Stable angina pectoris ( phlegm and permits) Integrative Medicine Outcome Assessment System
|School||Liaoning University of Traditional Chinese Medicine|
|Course||Traditional Chinese Medicine|
|Keywords||Coronary heart disease Stable angina pectoris Chest Impediment Efficacy evaluation Clinical observation|
Objectie:With coronary heart disease stable angina (phlegm and blood stasis syndrome) mutual "for demonstration and the establishment of a prominent characteristic, combine traditional Chinese and western medicine, traditional Chinese medicine the curative effect of evaluation index system.Research methods and processes:This study included four stages:The first stage: recommend the selection of evaluation indicators. Through the reference countries and the industry standard, using "China academic journal CNKI database,", "Chinese biomedical document database (such as CBMDdisk)", MEDLINE database retrieval 1999-2009 relevant coronary heart disease outcomes assessment, formulate the relevant literature inclusion criteria and exclusion standard. Will meet standards according to the title, author, literature published authors unit, press, time, journal, subject support, research types, sample size, inclusion criteria, treatment methods (scheme), evaluation indexes, the author related paper ten input Excel table three fields established database. Through the literature analysis to chase a database of literature with comprehensive reading and essay for the principle, screening of coronary heart disease, angina, forming effect assessment indexes of 1 recommended index.The second stage: the selection of evaluation indexes. Through the expert consultation method, and in accordance with the principle of recommended screening, index evaluation index group 1 of preliminary delete selected indicators of evaluation indexes, forming a recommendation of 2. Use system analysis method of McKinsey logic tree with the recommended evaluation index group of 2 of each index logical relationship for qualitative analysis and quantitative integration, puts forward index options, according to the evaluation standard, through of each alternative expert meeting assessment, and ultimately the most feasible scheme determines the index.The third stage: the curative effect of the establishment of evaluation index system framework. Through the analytic hierarchy process to the most feasible scheme of each index according to different attribute index from the top down into three layers are formed "coronary heart disease stable angina (phlegm and blood stasis syndrome) combine traditional Chinese and western medicine, mutual" effect assessment index system "framework.The fourth stage: Combine traditional Chinese and western medicine, the formation of curative effect evaluation index system. This stage through ahp combined with the Delphi method and get index weight and expert advice. And put all the expert advice to collect, and statistical data and feedback to the experts together until the next round, so repeatedly expert advice trend is consistent, data standard finalized coronary heart disease stable angina (phlegm and blood stasis syndrome) combine traditional Chinese and western medicine, mutual "effect assessment index system.Results:1. effect assessment of related literature retrieval coronary heart disease 6257 article, met inclusion criteria to study and entry of a database of literature articles. 510 Screening effect assessment indexes of coronary artery disease angina, namely recommendation 146 of the evaluation index group 1 contains index 146 items.2. the basis of the principle that index selection, evaluation index 2 recommended containing index 62 items.3. produce five indicators alternatives. After finally to put forward by assessing the coronary stable angina (phlegm and blood stasis syndrome) mutual "itcwm curative effect evaluation index the most feasible solutions, including four dimensions, 13 indicators. 4. Using ahp get efficacy evaluation index system framework includes target strata, criterion layer, index layer. Target layer namely primary index, including index, namely, coronary heart disease, a stable angina (phlegm and blood stasis syndrome) combine traditional Chinese and western medicine, mutual "effect assessment index system; Criterion strata namely secondary indexes, including four, namely indicators of TCM syndrome, western medicine disease, quality of life, the destination event. Index layer namely level 3 index, including indexes, namely syndrome 12 his rating scale, syndrome since rating scale, coronary arteriography and exercise treadmill testing, angina pectoris integral, resting electrocardiogram, a year again hospitalization times, coronary heart disease, coronary hospitalization days malignant arrhythmia, heart failure, nonfatal myocardial infarction, heart disease all-cause.5. Three rounds Delphi expert questionnaire for 91.38%, 96.23% 97.95% respectively, said experts, 100% this research paid great attention; Experts on the authority of the indicators in degree coefficient between fluctuation, Maurice efficiently ~ the result of evaluation experts said the high reliability.6. Expert advice and by reference to the analysis of statistical results and finally formed coronary stable angina (phlegm and blood stasis syndrome) combine traditional Chinese and western medicine, mutual "effect assessment index system including the first-order index 1 item; Four secondary indexes, namely syndromes, western medicine disease, quality of life, the destination events; Level 3 index 9, namely syndrome he rating scale, syndrome self-assessment instrument, exercise treadmill testing, angina pectoris integral, resting electrocardiogram, malignant arrhythmia, heart failure, nonfatal myocardial infarction, heart disease all-cause.Conclusion1.Current effect assessment of coronary artery disease angina on its western have definite evaluation index and methods.2. TCM curative effect evaluation of coronary artery disease angina larger, although still controversial in continuous exploration and improved, but has not reached the agreement. Standards are inconsistent, evaluation method chaos, evaluation index subjectivity is too large, these are difficult to highlight the characteristics and advantages of traditional Chinese medicine, which hampered the development of TCM course.3. Coronary heart disease stable angina efficacy of combination of Chinese and western medicine evaluation index system should be multidimensional, multi-index and multi-level comprehensive evaluation. In the process of performance evaluation should also combining evidence-based medicine, health economics, medical statistics and other related knowledge, and to disease and syndrome combination as the main ideas, the overall level of comprehensive evaluation system established curative effect.4. The research is only a tentative try, though in unceasing revision, but there are still some unsatisfactory place, to be in a follow-up study constantly be perfected.