基于Delphi法修订带下病中医诊疗指南问卷调查研究

发布时间：2018-01-23 18:09

本文关键词： 带下病诊疗指南修订 Delphi法问卷调查　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：应用Delphi法(德尔菲法)进行专家问卷调查,对现有《带下病中医诊疗指南》进行科学规范的修订,以期形成合理规范,实用易行的新的《带下病中医诊疗指南》,更好的发挥其临床指导作用。方法：1.文献研究：采取人工检索和计算机检索、网络检索相结合的方法,充分查找与本课题相关文献。按照文献纳入排除标准,整理相关文献,为修订带下病临床指南的内容提供依据。2.问卷调查方法：采用循证医学理念,在文献研究和原有指南的基础上,运用Delphi法设计原则,结合专家建议,制定专家问卷调查表。将问卷以电子邮件的方式发放给挑选的妇科专家。3.统计学方法：采用SPSS19.0统计学软件,统计相关指标的均数、频数、频率、满分比、变异系数等。结果：1.文献研究结果：本研究共纳入带下病古书籍86本,相关文献154篇,其中带下过多133篇,带下过少21篇,主要涉及带下病的定义、诊断、证候特点、内治法、外治法、食疗、预防调护等方面。2.问卷调查结果：(1)专家积极系数结果：本研究共选择全国范围内30位妇科专家,进行三轮问卷调查,回收份数分为29、29、24,问卷回收率分别为,96.67%、96.67%,80.00%,说明本课题受到参与问卷调查专家高度关注,保证了结果的可信度。(2)条目可靠度结果：三轮问卷条目专家的熟悉度除1条为0.78,其余条目均值介于0.82-0.99,重要程度均值介于3.67～4.89,食疗部分的重要性相对偏低；专家意见协调程度除两个条目的CV值为0.27,其余介于0.06-0.24,说明条目专家共识度具有统计意义。(3)专家共识结果：三轮专家问卷调查的条目总数分别为62、39、6,达成专家共识条目数分别为48、37、5,分别占总条目数的77.42%、94.87%、83.33%,说明专家条目的共识程度较好。经过三轮专家问卷调查,对带下病的定义、分类、诊断、辨证要点、常见证型的证候特点和治法方药、中成药、中医外治法、中医特色疗法以及预防调摄达成专家共识。结论：本研究参照国内外的指南修订的步骤,采用循证医学的理念,以文献研究为基础,应用改良Delphi法对带下病诊疗进行标准化研究,最终形成带下病专家共识样稿。说明Delphi法具有一定的科学性和可操作性,是中医诊疗标准化研究中具有重要意义的方法学。循证医学原理与Delphi法专家问卷调查结合,在中医诊疗指南的制定与修订领域均值得借鉴。
[Abstract]:Objective: to use the Delphi method (Delphi method) to carry on the expert questionnaire survey, to carry on the scientific standard revision to the present "the Chinese medicine diagnosis and treatment guide" of the disease with the belt, in order to form the reasonable standard. Practical and easy to use the new Chinese medicine diagnosis and treatment guide, better play its clinical guidance role. Methods: 1. Literature research: the combination of artificial search and computer retrieval, network retrieval method. In order to provide the basis for the revision of clinical guidelines for subclinical diseases, the questionnaire survey method: the concept of evidence-based medicine. On the basis of the literature research and the original guide, the design principle of Delphi method is used, and the expert suggestion is combined. Develop expert questionnaire. Send the questionnaire to selected gynecological experts by email. Statistical method: use SPSS19.0 statistical software, statistics related indicators of the average, frequency. Results: 1.Results: the results of literature research: this study included 86 ancient books with lower diseases, 154 related papers, including 133 articles with more than 133 articles and 21 articles with too few articles. It mainly involves the definition, diagnosis, syndrome characteristics, internal treatment, external treatment, diet therapy. The positive coefficient of experts: 30 gynecological experts from all over the country were selected to carry out three rounds of questionnaires, and the number of the recovered parts was 29 / 29. The recovery rate of the questionnaire is respectively 96.67 and 96.670.This indicates that this topic is highly concerned by the experts involved in the questionnaire survey. Reliability results: the familiarity of experts in three rounds of questionnaires was 0.78, and the average of the other items was between 0.82-0.99. The mean value of important degree was between 3.67 and 4.89, and the importance of the part of diet therapy was relatively low. The degree of coordination of expert opinions ranged from 0.06-0.24 except for two entries with a CV of 0.27. The result of expert consensus is: the total number of items in three rounds of expert questionnaire is 622 / 39 / 6 respectively, and the number of items reached by expert consensus is 48 / 37 / 5 respectively. 77.42% of the total items account for 83.33% of the total items, indicating that the consensus of the expert items is good. After three rounds of expert questionnaires, the definition, classification and diagnosis of diseases with them are discussed. The main points of syndrome differentiation, syndromes characteristics of common syndrome types, Chinese medicine, Chinese patent medicine, external treatment of traditional Chinese medicine, characteristic therapy of traditional Chinese medicine and prevention adjustment reached an expert consensus. Conclusion: this study refers to the revised steps of the guidelines at home and abroad. Using the concept of evidence-based medicine, based on literature research, the improved Delphi method was used to standardize the diagnosis and treatment of subband diseases. The result shows that the Delphi method is scientific and operable. Evidence-based medicine principle combined with Delphi expert questionnaire survey can be used for reference in the field of making and revising the guidelines of TCM diagnosis and treatment.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.13

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