Li Xiao-yan, Wen Ze-huai, Liang Wei-xiong, Xu Wei-hua, Li Su-yun, Yu Xue-qing, Wang Hai-feng
the Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangdong Province, China.
Zhong Xi Yi Jie He Xue Bao. 2010 Dec;8(12):1153-8. doi: 10.3736/jcim20101207.
To evaluate the consistency of tongue manifestation and pulse condition observed by traditional Chinese medicine clinicians.
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.
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).
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.
评估中医临床医生对舌象和脉象观察的一致性。
本研究采用现场调查和直接询问的方法。同一科室的两名医生独立判断舌象和脉象。观察者之间的一致性采用Kappa统计量进行评估。
本研究共纳入55例患者。舌体观察中有13例不一致（23.6%），舌形观察中有7例不一致（12.7%）。舌体观察一致性（Kappa=0.649）和舌形观察一致性（Kappa=0.752）良好。舌苔观察中有24例不一致（43.6%），其一致性为中等（Kappa=0.525）。脉象诊断中有22例不一致（40%），其诊断一致性也为中等（Kappa=0.562）。
不同临床医生对舌象和脉象的观察及诊断一致性中等。通过分析不一致的原因，有必要从细化标准、研究者态度和加强研究者培训等三个方面提高一致性。
