基于德尔菲法的儿童社区获得性肺炎中医证候专家问卷分析

doi:10.20274/j.cnki.issn.1674-3865.2025.05.009

Abstract

Abstract:

Objective To investigate the diagnostic experience of experts on the syndrome of community-acquired pneumonia(CAP) in children by using the Delphi method, screen for the diagnostic indicators of syndromes, evaluate their importance, and provide evidence for the formulation of diagnostic standards for pediatric CAP. Methods Based on literature research, a questionnaire survey was conducted among selected experts using the Delphi method. The results of the questionnaire were statistically processed using Excel and SPSS 27.0 software, and the expert positive coefficient, expert authority coefficient, and the expert opinion coordination degree and concentration degree were calculated. Results A total of 30 domestic experts were selected for the questionnaire survey, with a questionnaire recovery rate of 90%. The expert authority coefficient was 0.905, and the expert coordination coefficient was 0.348(P<0.001). A total of 8 syndrome types were set up in the first round of expert questionnaire survey, including syndrome of heat pathogen blocking the lung, syndrome of lung and spleen-qi deficiency, syndrome of damp-heat blocking the lung, syndrome of wind-cold blocking the lung, syndrome of wind-heat blocking the lung, syndrome of toxic-heat blocking the lung, syndrome of phlegm-heat blocking the lung and syndrome of yin-deficiency with lung-heat, and their syndrome characteristics were analyzed. Conclusion This study initially explores the distribution pattern and characteristics of TCM syndromes in pediatric CAP, laying a foundation for subsequent researches on the diagnostic standards and clinical studies of TCM syndromes in pediatric CAP.

Key words: Community-acquired pneumonia, Delphi method, Syndrome, Expert questionnaire, Child

CLC Number:

R725.6

Qian LIU, Xuefeng WANG, Xiuying ZHANG, Xinran FENG, Yanyan NI, Zhifan TIAN, Hui WANG. Analysis of expert questionnaire on TCM syndromes of community-acquired pneumonia in children based on Delphi method[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(5): 410-417.

Figures/Tables 10

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References 14

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适用度评分	量化值	判断依据（Ca）	对专家判断的影响程度			熟悉程度（Cs）	量化值
适用度评分	量化值	判断依据（Ca）	大	中	小	熟悉程度（Cs）	量化值
很重要	5	理论知识	0.3	0.2	0.1	很熟悉	1.0
重要	4	实践经验	0.3	0.2	0.1	熟悉	0.8
一般	3	参考国内外资料	0.3	0.2	0.1	一般	0.6
不重要	2	个人直觉	0.3	0.2	0.1	不太熟悉	0.4
很不重要	1					不熟悉	0.2

证型	均值	变异系数	满分比（%）
痰热闭肺证	5.00	0.00	100.00
风热闭肺证	4.75	0.11	81.48
肺脾气虚证	3.36	0.54	44.44
风寒闭肺证	3.43	0.28	32.22
阴虚肺热证	3.25	0.57	37.04
毒热闭肺证	4.71	0.14	81.48
湿热闭肺证	3.07	0.46	39.63
热邪闭肺证	3.11	0.59	33.33

指标	均值	标准差	变异系数	满分比（%）	保留情况	指标	均值	标准差	变异系数	满分比（%）	保留情况
发热	4.67	1.04	0.22	88.89	√	面红	3.52	1.87	0.53	40.74	√
高热	4.89	0.42	0.09	96.30	√	唇绀	3.74	1.95	0.52	62.96	√
高热不退	3.93	1.47	0.37	48.15	√	唇干	3.26	1.91	0.59	29.63	√
有汗	3.15	1.63	0.52	29.63	√	口渴	3.59	1.28	0.36	18.52	×
身热	3.52	1.87	0.53	44.44	√	口干	3.19	1.67	0.52	14.81	×
热势反复	3.00	2.08	0.69	40.74	√	大便秘结	4.00	1.21	0.30	44.44	√
咳嗽	4.44	1.60	0.36	92.59	√	小便黄	3.07	1.86	0.61	22.22	√
咳声重浊	4.67	0.88	0.19	88.89	√	咽红	3.81	1.76	0.46	51.85	√
阵咳	3.74	1.77	0.47	55.56	√	胸闷	2.56	1.76	0.69	3.70	×
喉间痰鸣	4.67	1.04	0.22	85.19	√	烦躁不安	3.11	1.58	0.51	18.52	√
痰黄	4.67	0.62	0.13	74.07	√	纳呆	3.07	1.64	0.53	11.11	×
痰黏稠	4.00	1.75	0.44	59.26	√	食欲下降	3.00	1.88	0.63	29.63	√
多痰	3.63	1.80	0.50	48.15	√	舌质红	4.81	0.48	0.10	88.89	√
声如拽锯	3.04	1.87	0.62	25.93	√	苔黄腻	4.52	1.09	0.24	77.78	√
气促	4.30	1.59	0.37	74.07	√	舌苔黄	3.85	1.75	0.45	51.85	√
气喘息粗	4.22	1.45	0.34	66.67	√	脉滑数	4.44	1.34	0.30	74.07	√
喘憋	3.93	1.44	0.37	48.15	√	脉洪数	2.26	1.99	0.88	7.41	×
鼻煽	4.33	1.04	0.24	51.85	√	指纹紫滞	4.00	1.78	0.44	66.67	√

指标	均值	标准差	变异系数	满分比（%）	保留情况	指标	均值	标准差	变异系数	满分比（%）	保留情况
低热	4.56	1.05	0.23	74.07	√	口干	3.15	2.14	0.68	37.04	√
手足心热	4.44	1.34	0.30	74.07	√	大便秘结	3.48	1.67	0.48	29.63	√
潮热	3.59	1.85	0.51	40.74	√	口干欲饮	2.41	2.19	0.91	22.22	×
发热	2.52	1.99	0.79	14.81	×	小便黄	2.33	2.22	0.95	22.22	×
干咳	4.56	1.01	0.22	74.07	√	汗出	1.63	1.84	1.13	7.41	×
咳嗽	3.19	2.32	0.73	55.56	√	盗汗	3.30	2.05	0.62	37.04	√
咳嗽频作	1.78	1.93	1.08	18.52	×	咽干	2.52	2.03	0.80	11.11	×
久咳	4.00	1.62	0.40	59.26	√	咽红	3.32	2.10	0.63	11.11	×
少痰	3.96	1.77	0.45	62.96	√	舌质红	4.11	1.60	0.39	66.67	√
痰黏稠	2.52	2.16	0.86	29.63	×	舌干红	1.78	2.10	1.18	18.52	×
唇干	3.00	2.08	0.69	29.63	√	苔花剥	3.37	2.10	0.62	59.26	√
面色潮红	2.19	2.08	0.95	14.81	×	舌苔少	4.07	1.77	0.44	70.37	√
面红	2.02	2.08	0.88	14.81	×	脉数	1.33	1.86	1.40	14.81	×
口唇红	2.52	2.05	0.81	14.81	×	脉细数	4.19	1.59	0.38	66.67	√
口渴	2.07	2.09	1.01	11.11	×	指纹淡紫	2.07	2.11	1.02	25.93	×

指标	均值	标准差	变异系数	满分比（%）	保留情况	指标	均值	标准差	变异系数	满分比（%）	保留情况
发热	4.70	0.99	0.21	88.89	√	大便秘结	2.96	1.93	0.65	25.93	√
高热	2.89	2.03	0.70	29.63	×	小便黄	3.81	1.62	0.42	40.74	√
持续高热	2.26	1.93	0.86	14.81	×	汗出	2.44	1.91	0.78	18.52	×
身热	2.96	2.05	0.69	25.93	×	微有汗出	2.26	1.95	0.86	14.81	×
咳嗽	4.37	1.60	0.37	85.19	√	鼻塞	2.44	1.93	0.79	14.81	×
咳嗽频作	4.00	1.57	0.39	51.85	√	流黄涕	3.41	1.58	0.46	29.63	√
咳声重浊	2.67	2.08	0.78	29.63	×	流浊涕	3.00	1.82	0.61	22.22	√
咳声气粗	3.81	1.78	0.47	51.85	√	吞咽时咽痛	3.44	2.12	0.62	48.15	√
呛咳	2.15	2.11	0.98	18.52	×	咽干	2.74	1.95	0.71	18.52	×
阵咳	3.19	2.02	0.63	33.33	√	烦躁不安	2.04	1.97	0.97	7.41	×
干咳	1.37	1.69	1.23	3.70	×	纳呆	2.11	1.78	0.85	7.41	×
痰黄	3.78	1.58	0.42	40.74	√	纳少	2.48	1.93	0.78	11.11	×
气促	3.56	1.83	0.51	37.04	√	舌质红	3.26	2.25	0.69	55.56	√
喘息	3.00	1.71	0.57	14.81	×	舌尖红	2.85	2.18	0.76	37.04	×
恶风	3.19	1.90	0.60	33.33	√	苔薄黄	3.63	2.08	0.57	62.96	√
鼻煽	2.59	2.06	0.80	18.52	×	苔黄	2.15	2.21	1.03	25.93	×
面红	3.56	1.85	0.52	40.74	√	脉浮数	4.15	1.63	0.39	70.37	√
口唇红	3.44	1.97	0.57	44.44	√	脉数	2.67	2.25	0.84	37.04	×
唇干	2.04	2.23	1.09	22.22	×	指纹浮紫	2.89	2.26	0.78	48.15	×
口渴	2.85	1.94	0.68	25.93	×	指纹紫滞	2.11	2.10	1.00	22.22	×

Analysis of expert questionnaire on TCM syndromes of community-acquired pneumonia in children based on Delphi method

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指标	均值	标准差	变异系数	满分比（%）	保留情况	指标	均值	标准差	变异系数	满分比（%）	保留情况
高热不退	2.96	2.29	0.77	48.15	×	面红	3.23	2.22	0.69	25.93	√
高热	3.54	1.30	0.37	33.33	√	吞咽时咽痛	3.35	2.15	0.64	25.93	√
壮热	2.23	2.18	0.98	22.22	×	咽红	1.62	1.92	1.19	14.81	×
发热	3.42	1.34	0.39	33.33	√	烦躁不安	2.50	2.30	0.92	37.04	×
咳嗽	3.31	1.68	0.51	33.33	√	舌质红	3.19	2.38	0.75	55.56	√
咳嗽频作	2.42	2.35	0.97	37.04	×	舌质绛色	2.04	2.13	1.04	14.81	×
痰质稠	3.42	1.23	0.36	29.63	√	苔黄	3.69	2.43	0.66	44.44	√
质黏难咳	1.77	2.12	0.20	18.52	×	苔黄腻	1.65	1.94	1.17	11.11	×
痰黄或白	1.69	2.02	1.19	7.41	×	舌苔薄黄	0.81	1.58	1.94	3.70	×
气促	3.23	1.36	0.42	33.33	√	苔薄	0.73	1.43	1.96	3.70	×
喘促	2.15	2.28	1.06	29.63	×	脉浮数	1.35	1.90	1.40	11.11	×
口渴	3.02	1.86	0.62	22.22	√	脉数	3.23	2.07	0.64	37.04	√
口干欲饮	2.19	2.19	1.00	18.52	×	脉滑数	2.12	2.36	1.11	25.93	×
大便秘结	3.85	1.33	0.35	40.74	√	指纹青紫	1.85	2.13	1.15	14.81	×
汗出	1.54	1.86	1.21	11.11	×	指纹紫	1.50	2.18	1.45	18.52	×
鼻煽	2.35	2.23	0.95	33.33	×

指标	均值	标准差	变异系数	满分比（%）	保留情况	指标	均值	标准差	变异系数	满分比（%）	保留情况
恶寒	4.19	1.59	0.38	66.67	√	无汗	3.52	2.01	0.57	48.15	√
发热	3.67	1.73	0.47	44.44	√	流清涕	4.07	1.77	0.44	66.67	√
低热	1.74	1.97	1.13	11.11	×	鼻塞	4.30	1.33	0.31	59.26	√
咳嗽	4.67	1.00	0.21	81.48	√	头身痛	3.48	1.78	0.51	29.63	√
呛咳	3.07	2.18	0.71	44.44	√	舌质淡红	3.22	2.28	0.71	55.56	√
咳声重浊	2.52	2.33	0.92	37.04	×	舌质淡	2.33	2.35	1.01	33.33	×
痰清稀	2.85	2.20	0.77	37.04	×	苔白腻	1.33	1.78	1.34	7.41	×
痰白	3.74	1.89	0.51	51.85	√	苔薄白	2.74	2.23	0.81	33.33	×
气促	2.41	2.08	0.86	18.52	×	脉浮紧	3.74	2.07	0.55	62.96	√
面白	2.52	2.23	0.88	29.63	×	指纹浮红	3.44	2.17	0.63	55.56	√
口不渴	3.56	2.03	0.57	51.85	√	指纹红	1.44	1.97	1.37	14.81	×
小便清长	2.26	2.18	0.96	22.22	×

指标	均值	标准差	变异系数	满分比（%）	保留情况	指标	均值	标准差	变异系数	满分比（%）	保留情况
低热	2.37	2.04	0.86	22.22	×	纳呆	3.89	1.78	0.46	59.00	√
发热	1.15	1.63	1.42	7.41	×	形体消瘦	2.96	1.83	0.62	25.93	×
咳嗽无力	4.07	1.82	0.45	74.07	√	睡眠欠佳	2.19	2.11	0.96	18.52	×
咳嗽	2.74	2.11	0.77	29.63	×	反复感冒	4.48	1.09	0.24	70.37	√
久咳	4.07	1.36	0.33	48.15	√	舌质淡	4.56	1.05	0.23	74.07	√
多痰	2.37	2.08	0.88	18.52	×	舌胖大有齿痕	3.48	1.97	0.57	40.74	√
痰清稀	3.67	1.88	0.51	48.15	√	苔薄白	3.33	2.02	0.61	40.74	√
痰白	3.26	1.89	0.58	29.63	√	舌白腻	2.30	2.07	0.90	18.52	×
气短	3.41	1.95	0.57	37.04	√	苔白	2.00	2.00	1.00	11.11	×
面色白	2.59	2.14	0.82	25.93	×	脉细无力	2.89	2.21	0.76	37.04	×
面色少华	3.48	2.01	0.58	48.15	√	脉细弱	3.11	1.99	0.64	29.63	√
面色萎黄	3.52	1.85	0.52	37.04	√	脉弱	1.74	1.97	1.13	11.11	×
大便溏薄	3.89	1.53	0.39	40.74	√	脉沉弱无力	1.44	1.76	1.22	7.41	×
多汗	3.00	2.27	0.76	44.44	√	脉沉细弱	1.67	1.96	1.17	14.81	×
自汗	3.70	1.94	0.52	55.56	√	指纹淡红	3.15	2.07	0.66	33.33	√
恶心	0.89	1.40	1.57	0.00	×	指纹淡	2.41	2.26	0.94	25.93	×
呕吐	0.85	1.29	1.52	0.00	×	指纹淡暗不显	1.26	1.72	1.37	7.41	×

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