對中醫外感常見症狀術語標準化之初探

Terminology Standardization for Common Symptoms of Exogenous Febrile Disease in Traditional Chinese Medicine: A Preliminary Study

陳運泰(Yun-Tai Chen) ； 陳嘉允(Chia-Yun Chen) ； 陳稼洺(Jia-Ming Chen) ； 鄭宗琳(Tsung-Lin Cheng) ； 張恒鴻(Hen-Hong Chang) ； 許堯欽(Yao-Chin Hsu) ； 楊中賢(Chung-Hsien Yang) ； 林宏任(Hung-Jen Lin) ； 羅綸謙(Lun-Chien Lo)

《中醫藥雜誌》 26卷1期 (2015/06) Pp. 45-58

https://doi.org/10.3966/101764462015062601005

摘要

目的：本研究旨在透過共識的凝聚，對中醫外感常見症狀術語的涵義及臨床操作模式進行標準化，以提昇中醫症狀術語臨床運用的一致性。方法：採取文獻整理和專家共識法擬定初步標準化內容，再以李克特量表的形式製成半開放式問卷，交寄中醫師填答與回饋，問卷回收後分析認同度，並以Cronbach's alpha指數檢測一致性。結果：專家選定惡風、惡寒、自汗、痰、口渴、喘、咳嗽、咽喉痛、項強和頭痛等十項外感常見症狀，擬定其涵義及臨床操作模式，此共識內容在問卷填寫者間獲得很高的認同，並有顯著的一致性，顯示了良好的共識。結論：本研究首度嘗試以調查認同度的方式整合中醫師對症狀術語的共識，雖僅為初步成果，仍為症狀術語的研究提供了新方向，未來可參考本方法持續對重要的症狀術語進行標準化，並擴大參與面，凝聚更高的共識，提高中診斷的信度和客觀性。

關鍵字

中醫學 ； 診斷 ； 症狀術語 ； 標準化 ； 認同度 ； 一致性

並列摘要

Purpose: Symptoms with highly agreed definitions are essential for establishment of an objective traditional Chinese medicine (TCM) system. This study was intended to standardize definitions of ten symptoms of exogenous febrile disease in TCM. We attempted to build a preliminary consensus of definitions of these symptoms within the group of TCM physicians in Taiwan. Methods: We adapted methods of literature collection and panel meeting to build a preliminary consensus of definitions of these symptoms. The result was transformed to questionnaire in the form of Likert scale. Then we used purposive sampling to select TCM physicians work in teaching hospital and delivered questionnaire to them. After return of questionnaires, average value and Cronbach's alpha were calculated for testing the agreement and consistency, respectively. Results: The standardization of meaning and operational procedure of ten symptoms were performed, they were aversion to wind, aversion to cold, spontaneous sweating, sputum, thirsty, dyspnea, cough, sore throat, stiffness of the neck and headache. Conclusion: The result revealed that survey respondents were in high agreement with the preliminary consensus built by experts. The consistency also had statistical significance. For increasing the reliability and objectivity of TCM diagnosis, definitions of other symptoms should keep be standardized, and methodology of this study was recommended to the following researcher.

並列關鍵字

Traditional Chinese medicine ； diagnosis ； symptom terminology ； standardization ； consistency ； agreement

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