Victoria University , Melbourne, Australia.
J Altern Complement Med. 2009 Oct;15(10):1099-105. doi: 10.1089/acm.2009.0020.
Toyohari meridian therapy (TMT) is a Japanese system of acupuncture. Acupoint selection follows diagnosis of the primary and secondary patterns of disharmony (sho) and disturbances in the yang channels. Pulse diagnosis and abdominal palpation diagnosis are the two main diagnostic methods used. Little is known about the reliability of pulse, abdominal, and pattern diagnosis in TMT. This is important since diagnosis of the sho determines acupoint treatment. If diagnosis is unreliable, there can be less confidence that the patient will receive optimal treatment.
The objective of this study is to assess the level of agreement between two TMT practitioners on pulse diagnosis, abdominal diagnosis, and diagnosis of the primary and secondary sho.
An inter-rater reliability study was conducted. Two (2) TMT practitioners separately conducted a TMT examination and completed an assessment form, choosing from a range of possible responses relating to pulse characteristics, abdominal diagnosis, and diagnosis of primary sho and secondary sho. The kappa coefficient was used as a measure of inter-rater reliability of the outcome variables.
Sixty-two (62) Australians (22 males, 40 females) aged 20-65 years participated (mean age 49.2 +/- 12.2 years). Level of agreement for pulse diagnosis was 57%, 61%, and 77% for pulse depth, speed, and strength, respectively. For abdominal diagnosis, the level of agreement for involvement of the Lung, Kidney, Spleen, and Liver abdominal regions was 58%, 53%, 35%, and 10%, respectively. The overall level of agreement on primary sho diagnosis was 48% and for secondary sho diagnosis, 44%.
Overall, there was a reasonable level of agreement on basic pulse characteristics and on abdominal diagnosis for two of the abdominal regions. Level of agreement on primary and secondary sho diagnosis suggests room for improvement. Further studies are required in order to gain a greater understanding of the reliability of diagnosis in TMT.
玩具疗法（TMT）是一种日本式针灸系统。穴位选择遵循主要和次要失调模式（和）以及阳经紊乱的诊断。脉诊和腹诊诊断是两种主要的诊断方法。关于 TMT 中的脉诊、腹诊和模式诊断的可靠性知之甚少。这一点很重要，因为和的诊断决定了穴位治疗。如果诊断不可靠，那么患者接受最佳治疗的信心就会降低。
本研究的目的是评估两名 TMT 从业者在脉诊、腹诊和主要和次要和诊断方面的一致性水平。
进行了一项观察者间可靠性研究。两名（2 名） TMT 从业者分别进行 TMT 检查并填写评估表，从与脉象特征、腹诊和主要和诊断和次要和诊断相关的一系列可能反应中进行选择。kappa 系数用于衡量结果变量的观察者间可靠性。
共有 62 名（22 名男性，40 名女性）年龄在 20-65 岁的澳大利亚人（平均年龄 49.2 +/- 12.2 岁）参与了研究。脉诊深度、速度和力量的一致性水平分别为 57%、61%和 77%。对于腹诊，肺、肾、脾和肝腹部区域的一致性水平分别为 58%、53%、35%和 10%。主要和诊断的总体一致性水平为 48%，次要和诊断的一致性水平为 44%。
总体而言，在基本脉象特征和两个腹部区域的腹诊方面，存在相当程度的一致性。主要和次要和诊断的一致性水平表明还有改进的空间。需要进一步的研究，以便更深入地了解 TMT 中诊断的可靠性。
