基于专家咨询问卷调查的慢性肾功能衰竭相关症状对证候要素贡献度的研究

摘要

目的：运用专家咨询问卷调查的方法获取慢性肾功能衰竭的常见症状对证候要素的贡献度。方法在前期研究结果的基础上，制订专家咨询问卷，对全国8个中心12家医院中长期从事肾病临床工作5年以上且具有副高级及以上职称的专家进行调查。在第一轮专家咨询问卷结果的基础上，经过专家进一步论证。在分析专家对慢性肾功能衰竭症状对证候要素重要性程度的均数、百分比及变异系数结果的基础上，获取慢性肾功能衰竭常见症状对证候要素贡献度。结果本次专家咨询问卷调查共发放问卷101份，收回问卷101份，回收率为100%，其中有效问卷101份。按照专家给予的症状对证候要素重要性程度的评价情况，同时满足变异系数≤0.35、均值≥4.50的结果作为慢性肾衰竭常见症状对证候要素的贡献度。其中，病位类证候要素“肾”相关症状贡献度分布情况为：腰膝酸软(10分)、夜尿频多(9分)、腰膝酸痛(8分)、水肿(7分)、腰冷(7分)等。结论通过专家问卷的咨询调查，进一步确定了代表专家共识意见的慢性肾功能衰竭相关症状对证候要素的贡献度，临床专家对疾病方面有了更深层次的认识，同时为后期建立慢性肾功能衰竭基于证候要素的中医证候诊断标准提供了依据。%Objective To get contribution degree of related symptoms of chronic renal failure to syndromes factor through expert advice questionnaire. Methods On the basis of previous research results, making expert advice ques-tionnaire. Experts with clinical experience of kidney disease for more than five years and having a title of Deputy Se-nior or above among the 8 centers and 12 hospitals throughout the country were investigated. On the basis of the results in first round questionnaire, then further demonstrated by experts. The mean, percentage and variation coefficient made by experts on the disease symptom syndrome contribution to chronic renal failure common symptoms were analyzed to get syndromes contribution to chronic renal failure. Results 101 expert consultation questionnaires were distributed and questionnaires were sent back in same number with recovery percent of 100%, and all of them were valid question-naires. According to the situation of evaluation given by experts of the importance degree of symptoms to syndrome ele-ments, the result both satisfied the variation coefficient of≤0.35, the average of≥4.50 as the contribution of the com-mon symptoms of chronic renal failure to chronic renal failure syndrome elements. Among them, the disease syndrome factor of kidney related syndrome contribution degree distribution situation was as follows: soreness and weakness of waist and knees (10 points), frequent night urinate (9 points), waist and knee pain (8 points), edema (7 points), coldness in waist (7 points), etc. Conclusion Through expert consultation survey questionnaire, it can further determine the con-sensus of expert opinion for contribution of symptoms associated with chronic renal failure to syndromes factors, which means that clinical experts have a deeper understanding of disease awareness. While the results provide the foundation for diagnostic criteria basis for latter establishment of the disease based on syndrome elements of TCM diagnostic criteria.