Chiang Hui-Chu, Chang Hen-Hong, Huang Po-Yu, Hsu Mutsu
Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan; Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Graduate Institute of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan.
Taiwan J Obstet Gynecol. 2014 Sep;53(3):317-23. doi: 10.1016/j.tjog.2013.06.013.
Qi deficiency (QD), one of the most common disorders in Traditional Chinese medicine (TCM), is relevant to many disorders in obstetrics and gynecology. This study aimed to identify the common processes and criteria for diagnosing QD among contemporary proficient TCM practitioners.
Steps of decision tree analysis and modified Delphi method were merged together into four-round postal questionnaires to collect qualitative and quantitative data. Open-ended questions and content analysis were used to explore the proficient TCM practitioners' cognitive activities used for diagnosis. The statements obtained from the qualitative responses were used to develop the items for subsequent questionnaires. Based on the TCM practitioners' responses, the diagnostic processes and criteria for making diagnosis were generated.
Twenty-eight out of the 30 participants completed all four questionnaires from June 2007 to January 2010. The 11 diagnostic procedures identified in the returned first round of questionnaires were used as the alternatives to select and rank for all the steps to diagnose QD. After three more rounds of postal surveys, an algorithm with a five-stage diagnostic process as well as sets of decision criteria were identified. Although the priorities of procedures and descriptions of reasoning were varied, the content revealed the major themes in the model. The criteria to differentiate signs and symptoms (S/S) included five principles for correlating S/S with QD, and 17 S/S should be differentiated carefully.
The results demonstrate that the TCM practitioners precisely diagnosed QD using a number of specific procedures and criteria that could be used as a reference to understand women complaining of S/S that could be similar to QD.
气虚是中医最常见的病症之一,与妇产科的多种病症相关。本研究旨在确定当代熟练的中医从业者诊断气虚的常见过程和标准。
将决策树分析步骤和改良德尔菲法合并到四轮邮政问卷中,以收集定性和定量数据。采用开放式问题和内容分析法,探索熟练中医从业者用于诊断的认知活动。从定性回答中获得的陈述用于编制后续问卷的项目。根据中医从业者的回答,生成诊断过程和诊断标准。
2007年6月至2010年1月,30名参与者中有28人完成了所有四轮问卷。第一轮问卷中确定的11种诊断程序被用作诊断气虚所有步骤的备选程序,并进行选择和排序。经过三轮邮政调查,确定了一个具有五阶段诊断过程的算法以及一套决策标准。尽管程序的优先级和推理描述各不相同,但内容揭示了模型中的主要主题。区分症状和体征(S/S)的标准包括将S/S与气虚相关联的五条原则,应仔细区分17种S/S。
结果表明,中医从业者使用一些特定的程序和标准准确诊断了气虚,这些程序和标准可作为参考,用于理解抱怨有类似于气虚的S/S的女性的情况。