“崔氏观手指诊痛风”检查技术的可行性临床研究

发布时间：2018-05-17 23:10

本文选题：痛风 + 观手指　；参考：《河南中医药大学》2016年硕士论文

【摘要】：目的:探讨“崔氏观手指诊痛风”检查技术、双源CT(DECT)尿酸盐结晶成像技术对痛风的临床诊断价值,以及“崔氏观手指诊痛风”技术在传承过程中的一致性。并进一步分析总结崔公让导师善用望诊方法的学术思想,为该诊断技术的推广提供临床科学依据。方法:通过前瞻性设计,自2015年3月至2016年3月期间在河南中医药大学第一附属医院崔公让名医传承工作室(痛风专科门诊)诊治,符合纳入标准的120例患者,全部经美国风湿病协会(ACR)1977年制定的急性痛风关节炎标准明确诊断,分为“有病”组60例,“无病”组60例。采用盲法比较诊断方法,统计分析“崔氏观手指诊痛风”检查技术、传承弟子诊断、DECT尿酸盐结晶成像技术的诊断价值,以及传承过程中的一致性。所得数值采用SPSS20.0软件进行统计学分析。结果:1.通过对120例患者的前瞻盲法诊断,DECT尿酸盐结晶沉积检查诊断痛风敏感度为96.67%,特异度为86.7%,漏诊率为3.33%,误诊率为13.3%,诊断效率91.67%,阳性预测值为87.91%,阴性预测值为96.3%,Youden指数为0.83;“崔氏观手指诊痛风”检查技术诊断痛风敏感度为95%,特异度为75%,漏诊率为5%,误诊率为25%,诊断效率85%,阳性预测值为79.17%,阴性预测值为93.75%,Youden指数为0.7。两种诊断痛风方法都有明确的意义。2.传承弟子运用“崔氏观手指诊痛风”检查技术诊断,同崔公让教授诊断结果有一定的差异,两者观察符合率80%,一致性Kappa值为0.625,诊断符合一致性程度为好。结论:1.“崔氏观手指诊痛风”检查技术与DECT尿酸盐结晶沉积检查,对诊断痛风都有明确的意义。2.“崔氏观手指诊痛风”检查技术在传承中一致性较高,且简单易学,便捷无创,适合推广应用于痛风早期诊断,达到“治未病”的目的。
[Abstract]:Objective: To explore the clinical diagnostic value of "Cui's view finger diagnosis gout", the clinical diagnostic value of double source CT (DECT) urate crystal for gout, as well as the consistency of "Cui's view finger gout" technique in the process of inheritance, and to further analyze and summarize the academic thought of Cui Gong to Dao Shishan for the diagnosis of this technique. Clinical scientific basis. Methods: through prospective design, from March 2015 to March 2016, the First Affiliated Hospital of Henan University of traditional Chinese medicine was diagnosed and treated by Cui Gong heritage studio (gout specialist outpatient) at Henan University of traditional Chinese medicine (gouty specialist clinic), which met the standard of 120 patients, all of the acute gout arthritis marked by the American Society of rheumatism (ACR) in 1977. There were 60 cases of "disease" group and 60 cases of "disease free" group. A blind method was used to compare the diagnosis of "Cui's view of finger diagnosis gout", the diagnosis of disciples, the diagnostic value of DECT uric acid crystal imaging technology, and the character of the inheritance process. The value of the results was SPSS20.0 software for statistics. Results: 1. through the prospective blind diagnosis of 120 patients, DECT uric acid salt crystal deposition was used to diagnose gout sensitivity 96.67%, specificity 86.7%, missed diagnosis rate 3.33%, misdiagnosis rate 13.3%, diagnostic efficiency 91.67%, positive predictive value 87.91%, negative predictive value 96.3%, and Youden index of 0.83; "Cui's view finger diagnosis gout" The diagnostic gout sensitivity was 95%, the specificity was 75%, the misdiagnosis rate was 5%, the misdiagnosis rate was 25%, the diagnostic efficiency was 85%, the positive predictive value was 79.17%, the negative predictive value was 93.75%, the Youden index was 0.7. two diagnostic gout methods, and the.2. disciples used Cui's view finger examination gout examination technique diagnosis, with Cui Gong to let the professor The diagnosis results were different, the coincidence rate was 80%, the consistency Kappa value was 0.625, the diagnosis accords with the consistency degree. Conclusion: 1. "Cui's view finger diagnosis gout" examination technique and the DECT uric acid salt crystallizing examination are of definite significance to the diagnosis gout.2. "Cui's view finger diagnosis gout" examination technique in the inheritance. It is easy to learn, convenient and non-invasive. It is suitable for popularization and application in early diagnosis of gout and to achieve the goal of "treating disease".
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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