目的:明确心气虚证证候,为中医心气虚证诊断标准修订提供参考。方法:全面搜集中国知网(CNKI)、万方数据知识服务平台、维普资讯(VIP)数据库中有关心气虚证论文,形成心气虚证文献库,提取其中心气虚证诊断标准。采用Excel 2016软件提取其中的症状与体征形成初步诊断条目池,制定《心气虚证诊断条目专家咨询问卷》。采用德尔菲法,向全国21名专家发送问卷,回收资料后采用Excel 2016及SPSS 21.0软件进行均数、变异系数及满分比的统计分析,最终得出心气虚证中重要的诊断条目。结果:在文献检索中提取出230篇有效论文,得到心气虚证诊断标准22种,提取其中的症状和体征共得到诊断条目34条。回收有效问卷21份,专家积极系数为100%,筛选出心气虚证诊断条目12条,初步确定了心气虚证的重要诊断条目。心气虚证中重要的诊断条目为:胸闷、心悸或怔忡、心悸活动后加重、气短、动则少气、神疲乏力、少气懒言、自汗、舌淡、脉细、脉弱、左心室射血分数(LVEF)减少。较为重要的诊断条目为:面色少华、脉结或代、心脏射血前期(PEP)延长、PEP/LVEF增高。结论:确定心气虚证诊断条目12项,较为重要的条目4项,可供第二轮专家调查,为心气虚证诊断标准修订提供了有益参考。
Objective: To determine the characteristics of heart-qi deficiency syndrome, and to provide reference for the diagnosis and evaluation of heart-qi deficiency syndrome in Chinese medicine. Methods: A comprehensive collection of papers on heart-qi deficiency syndrome in CNKI, Wanfang Data Knowledge Service Platform and VIP database was conducted to form a literature base of heart-qi deficiency syndrome and extract its diagnostic criteria. Excel 2016 software was used to extract the symptoms and signs to form a pool of preliminary diagnostic items, and the Expert Consultation Volume for Diagnostic Items of Heart-Qi Deficiency Syndrome was formulated. Delphi method was used to send questionnaires to 21 experts in China. After the data were collected, Excel 2016 and SPSS 21.0 software were used for statistical analysis of mean, coefficient of variation and full score ratio, and important diagnostic items of heart-qi deficiency syndrome were obtained. Results: In the literature search, 230 effective papers were extracted, 22 kinds of diagnostic criteria for heart-qi deficiency syndrome were obtained, and 34 symptoms were collected from the symptoms and signs. 21 valid questionnaires were collected, and the expert's positive coefficient was 100%. 12 diagnostic items of heart-qi deficiency syndrome were screened out, and important diagnostic items of heart -qi deficiency syndrome were preliminarily determined. Important diagnostic items in heart -qi deficiency syndrome are: chest tightness, heart palpitations or convulsions, increased heart palpitations, shortness of breath, less gas, fatigue, less sweat, thin tongue, thin pulse, weak pulse, LVEF cut back. Conclusion: Determining 12 items of heart-qi deficiency syndrome diagnosis and 4 items of more important items are available for the second round of expert investigation, which provides a useful reference for the revision of diagnostic criteria for heart qi deficiency syndrome.
Guiding Journal of Traditional Chinese Medicine and Pharmacy