【摘要】 目的:探讨中医痰证的辨证要素的项目以及权重,为中医痰证诊断标准的建立提供证据支持。方法:通过文献研究得出痰证最相关的10个病种,收集病例519例以及辨证相关宏观表征,通过频数筛选进一步缩减辨证要素数目,最后采用Logistics回归分析筛选出中医痰证辨证要素。结果:经过两次回归分析后,最后形成12个辨证要素,分别为x1神疲、x2胸闷、x3短气、x4咳嗽、x5咯痰、x6口渴、x7舌淡暗、x8苔白、x9苔腻、x10脉弦、x11脉滑、x12脉细,根据统计分析结果,去掉反向指标为x3短气、x6口渴、x12脉细,获得中医痰证相关辨证要素为9个,为x1神疲(1.27)、x2胸闷(3.33)、x4咳嗽(3.57)、x5咯痰(1.37)、x7舌淡暗(1.49)、x8苔白(1.21)、x9苔腻(2.66)、x10脉弦(1.65)、x11脉滑(1.73),组织相关中医临床专家进行了2次讨论,将辨证要素分为主要诊断参考指标及次要参考指标,分别为主要参考指标:x2胸闷、x4咳嗽、x5咯痰,x11脉滑、x9苔腻;次要参考指标:x1神疲、x7舌淡暗、x8苔白、x10脉弦。结论:中医痰证诊断辨证要素主要参考指标胸闷、咳嗽、咯痰,脉滑、苔腻;次要参考指标:神疲、舌淡暗、苔白、脉弦。但是由于该研究为病例回顾性研究,证据支持级别不高,其推广仍需要更多的研究支持及不断完善。更多还原

【Abstract】 Objective: To discuss the essential elements of syndrome differentiation in treating phlegm syndrome of Chinese medicine and explore their respective weight, and to provide some reference for the establishment of diagnostic criteria for phlegm syndrome. Methods: Through literature review, the most relevant 10 types of phlegm syndrome were summarized, 519 cases were collected and the obvious symptoms related were differentiated. The number of essential elements of syndrome differentiation was further reduced through frequency screening. Then the essential elements of syndrome differentiation in treating phlegm syndrome of Chinese medicine were screened by the logistic regression analysis.Results:After twice regression analysis,12 essential elements of syndrome differentiation were obtained:x1 spiritlessness,x2 chest oppression,x3 shortness of breath, x4 cough, x5 sputum expectoration, x6 thirst, x7 pale or dark tongue, x8 white fur,x9 greasy fur,x10 string-like pulse,x11 slippery pulse and x12 thin pulse. According to the results of statistical analysis,contrarian indicators,namely x3 shortness of breath,x6 thirst and x12 thin pulse,were excluded. Nine essential elements of syndrome differentiation in treating phlegm syndrome of Chinese medicine were obtained: x1 spiritlessness(1.27),x2 chest oppression(3.33),x4 cough(3.57),x5 sputum expectoration(1.37),x7 pale or dark tongue(1.49),x8 white fur(1.21), x9 greasy fur(2.66), x10 string-like pulse(1.65) and x11 slippery pulse(1.73). Relevant experts of Chinese medicine carried out two discussions,at which the nine essential elements of syndrome differentiation in treating phlegm syndrome of Chinese medicine were divided into the main diagnostic indicators(x2 chest oppression,x4 cough,x5 sputum expectoration,x11 slippery pulse and x9 greasy fur) and the secondary diagnostic indicators(x1 spiritlessness,x7 pale or dark tongue,x8 white fur and x10 string-like pulse). Conclusion: The main diagnostic indicators for phlegm syndrome based on syndrome differentiation are chest oppression, cough, sputum expectoration, slippery pulse and greasy fur, while its secondary diagnostic indicators are spiritlessness, pale or dark tongue, white fur and string-like pulse. However, as this study is a retrospective case study with a relatively low level of evidence support, its promotion still needs support from more researches and further improvement.更多还原