腰椎间盘突出症辨证分型评估表的编制及应用研究

摘要

Objective To construct Evaluation Form for TCM Nursing with Syndrome Differentiation for Lumbar Disc Herniation in order to provide references for better nursing care of patients with lumbar disc herniation with syndrome differentiation.Methods According to the principle of "discern Yin and Yang,grasp the main symptoms",literature analysis and Delphi method were used to draft the primary and secondary symptoms of lumbar disc herniation's common syndromes,and Evaluation Form for TCM Nursing with Syndrome Differentiation for Lumbar Disc Herniation was developed.Totally 84 patients were recruited,and results evaluated by clinical physicians and nurses using the evaluation form were compared.Results By means of the evaluation form,80 patients were considered as the type of "Xue yu qi zhi",1 patient as the type of "Han shi bi zu",the others three as the type of "Gan shen kui xu";according to clinical physicians,83 patients were the type of "Xue yu qi zhi",and 1 patient was the type of "Gan shen kui xu".The consistency rate of two methods was 96.43％,and there was no significant difference (P＞0.05).Conclusion There was no statistically significant difference between the results from clinical physicians and nurses using the evaluation form.The evaluation form is applicable in clinical practice,which can lay the foundation for nurses to carry out nursing with syndrome differentiation.%目的 编制腰椎间盘突出症辨证分型评估表,并对其应用效果进行评价,旨在为护士提供腰椎间盘突出症辨证施护的辅助工具.方法 遵循“定阴阳、抓主症”的辨证原则,通过文献分析法与德尔菲法明确腰椎间盘突出症各中医证型的主次症状,编制腰椎间盘突出症辨证分型评估表.选取84例患者,对比护士采用评估表辨证结果和医疗专家辨证结果的一致性.结果 84例腰椎间盘突出症患者中,护士判断为血瘀气滞型80例,寒湿痹阻型1例,肝肾亏虚型3例;医疗专家判断为血瘀气滞型83例,肝肾亏虚型1例,一致率为96.43％,差异无统计学意义(P＞0.05).结论 护士采用腰椎间盘突出症辨证分型评估表的辨证结果与医疗专家辨证结果的一致性高,说明腰椎间盘突出症辨证分型评估表具有较好的临床应用价值,可作为护士腰椎间盘突出症辨证施护的辅助工具.