(血虚、寒凝血瘀、气滞血瘀)的病例占87.3%,其中气滞血瘀证患者最多(占77.0%),指南应用符合率均为100%,但血虚证候完全符合率最高(75.9%),气滞血瘀证候完全符合率最低(12.6%);按疼痛程度分级,轻度(Ⅰ级)125例、中度(Ⅱ级)148例、重度(Ⅲ级)27例。结论:本指南诊断内容临床应用符合度较好,对临床实践具有一定的指导作用;细化证候分类内容评价,能够更准确评价指南应用的一致性;疼痛程度分级对于治疗方案的选择具有一定的价值。
Objective： Based on the study of clinical application and diagnostic content of TCM Clinical Practice Guidelines for Postpartum Abdominal Pain, to evaluate the consistency of the clinical application and the clinical practice guidelines, in order to discuss the evaluation method of the diagnostic contents of TCM Clinical Practice Guidelines for Gynecology. Methods： Evaluation of CPG application for postpartum abdominal pain was conducted according to the evaluation method of Traditional Chinese Medicine Clinical Practice Guidelines Application which published by State administration of Traditional Chinese Medicine of the People’s Republic of China. TCM disease diagnosis, disease diagnosis of western medicine and syndrome classification were taken as key indexes, quantitative table and grading score were introduced to improve the accuracy and objectivity of judgment; pain grading standards was introduced to evaluate the degree of postpartum abdominal pain. Results： The coincidence rate of the disease diagnosis of Western medicine, TCM disease diagnosis and syndrome classification content were 100%, 100%, 87.3% respectively, but the complete coincidence rate were 100%, 86.7%, 17.3% respectively. The coincidence rate of classification of syndromes in accordance with guidelines（blood deficiency, cold congelation and blood stasis, qi stagnation and blood stasis） was 87.3%, while the coincidence rate of qi stagnation and blood stasis was as high as 77.0%. Guide application coincidence rate was 100% in three groups, while the highest coincidence rate was blood deficiency（75.9%）, the lowest coincidence rate was qi stagnation and blood stasis（12.6%）. According to the grading of pain, number of cases of mild（grade I）, moderate（grade I） and severe（grade II） were 125, 148 and 27 respectively. Conclusion： The application coincidence rate of diagnostic content in TCM Clinical Practice Guidelines for Postpartum Abdominal Pain was good, which could provide certain reference for clinical practice. Refining syndrome classification could improve the accuracy of guidelines application, and grading of pain could be valuable tor selection of therapeutic regimen.
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2016年第12期5130-5133,共4页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家中医药管理局中医标准化项目(No.ZYYS-2013[0010])
北京中医药科技发展资金项目(No.JJ2015-61)
中国中医科学院自主选题研究项目(No.Z0411)~~
关键词
产后腹痛
中医诊疗指南
应用性评价方法
Postpartum abdominal pain
TCM clinical practice guidelines
Evaluation of CPG application
作者简介
通讯作者：戴海青，海南省海口市和平北路47号海南省中医院，邮编：570203，电话：0898—66131308，E—mail：tiandan9999@163．com
郜亚茹，北京市东城区东直门内南小街16号中国中医科学院中医临床基础医学研究所，邮编：100700，电话：010—64093279 E—mail：gaoyaru．cool@163．com
王丽颖，北京市东城区东直门内南小街16号中国中医科学院中医临床基础医学研究所，邮编：100700，电话：010—64093279 E—mail：coldmoon_ly@163．com
