基于德尔菲法的肺结节常见中医证候及证候要素研究OA

Objective To preliminarily establish diagnostic criteria for common traditional Chinese medicine(TCM)syndromes and syndrome elements of pulmonary nodules,providing a basis for standardized TCM diagnosis and treatment of pulmonary nodules.Methods Literature related to common TCM syndromes of pulmonary nodules was searched to establish an item pool.The questionnaire items were further deleted and supplemented through expert group discussions.Based on this,two rounds of questionnaire surveys were conducted among experts nationwide using the Delphi method to determine the importance of each item and preliminarily establish diagnostic criteria for common TCM syndromes and syndrome elements of pulmonary nodules.Results The positive coefficients of experts in the two rounds of consultation were 100.00%and 90.48%,respectively,and the expert opinions were basically consistent.Regarding pathogenesis,it was considered that healthy qi deficiency and toxin accumulation could be regarded as the basic pathogenesis of pulmonary nodules.Expert opinions on healthy qi deficiency-related pathogeneses,including lung and spleen qi deficiency and lung yin deficiency,showed a high degree of concentration and coordination.Expert opinions on pathogenic factors related to excess syndromes,including qi stagnation,blood stasis,and phlegm turbidity,also showed a high degree of concentration and coordination.Among the common basic syndrome types,expert opinions on lung and spleen qi deficiency syndrome,liver qi stagnation syndrome,spleen deficiency with excessive dampness syndrome,qi deficiency with blood stasis syndrome,qi-yin deficiency syndrome,and phlegm-heat blood stasis syndrome showed a high degree of concentration and coordination.Regarding the key points for syndrome differentiation of common syndromes,expert opinions mainly focused on 14 items for qi-yin deficiency syndrome,13 items for lung and spleen qi deficiency syndrome,9 items for phlegm-heat blood stasis syndrome,11 items for liver qi stagnation syndrome,17 items for spleen deficiency with excessive dampness syndrome,and 11 items for qi deficiency with blood stasis syndrome.Conclusion Diagnostic criteria for common TCM syndromes and syndrome elements of pulmonary nodules were preliminarily established.