Agreements among traditional Chinese medicine practitioners in the diagnosis and treatment of irritable bowel syndrome
Agreements among traditional Chinese medicine practitioners in the diagnosis and treatment of irritable bowel syndrome
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DOI：
10.1111/j.1365-2036.2004.02242.x
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发表时间：
2004-11-15
影响因子：
7.6
通讯作者：
Chan, FKL
中科院分区：
文献类型：
--
作者：
Sung, JJY;Leung, WK;Chan, FKL
背景资料：目的：探讨中医药对肠易激综合征的诊断和用药的一致性，为临床合理用药提供依据。研究分为三个阶段：（i）设盲个体评估，（ii）讨论以达成诊断和治疗共识。(iii)根据一致同意的诊断标准进行个人评估。招募其他原因腹泻的患者作为阶段（iii）的对照。百分比协议和卡帕值的诊断，治疗原则和regiments.Results：39肠易激综合征患者进行了评估阶段（i），而65肠易激综合征患者和17个非肠易激综合征对照进行了研究阶段（iii）。诊断、治疗原则和方案的平均一致率分别为：I期57、58和52%，III期80、81和80%（P = 0.002）。相应地，在诊断（0.1.1-0.34，P = 0.015）和治疗原则（0.16-0.37，P = 0.002）方面的平均kappa值有显著改善，但在治疗方案方面没有改善。中医师之间的相互理解和意见的融合可以达到一致的诊断。
Background: Traditional Chinese Medicine was frequently used by patients with irritable bowel syndrome.Aim: To evaluate the agreement on diagnoses and prescription of irritable bowel syndrome among Traditional Chinese Medicine practitioners.Methods: Consecutive irritable bowel syndrome patients were interviewed independently by four Traditional Chinese Medicine practitioners. The study was divided into three phases: (i) blinded individual assessment, (ii) discussion to achieve consensus on diagnosis and treatment. (iii) individual assessment based on consensual diagnostic criteria. Patients with other causes of diarrhoea were recruited as controls in phase (iii). Percentage agreement and kappa-value in diagnosis, treatment principle and regime were determined.Results: Thirty-nine irritable bowel syndrome patients were assessed in phase (i) whereas 65 irritable bowel syndrome patients and 17 non-irritable bowel syndrome controls were studied in phase (iii). The mean agreement rates in diagnosis, treatment principle and regimen were: 57, 58 and 52% for phase (i) and 80, 81 and 80% for phase (iii) (P = 0.002). Accordingly, there was significant improvement in the mean kappa-values in diagnosis (0.1.1-0.34, P = 0.015) and treatment principle (0.16-0.37, P = 0.002) but not in treatment regime.Conclusions: Variations in diagnosis and treatment principles do exist among Traditional Chinese Medicine practitioners. Concordant diagnosis can be reached by mutual understanding and converging opinion among Traditional Chinese Medicine practitioners.