评测中医临床医生观察舌象及脉象一致性的研究

doi:10.3736/jcim20101207

Abstract

Objective

To evaluate the consistency of tongue manifestation and pulse condition observed by traditional Chinese medicine clinicians.

Methods

Field investigation and direct inquiry were performed in the study. Two physicians from the same department judged tongue manifestation and pulse condition independently. The consistency among observers was assessed by means of Kappa statistics.

Results

A total of 55 patients were included in the study. There were 13 inconsistent cases (23. 6%) in tongue body observation and 7 cases (12.7%) in form of the tongue observation. The observation consistency of tongue body (Kappa=0.649) and form of the tongue (Kappa=0.752) were good. There were 24 inconsistent cases (43.6%) in tongue fur observation, the consistency of which was moderate (Kappa = 0. 525). There were 22 inconsistent cases (40%) in pulse condition diagnosis, the diagnosis consistency of which was also moderate (Kappa=0.562).

Conclusion

Observation and diagnosis consistency of tongue manifestation and pulse condition were moderately the same between different clinicians. By analyzing the reasons of inconsistency, it is necessary to improve the consistency in three aspects, such as the detailed-oriented criterion, the attitude of researchers and better training of researchers.

Key words: Consensus, Statistics, Nonparametric, Tongue presentations, Pulse presentations, Traditional Chinese medicine

Xiao-yan Li , Ze-huai Wen, Wei-xiong Liang , Wei-hua Xu, Su-yun Li, Xue-qing Yu , Hai-feng Wang. Evaluation of consistency of tongue and pulse signs observed by traditional Chinese medicine clinicians. Journal of Chinese Integrative Medicine, 2010, 8(12): 1153-1158.

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URL: http://www.jcimjournal.com/EN/10.3736/jcim20101207

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						B医生舌苔观察结果							合计
		白干	白厚腻	白黄滑	白黄厚腻	薄白黄	薄黄腻	花剥	黄干	黄厚腻	黄腻干	无苔	合计
	白干	2	2	0	0	0	0	0	1	0	0	0	5
	白厚腻	0	6	0	1	2	1	0	1	0	0	0	11
A	白黄滑	0	0	1	0	0	0	0	0	0	0	0	1
医	白黄厚腻	0	0	0	1	0	0	0	0	0	0	0	1
生	薄白黄	1	0	0	0	15	0	0	1	0	0	0	17
壬	薄白黄	1	0	0	0	15	0	0	1	0	0	0	17
〇	薄黄腻	0	0	0	0	0	0. 001*	0	0	0	0	0	0
苔	薄黄腻	0	0	0	0	0	0. 001*	0	0	0	0	0	0
观	花剥	0	0	0	0	0	0	2	0	0	0	0	2
察	花剥	0	0	0	0	0	0	2	0	0	0	0	2
结	黄干	0	0	0	0	0	0	0	2	1	0	0	3
果	黄厚腻	0	0	0	1	1	0	0	1	8	0	0	11
	黄腻干	0	0	0	0	0	0	0	1	0	0. 001*	0	1
	无苔	0	0	0	0	0	0	0	0	0	0	3	3
	合计	3	8	1	3	18	1	2	7	9	0	0	55


白	(2)	白厚	(1)	白腻	(1)
白干	(1)	黄干	(1)
白黄滑(1)		白滑	(1)
白腻	(6)	白厚	(1)	白黄厚(1)		薄黄 (2)	薄黄腻(1)
薄白	(6)	白	(1)	薄	(3)	薄白黄(1)	薄黄 (1)
薄黄	(1)	黄	(1)
黄	(1)	黄腻	(1)
黄厚	(1)	白黄厚(1)
黄厚腻(1)		黄厚	(1)
黄腻	(3)	薄黄	(1)	黄	(1)	黄厚腻(1)
黄腻干(1)		黄干	(1)

			B医生切脉结果
	沉	-1	沉细	-1
	沉滑结代(1)		沉细结代	-1
A	沉细	-3	沉	-1	沉细滑(1)		沉细数(1)
医	沉细结代(1)		沉细	-1
生	沉细数	-1	沉细数结代(1)
切	滑	-4	沉	-1	沉滑	-2	浮 ⑴
脉	细	-3	沉细	-2	滑	-1
结	细数	-3	沉细	-1	滑数	-1	细滑数(1)
果	弦	-2	沉	-1	沉弦	-1
	弦滑	-1	沉细	-1
	弦细	-2	沉弦细	-1	浮脉	-1

Evaluation of consistency of tongue and pulse signs observed by traditional Chinese medicine clinicians

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