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Journal of Chinese Integrative Medicine ›› 2009, Vol. 7 ›› Issue (1): 20-24.doi: 10.3736/jcim20090103

Special Issue: Traditional Chinese Medicine

• Original Clinical Research • Previous Articles     Next Articles

Development and evaluation of an inquiry scale for diagnosis of heart system syndromes in traditional Chinese medicine

 Guo-ping Liua, Yi-qin Wanga, Ying Donga, Nai-qing Zhaob, Zhao-xia Xua, Fu-feng Lia, Hai-xia Yana,Peng Qian a, Rui Guoa, Xiao-dan Zhanga, Dan Dia   

  1. a Laboratory of Syndromes of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
    b Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, Shanghai 200032, China
  • Received:2008-07-28 Accepted:2008-09-29 Online:2009-01-20 Published:2009-01-15

Objective

To develop an inquiry scale for diagnosis of heart system syndromes, and to discuss the provisional standardization of the inquiry method in traditional Chinese medicine (TCM).
Methods

Based on scale-making method, Chinese medicine theory and literature searching, an inquiry scale for diagnosis of heart system syndromes in TCM was developed. Statistics method, frequency counting and Delphi method were used for analysis. The inquiry scale was revised and tested repeatedly to check the test reliability, internal consistency reliability, and content validity, etc.
Results

The inquiry scale for diagnosis of heart system syndromes mainly covered basic data, chief complaint, history of present illness (accompanying symptoms) and past history, with appendix of inspection and palpation information as well as diagnosis made according to traditional Chinese and Western medicine. Among them, general inquiries covered fever and chills, sweating, head-body and chest-belly symptoms, taste and diet, stool and urine, sleep, mood, and gynecologic symptoms, which were scaled in 8 dimensions. And 66 symptom variables were screened finally. The scale had a good content validity and its coefficient alpha was 0.82. For the results of test-retest reliability, the Kappa values of using the scale for diagnosis of heart-qi deficiency, heart-yang deficiency, turbid phlegm, and cold coagulation twice by the same doctor ranged from 0.74 to 1, showing that the consistency of the scale was relatively high. The Kappa values of evaluation of scorer reliability in diagnosis of heart-qi deficiency, heart-yang deficiency, and heart-yin deficiency were also high, which were 0.63, 0.72, 1 and 0.48 respectively. Other results of diagnosis had low-consistency or even no diagnostic agreement.
Conclusion

The research on the scale for inquiry in TCM indicates that it is feasible for the standardization of inquiry scale for diagnosis of heart system syndromes in TCM, offering a reference for research on the inquiry scales for other systems.

Key words: Inquiring, Heart symptom complex, Scale

Table 1

Consistency of syndrome diagnosis in traditional Chinese medicine"

Syndrome Kappa value 95% confidence interval
Heart-qi deficiency 0.69 0.42-0.96
Heart-yang deficiency 0.80 0.52-1.00
Heart-yin deficiency 0.28 0.06-0.50
Heart-blood deficiency 0.33 0.08-0.58
Turbid phlegm 0.78 0.52-1.00
Blood stasis 0.33 0.08-0.58
Qi stagnation 0.54 0.19-0.89
Flaring heart-fire 0.52 0.17-0.86
Cold coagulation 0.72 0.34-1.00

Figure 2

Reliability of the scorer"

Syndrome Kappa value 95% confidence interval
Heart-qi deficiency 0.63 0.26-0.91
Heart-yang deficiency 0.72 0.42-1
Heart-yin deficiency 0.48 0.21-0.77
Heart-blood deficiency 1.00
Turbid phlegm 0.03 –0.03-0.12
Blood stasis 0.14 –7.57×10-17-0.33
Qi stagnation 0.17 –0.06-0.46
Flaring heart-fire
Cold coagulation
[1] State Administration of Traditional Chinese Medicine. Diagnostic and therapeutic effect evaluation criteria of diseases and syndromes in traditional Chinese medicine[M]. Nanjing: Nanjing University Press,1994: 19-20
国家中医药管理局. 中医病证诊断疗效标准[M]. 南京: 南京大学出版社,1994: 19-20
[2] Deng TT. Diagnostics of traditional Chinese medicine[M]. Shanghai: Shanghai Scientific and Technical Publishers,1984: 1-190
邓铁涛 . 中医诊断学[M]. 上海: 上海科学技术出版社,1984: 1-190
[3] Wang YQ. Diagnostics of traditional Chinese medicine[M]. Beijing: China Press of Traditional Chinese Medicine,2004: 8-189
王忆勤 . 中医诊断学[M]. 北京: 中国中医药出版社,2004: 8-189
[4] Committee of Cardiovascular Disease, China Society of Integrated Traditional Chinese and Western Medicine. The standard of distinguishing coronary artery disease by syndrome differentiation[J]. Zhongguo Zhong Xi Yi Jie He Za Zhi, 1991,11(5):257
中国中西医结合学会心血管分会. 冠心病中医辨证标准[J]. 中国中西医结合杂志, 1991,11(5):257
[5] Zhang BY. Internal medicine of traditional Chinese medicine[M]. Shanghai: Shanghai Scientific and Technical Publishers,2000: 103-116
张伯臾 . 中医内科学[M]. 上海: 上海科学技术出版社,2000: 103-116
[6] Wang YY. Internal medicine of traditional Chinese medicine[M]. Shanghai: Shanghai Scientific and Technical Publishers,1997: 100-132
王永炎 . 中医内科学[M]. 上海: 上海科学技术出版社,1997: 100-132
[7] Zhou ZY. Internal medicine of traditional Chinese medicine[M]. Beijing: China Press of Traditional Chinese Medicine,2003: 80-120
周仲瑛 . 中医内科学[M]. 北京: 中国中医药出版社,2003: 80-120
[8] Ye RG. Western internal medicine(5th ed)[M]. Beijing: People's Medical Publishing House, 2002,( 5th ed):171-372
叶任高 . 西医内科学(第5版)[M]. 北京: 人民卫生出版社, 2002,( 第5版):171-372
[9] Liu JP. Clinical reasearch methodology for evidence-based Chinese medicine[M]. Beijing: People's Medical Publishing House,2006: 72-79
刘建平 . 循证中医药临床研究方法学[M]. 北京: 人民卫生出版社,2006: 72-79
[10] State Bureau of Technical Supervision. Clinical terminology of traditional Chinese medical diagnosis and treatment of syndromes[M]. Beijing: Standards Press of China,1997: 17-36
国家技术监督局. 中医临床诊疗术语——证候部分[M]. 北京: 中国标准出版社,1997: 17-36
[11] Yao NL. Differential diagnostics of symptoms in traditional Chinese medicine(2nd ed)[M]. Beijing: People's Medical Publishing House, 2005,( 2nd ed):19-438
姚乃礼 . 中医症状鉴别诊断学(第2版)[M]. 北京: 人民卫生出版社, 2005,( 第2版):19-438
[12] Wu ML. SPSS and statistics application[M]. Beijing: Science Press,2003: 1-118
吴明隆 . SPSS统计应用实务[M]. 北京: 科学出版社,2003: 1-118
[13] Ke HX, Shen H. Statistical analysis in survey research(2nd ed)[M]. Beijing: Communication University of China Press, 2005,( 2nd ed):324-342
柯惠新, 沈浩 . 调查研究中的统计分析法(第2版)[M]. 北京: 中国传媒大学出版社, 2005,( 第2版):324-342
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