慢性胃炎中医证候要素辨证量表研究(1)
[摘要] 目的 建立慢性胃炎中医证候要素辨证量表。 方法 制订慢性胃炎中医症状条目池，收集2013年1月～2016年12月北京中医药大学东方医院243例慢性胃炎门诊患者的四诊资料，保留出现率≥5%的症状，基于复杂系统熵聚堆方法提取证候要素，使用统计软件SPSS 20.0，利用向前步进(条件)回归法进行条目筛选，形成条目池；运用二分类Logistic回归分析确定各症状权重系数，再利用受试者工作特征(ROC)曲线确定各证候要素的诊断阈值。 结果 经条目筛选最后保留有效条目共36条，在此基础上建立了慢性胃炎中医证候要素辨证量表。量表中共有气滞、气虚、热、湿、阴虚、阳虚、血瘀、寒和痰9个证候要素，60分为诊断阈值。 结论 慢性胃炎证候要素辨证量表的研制是对慢性胃炎证候标准化规范化进行的有益探索。
[关键词] 慢性胃炎；证候要素；辨证量表；标准化
[中图分类号] R277.7 [文献标识码] A [文章编号] 1673-7210(2018)06(c)-0120-04
[Abstract] Objective To establish a TCM syndrome elements identification scale for chronic gastritis. Methods The item pool of TCM symptoms for chronic gastritis was made. The four diagnostic data of 243 outpatients with chronic gastritis in Dongfang Hospital Affiliated to Beijing University of Chinese Medicine from January 2013 to December 2016 was collected， of which， TCM syndrome elements having over 5% occurrence frequency were retained. TCM syndrome elements were extracted based on complex system entropy cluster. Statistical software SPSS 20.0 was used to analyze the data， and logistic regression of forward (conditional) method was used for the selection of scale items， so as to form item pool. Binary logistic regression analysis was used to confirm the weight coefficient of all symptoms， then receiver operating characteristic (ROC) curve was used to confirm the diagnostic threshold of all syndrome elements. Results Through items screening， a total of 36 significant items were retained， on basis of which， the TCM syndrome elements identification scale for chronic gastritis was established. There were 9 syndrome elements in the scale， including qi-stagnation， qi-deficiency， fire-heat， dampness， yin-deficiency， yang-deficiency， blood stasis， cold and phlegm. The diagnostic threshold score was 60 points. Conclusion The development of TCM syndrome elements identification scale for syndrome factors of chronic gastritis is an effective exploration for standardization of chronic gastritis syndrome.
[Key words] Chronic gastritis； Syndrome elements； Identification scale； Standardization
辨證论治，是中医学的基本特点之一，是理、法、方、药运用于临床的过程，即通过四诊八纲、脏腑、病因、病机等的中医基础理论对患者表现的症状、体征进行综合分析，辨别为何种证候，称辨证；在辨证的基础上，定出治疗措施，称论治[1]，证候是辨证论治的基础[2]。本研究从证候要素研究入手引入数理统计方法对数据进行分析，拟定证候要素辨证量表，为慢性胃炎的中医证候诊断提供实用工具。
1 资料与方法
1.1 一般资料
所有病例均来源于2013年1月～2016年12月北京中医药大学东方医院门诊收治的243例慢性胃炎患者。其中男85例(34.98%)，女158例(65.02%)；年龄23～81岁，平均(50.05±13.07)岁，其中<40岁55例(22.63%)，40～60岁130例(53.50%)，>60岁58例(23.87%)；病程1个月～40年，平均(49.90±81.00)个月，其中<1年97例(40.00%)，1～10年108例(44.44%)，>10年38例(15.56%)。, http://www.100md.com(郑思思 李军祥 王允亮 文占权 王丽 )
[关键词] 慢性胃炎；证候要素；辨证量表；标准化
[中图分类号] R277.7 [文献标识码] A [文章编号] 1673-7210(2018)06(c)-0120-04
[Abstract] Objective To establish a TCM syndrome elements identification scale for chronic gastritis. Methods The item pool of TCM symptoms for chronic gastritis was made. The four diagnostic data of 243 outpatients with chronic gastritis in Dongfang Hospital Affiliated to Beijing University of Chinese Medicine from January 2013 to December 2016 was collected， of which， TCM syndrome elements having over 5% occurrence frequency were retained. TCM syndrome elements were extracted based on complex system entropy cluster. Statistical software SPSS 20.0 was used to analyze the data， and logistic regression of forward (conditional) method was used for the selection of scale items， so as to form item pool. Binary logistic regression analysis was used to confirm the weight coefficient of all symptoms， then receiver operating characteristic (ROC) curve was used to confirm the diagnostic threshold of all syndrome elements. Results Through items screening， a total of 36 significant items were retained， on basis of which， the TCM syndrome elements identification scale for chronic gastritis was established. There were 9 syndrome elements in the scale， including qi-stagnation， qi-deficiency， fire-heat， dampness， yin-deficiency， yang-deficiency， blood stasis， cold and phlegm. The diagnostic threshold score was 60 points. Conclusion The development of TCM syndrome elements identification scale for syndrome factors of chronic gastritis is an effective exploration for standardization of chronic gastritis syndrome.
[Key words] Chronic gastritis； Syndrome elements； Identification scale； Standardization
辨證论治，是中医学的基本特点之一，是理、法、方、药运用于临床的过程，即通过四诊八纲、脏腑、病因、病机等的中医基础理论对患者表现的症状、体征进行综合分析，辨别为何种证候，称辨证；在辨证的基础上，定出治疗措施，称论治[1]，证候是辨证论治的基础[2]。本研究从证候要素研究入手引入数理统计方法对数据进行分析，拟定证候要素辨证量表，为慢性胃炎的中医证候诊断提供实用工具。
1 资料与方法
1.1 一般资料
所有病例均来源于2013年1月～2016年12月北京中医药大学东方医院门诊收治的243例慢性胃炎患者。其中男85例(34.98%)，女158例(65.02%)；年龄23～81岁，平均(50.05±13.07)岁，其中<40岁55例(22.63%)，40～60岁130例(53.50%)，>60岁58例(23.87%)；病程1个月～40年，平均(49.90±81.00)个月，其中<1年97例(40.00%)，1～10年108例(44.44%)，>10年38例(15.56%)。, http://www.100md.com(郑思思 李军祥 王允亮 文占权 王丽 )