中国中西医结合杂志2024，Vol.44Issue(5)：543-547,5.DOI:10.7661/j.cjim.20240308.105
急性冠脉综合征瘀毒互结证诊断标准研究
Research on Establishing Diagnostic Criteria for Acute Coronary Syndrome with Blood Stasis and Toxin
摘要
Abstract
Objective To establish diagnostic criteria for acute coronary syndrome(ACS)with blood stasis and toxin,based on the theoretical understanding of the etiology and pathogenesis of"blood stasis and toxin"in coronary heart disease.Methods An item pool was generated using systematic literature analysis and a clinical cross-sectional survey.The Delphi expert consultation process was used to filter entries,and weights were assigned to each item using the analytic hierarchy process.Diagnostic criteria were then established based on item weights and clinical practicability.Results A total of 43 items were selected through systematic literature analysis,and 39 items were selected from a cross-sectional survey of 400 patients,forming a pool of 67 items.After 2 rounds of Delphi expert consultation,28 items were retained.Following the analytic hierarchy process,9 high-weight(0.0430～0.1976),9 medium-weight(0.0153～0.0289),and 10 low-weight(0.0060～0.0147)items were confirmed.The final diagnostic criteria for ACS with a pattern of blood stasis and toxin were formed in three dimensions:necessary indicators(i.e.,progressively worsening chest pain,recurrent bouts of chest pain within the past month),physicochemical parameters(e.g.,elevated cardiac troponin or creatine kinase isoenzymes),and tongue/pulse characteristics(e.g.,bluish or purplish tongue;thin and stringlike pulse or astringent pulse).Kendall's concordance coefficients for the two rounds of expert questionnaires were 0.368 and 0.395 respectively,and Cronbach's α coe什icients were 0.967 and 0.893,respectively,indicating consistent expert opinion and reliable results.Conclusion The diagnostic criteria encompass macroscopic characteristics and physicochemical indicators that reflect the pathogenic features of stasis-toxin interaction,guiding the diagnosis of acute coronary syndrome with blood stasis and toxin.关键词
急性冠脉综合征/瘀毒互结证/德尔菲法/层次分析法/诊断标准Key words
acute coronary syndrome/binding of blood stasis and toxin pattern/Delphi method/analytical hierarchy process/diagnostic criteria引用本文复制引用
田文得,鞠建庆,高洁,付长庚,高铸烨,薛梅,徐浩,史大卓,陈可冀..急性冠脉综合征瘀毒互结证诊断标准研究[J].中国中西医结合杂志,2024,44(5):543-547,5.基金项目
国家中医药传承创新团队项目(No.ZYYCXTD-C-202007) （No.ZYYCXTD-C-202007）
中国中医科学院科技创新工程创新团队项目(No.CI2021B004) （No.CI2021B004）
