1. 东南大学附属中大医院
2. 中国药科大学中药复方研究室
3. 南京中医药大学基础医学院
纸质出版:2015
移动端阅览
[1]刘志刚,柴程芝,黄煌.大柴胡汤方证诊断标准研究方法探索[J].中医杂志,2015,56(02):160-162.
LIU Zhigang, CHAI Chengzhi, HUANG Huang. Research Methodology on the Syndrome Diagnostic Criteria for the Syndrome of Dachaihu Decoction[J]. Journal of Traditional Chinese Medicine2015, 56(2): 160-162.
[1]刘志刚,柴程芝,黄煌.大柴胡汤方证诊断标准研究方法探索[J].中医杂志,2015,56(02):160-162. DOI: 10.13288/j.11-2166/r.2015.02.019.
LIU Zhigang, CHAI Chengzhi, HUANG Huang. Research Methodology on the Syndrome Diagnostic Criteria for the Syndrome of Dachaihu Decoction[J]. Journal of Traditional Chinese Medicine2015, 56(2): 160-162. DOI: 10.13288/j.11-2166/r.2015.02.019.
目的以大柴胡汤为例探索方证诊断临床标准的确定方法。方法采取基于文献的病例对照研究方法
将与大柴胡汤方剂相似度≥0.75的医案病例作为病例组
以大柴胡汤医案主治疾病为配比因素、主治相同疾病的医案病例作为对照组。采集病例及对照医案的主治疾病、临床表现等信息建立数据库
对两组医案的临床表现进行单因素分析及Logistic分析
并在此基础上以ROC曲线分析方法确定大柴胡汤方证诊断标准。结果大柴胡汤临床表现的单因素分析共筛选17个指标
其中分值最高者为往来寒热、胸胁苦满
Logistic分析得到包含8个指标的量表;根据协方差系数(B)
选取相通的数价为相应变量的分值
得到总分为13.5分的大柴胡汤方证诊断量表;ROC分析表明曲线下面积(AUC)达到0.916。结论往来寒热、胸胁苦满为诊断大柴胡汤方证量表中分值最高的两项
这与对大柴胡汤的传统认识基本一致
表明Logistic回归分析结合ROC曲线分析方法确定方证诊断标准是可行的。
Objective To explore methods to determine syndrome diagnostic criteria using Dachaihu Decoction as an example. Methods A case-control study based on literature was conducted. Clinical cases with the prescription similar to Dachaihu Decoction( the similarity ≥ 0. 75) were chosen as the case group. Taking the diseases treated by Dachaihu Decoction in medical treatises as mixing ratio factors
cases with the same diseases were chosen as the control group. A database based on the information of the collected cases
diseases treated in the control group
clinical manifestations and other information was established. Single factor analysis and Logistic analysis were applied on clinical manifestations. And on this basis
syndrome diagnostic criteria for syndrome of Dachaihu Decoction was determined by ROC curve analysis. Results Seventeen indicators were screened out by single factor analysis of clinical manifestations
among which
alternate attacks of chill and fever and fullness and discomfort in chest and hypochondrium held the highest scores. Logistic analysis dedicated a scale including 8 indicators. According to the covariance coefficient( B)
we selected the interlinked numbers as the scores for corresponding variables and got a Dachaihu Decoction syndrome diagnostic scale with the total score of 13. 5. ROC analysis showed that the area under the curve( AUC) was 0. 916. Conclusion Alternate attacks of chills and fever
fullness and discomfort in chest and hypochondrium achieved the highest score in Dachaihu Decoction syndrome diagnostic scale
which was consistent with the traditional understanding of Dachaihu Decoction. It suggests that it is feasible to establish syndrome diagnostic criteria with Logistic regression analysis and ROC curve analysis.
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