【作者】 李霞；

【导师】 张葆青；

【作者基本信息】 山东中医药大学 ， 中医儿科学， 2010， 硕士

【摘要】 中医治疗小儿多发性抽搐症具有确切的疗效和明显的优势,但目前辨证分型尚无定论,治疗呈现出百家争鸣之势,治法不一。本研究目的：运用德尔菲(Delphi)法建立小儿多发性抽搐症中医规范化辨证标准。方法：本论文结合临床研究与文献研究结果,并参考既往研究成果,与课题组成员集体讨论形成第一轮《小儿多发性抽搐症中医辨证的研究》专家调查问卷；通过对收回的第一轮调查问卷分析,在此基础上形成第二轮《小儿多发性抽搐症中医辨证的研究》专家调查问卷。由EXCEL首先建立数据信息库,然后使用SPSS16.0导入数据库并进行统计分析,采用描述性分析、对比排序法等统计方法,观测专家意见的集中程度、协调程度,对问卷条目进行筛选、整理,初步建立小儿多发性抽搐症中医规范化辨证标准。结果：共进行两轮专家调查,从问卷回收情况来看,两轮问卷的专家积极系数分别为92.5%、97.5%,说明专家对本研究的参与积极性高；从专业分布来看,两轮问卷中隶属中医儿科学专业的专家分别占专家总数的81.1%、82.1%,说明具有良好的学科代表性；从专家职称来看,两轮问卷中拥有正高级职称的专家分别占专家总数的91.9%、94.9%,说明具有较高的权威性；从专家的地域分布上看,全部专家来自全国19个省市自治区,说明具有较好的地域代表性。两轮问卷均删除了不重要百分比R≥50%的条目,第二轮问卷亦删除个别变异系数CV值≥0.6、专家意见协调程度较差的条目。第二轮问卷中各辨证分型所保留条目(?)值均≥0.74、CV值均≤0.597,较第一轮专家调查问卷CV值介于0.144-2.747之间有明显改善,表明专家意见一致性较高,自此结束专家咨询。各辨证分型中所保留条目依据其重要性的大小,按照症状、舌象、脉象依次排列。结论：通过德尔菲法初步建立了小儿多发性抽搐症的中医辨证规律的研究,为小儿多发性抽搐症的治疗标准的建立奠定了坚实的基础；同时证明德尔菲法是中医证候规范化研究中具有客观性、实用性及可操作性的重要方法学。更多还原

【Abstract】 Chinese medicine treatment of children with multiple tic disorder has a definite effect and a clear advantage, but there is no conclusive syndrome type, Treatment showing a television news of the potential, different governing law.Objectives:The use of Delphi was established by multiple tic disorder in children standardization of TCM syndrome differentiation criteria.Methods:In this paper, combined with clinical research and literature studies, and reference to past research, task force members with the formation of the first round of group discussions, "Pediatric Multiple Tic Syndrome Differentiation of expert questionnaires; recovered through the analysis of the first round of the questionnaire, on this basis, the formation of the second round of "Pediatric Multiple Tic Syndrome Differentiation of expert questionnaire. First established by the EXCEL data base, and then use SPSS 16.0 Statistical Package for the import database and statistical analysis, using descriptive analysis and comparison of statistical methods to sort and France, observing the concentration of expert advice, coordination degree of The questionnaire for screening, sorting, and the initial establishment of the establishment of multiple tic disorder in children Differential TCM standardized criteria.Results:A total of two rounds of expert surveys, questionnaires recovered from the point of view, two experts from the positive coefficient of the questionnaire were 92.5%, 97.5%, indicating the participation of experts on the positive nature of this study was high; distribution from a professional point of view, two questionnaire attached to the Traditional Chinese Medicine of professional experts in pediatric specialists accounted for 81.1% of the total,82.1%, indicating a good representation of the subject; from specialist titles of view, the questionnaire has two experts with high professional title accounted for 91.9% of the total number of experts,94.9%, indicating a higher authority; from experts in terms of geographical distribution, all experts from the country 19 provinces and autonomous regions.Shows a good geographical representation. Two questionnaires were removed unimportant percentage of R≥50% of the entries, the second round of the questionnaire also delete individual coefficient of variation CV values≥0.6, expert advice on the degree of coordination less entry. The second round of questionnaires, each syndrome type X values are retained for≥0.74, CV values are≤0.597, compared with the first round of expert questionnaires CV values ranged from 0.144～2.747 between the marked improvement, indicating a more consistent expert opinion high, since the end of expert advice. The syndrome type retained in the size of the entries according to their importance, according to the symptoms, tongue, pulse in order of priority.Conclusions:Initially established through the Delphi method in children with multiple tic disorder Study on TCM for the treatment of children with multiple seizure disorders the establishment of standards laid a solid foundation; also confirmed that the Delphi method is the standardization of TCM syndrome research with the objective, practicality and operability of the key methodology.更多还原