世界中医药2025，Vol.20Issue(20)：3749-3758,3765,11.DOI:10.3969/j.issn.1673-7202.2025.20.021
冠状动脉粥样硬化性心脏病伴焦虑抑郁状态气滞血瘀证诊断条目筛选
Screening of Diagnostic Items for Qi Stagnation and Blood Stasis Syndrome in Coronary Atherosclerotic Heart Disease with Anxiety and Depression
摘要
Abstract
Objective:To screen diagnostic items for qi stagnation and blood stasis syndrome in patients with coronary atheroscle-rotic heart disease(coronary heart disease,CHD,for short)accompanied by anxiety and depression using the Delphi expert ques-tionnaire method.Methods:Based on highly recognized industry diagnostic and treatment standards,textbooks,and literature,a pool of diagnostic items was established and an expert consultation questionnaire was developed.Two rounds of questionnaire surveys were conducted.According to expert feedback,the expert positive coefficient,authority coefficient,expert coordination degree(Ken-dall's coefficient of concordance),scale content reliability coefficient(Cronbach's α),scale content validity index(S-CVI),as well as item mean score,full-score frequency,rank sum,percentage of unimportant ratings,and coefficient of variation were calculated.According to the item inclusion criteria,a diagnostic scale for qi stagnation and blood stasis syndrome in CHD patients with anxiety and depression was ultimately formed.Results:Based on the literature review,an initial item pool consisting of 41 somatic symp-toms and 43 psychological symptoms was constructed.In the two rounds of Delphi expert consultation,35 and 31 questionnaires were returned,respectively.The expert positive coefficients were 97.22％and 96.88％,and the authority coefficients were 0.93 and 0.95,respectively.For the somatic symptom section,Kendall's coefficients of concordance were 0.45 and 0.18,Cronbach's αcoefficients were 0.95 and 0.93,and S-CVI values were 0.56 and 0.77,respectively.For the psychological symptom section,Ken-dall's coefficients of concordance were 0.43 and 0.29,Cronbach's α coefficients were 0.97 and 0.95,and S-CVI values were 0.48 and 0.68,respectively.According to the item inclusion criteria,21 somatic symptoms and 25 psychological symptoms were retained after the first round,and 19 somatic symptoms and 19 psychological symptoms were retained after the second round.After classifica-tion,merging,and integration of the retained overlapping somatic and psychological symptoms,the final scale consisted of 15 somat-ic symptoms and 16 psychological symptoms.The somatic symptoms included chest pain,frequent sighing,dark-red or purplish lips,distended and tortuous sublingual veins,and a unsmooth or thready-unsmooth pulse.The psychological symptoms included depres-sion,decreased interest,sadness with a desire to cry,excessive fear and easy fright,and insomnia with excessive dreaming.Conclu-sion:The diagnostic items for qi stagnation and blood stasis syndrome in CHD patients with anxiety and depression were screened using the Delphi method.This process conforms to the traditional Chinese medicine syndrome differentiation framework,demon-strates high authority and good reliability,and can provide a basis for clinical diagnosis.关键词
冠状动脉粥样硬化性心脏病/焦虑抑郁/气滞血瘀证/德尔菲专家调查法/中医证候诊断量表Key words
Coronary heart disease/Anxiety and depression/Qi stagnation and blood stasis syndrome/Delphi method/Traditional Chinese medicine syndrome diagnosis scale分类
医药卫生引用本文复制引用
闻斐斐,吴振国,王凤荣..冠状动脉粥样硬化性心脏病伴焦虑抑郁状态气滞血瘀证诊断条目筛选[J].世界中医药,2025,20(20):3749-3758,3765,11.基金项目
国家自然科学基金面上项目(81874415) （81874415）
辽宁省中医药管理局中医药临床重点学(专)科服务能力建设项目(LNZYXZK201908) （专）
