Pan Ju-Hua, Huang Shi-Jing, Zheng Jun, Wu Wei, Xue Liu-Hua
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, BeiJing 100053, China.
Zhongguo Zhong Yao Za Zhi. 2013 Aug;38(15):2484-8.
The pathogenesis of acquired immune deficiency syndrome-associated recurrent oral ulcerations (AIDS-ROU) remained obscure and these was no specific treatment for it. Syndrome differentiation in traditional Chinese medicine (TCM) focus on integral regulation and has an advantage of the disease that etiology and pathogenesis remain obscure. A draft of Chinese medicine diagnosis and treatment standard procedure for AIDS-ROU was established by literature retrieval and peer review. Two questionnaires were carried out to investigate the confirmation and advice of in-group specialist to key points of the draft including diagnosis, treatment and nursing. Then the procedures were revised accordingly. The preliminary results showed the recovery rate of complete questionnaires in the 1st survey was 96%. Specialists confirmed more on outline, case history and physical examinations, syndrome differentiation of hyperactivity of fire due to Yin deficiency syndrome (HFYDS), treatment of heat accumulated in heart and spleen syndrome (HAHSS) and HFYDS, treatment of western medicine and nursing. They held different opinions on incidence, treatment of deficiency of spleen-QI and stomach-QI syndrome (DSSS) and criterion of therapeutical evaluation. Cronbach coefficient alpha (CCA) was 0.998 and split-half reliability R was 0.91. Recovery rate of complete questionnaires in 2nd survey was 100%. Specialists confirmed more on outline, etiology and pathogenesis, case history and physical examination, auxiliary examination, diagnostic criteria, syndrome differentiation and treatment of HAHSS and HFYDS. They held different opinions on syndrome differentiation and treatment of intermingled cold and heat syndrome and DSSS, nursing and the other therapies. CCA was 0.428 and split-half reliability R was 0.96. Coefficient of variations of the 2nd survey were less than those of the 1st survey, which mean coordination was improved. Each single item in two surveys contributed less difference in overall results according to weight coefficients. A new revision of the procedure was preliminarily established according to results of two surveys. Experts'activeness, concentration and coordination were good in two surveys. They had reached consensus in key points of the draft including diagnosis, treatment and nursing on the whole.
获得性免疫缺陷综合征相关复发性口腔溃疡（AIDS-ROU）的发病机制尚不清楚，且尚无特效治疗方法。中医辨证注重整体调节，对于病因病机尚不明确的疾病具有优势。通过文献检索和同行评议，制定了AIDS-ROU的中医诊疗规范草案。开展了两份问卷，以调查组内专家对草案要点（包括诊断、治疗和护理）的确认情况及建议。然后据此对规范进行修订。初步结果显示，第一次调查中完整问卷的回收率为96%。专家们对大纲、病史和体格检查、阴虚火旺证（HFYDS）的辨证、心脾积热证（HAHSS）和HFYDS的治疗、西医治疗及护理等方面的确认度较高。他们对发病率、脾气虚和胃气虚证（DSSS）的治疗及疗效评价标准存在不同意见。克朗巴赫系数α（CCA）为0.998，分半信度R为0.91。第二次调查中完整问卷的回收率为100%。专家们对大纲、病因病机、病史和体格检查、辅助检查、诊断标准、HAHSS和HFYDS的辨证及治疗等方面的确认度较高。他们对寒热错杂证和DSSS的辨证及治疗、护理及其他疗法存在不同意见。CCA为0.428，分半信度R为0.96。第二次调查的变异系数小于第一次调查，这意味着协调性有所提高。根据权重系数，两次调查中每个单项对总体结果的贡献差异较小。根据两次调查结果初步制定了规范的新修订版。两次调查中专家的积极性、专注度和协调性良好。他们在草案的诊断、治疗和护理等要点上总体达成了共识。
