Study On Standardization Of Traditional Chinese Medicine Disease Names And Syndromes Of Dilated Cardiomyopathy Based On Expert Questionnaire

Objective: Preliminary formation of expert opinions on traditional Chinese medicine(TCM)disease name,syndrome distribution and syndrome differentiation of dilated cardiomyopathy(DCM),in order to provide reference for further research on the standardization of TCM syndromes of DCM.Methods:Using the method of expert questionnaire,that is,Delphi method,on the basis of previous literature research and evaluation group demonstration,the "expert questionnaire on the Standardization of TCM disease name and Syndromes of dilated Cardiomyopathy" was developed,and the questionnaire was sent by e-mail to selected experts from hospitals in many provinces and cities across the country.These experts are professionals who have been engaged in clinical and/or scientific research in the field of TCM or integrated traditional Chinese and western medicine for a long time and have the title of deputy director or above.14 days later,these questionnaires were withdrawn and the contents of the questionnaire were collected and sorted out.Statistical experts on the questionnaire items of the concentration of opinions,coordination and other relevant indicators,according to expert advice to supplement,revise and improve the contents of the questionnaire,after two rounds of consultation.The opinions of the experts on the items listed in the questionnaire are basically consistent,and these items are summarized and analyzed to initially form the expert opinions on the TCM diseases names of DCM,the distribution law of TCM syndromes and the main points of syndrome differentiation.Results:(1)the positive coefficient of experts in the two rounds of questionnaires is 94.44% and 93.75% respectively.(2)the opinions of experts on heart distension as the TCM diseases names of DCM tend to be consistent.(3)In the expert consultation on the distribution of TCM syndrome elements and syndromes of DCM,the common clinical symptoms include chest tightness,palpitation,shortness of breath(especially movement),asthma(even unable to lie flat),tired and lazy speech,fatigue,edema and poor appetite;qi deficiency,yang deficiency,blood stasis and water stagnation in common disease syndrome elements;heart,lung,kidney and spleen in disease syndrome elements.The basic clinical syndromes include heart-qi deficiency syndrome,lung-qi deficiency syndrome,spleen-qi deficiency syndrome,heart-yang deficiency syndrome,spleen-yang deficiency syndrome and kidney-yang deficiency syndrome,and the expert opinions of blood stasis syndrome and water stagnation syndrome are highly concentrated and coordinated.(4)Most experts recommend that DCM be divided into stable stage and acute exacerbation stage for syndrome differentiation.Expert opinions show that the above basic clinical syndrome types and concurrent syndrome types are commonly seen in the stable stage of DCM,and the central qi deficiency syndrome,heart yang deficiency syndrome,kidney yang deficiency syndrome,blood stasis syndrome and water stagnation syndrome are especially common in the acute exacerbation stage of DCM.(5)In the expert consultation on the main points of syndrome differentiation of common syndrome types of DCM,palpitation,chest tightness,shortness of breath and wheezing(especially in movement),fatigue,tired and lazy speech,low voice,spontaneous sweating,pale complexion or Shaohua,light tongue,white moss and pulse deficiency were found in the syndrome of heart qi deficiency.In the syndrome of deficiency of lung qi,cough is weak,shortness of breath and wheezing(especially when moving),tired and lazy speech,low voice,fatigue,spontaneous sweating,fear of wind,easy to catch a cold,pale complexion,light tongue,white moss,weak pulse.The symptoms of spleen qi deficiency syndrome are listlessness,drowsiness,tired and lazy speech,fatigue,shortness of breath and wheezing(especially in movement),low voice,poor appetite,abdominal distension and severe fall(benefit after eating),thin stool,edema,pale or yellowish complexion,light tongue,white moss,slow pulse or weak pulse.Palpitations,chest tightness,shortness of breath and wheezing,tired and lazy speech,fatigue,fear of cold and cold limbs,pale complexion,light fat or purple tongue,slippery white moss,weak pulse or generation in heart-yang deficiency syndrome;poor appetite,abdominal distension,abdominal pain,cold limbs,fear of cold and warmth,face white and Shaohua or floatation,loose stools or incomplete stools,edema,puffiness of tongue,tongue with tooth marks,white or slippery tongue,deep pulse or weak pulse in spleen-yang deficiency syndrome.The symptoms of kidney yang deficiency syndrome are dizziness,pale or swarthy complexion,soreness or cold pain in waist and knees,fear of cold and cold limbs,listlessness,decreased libido,male impotence,premature ejaculation or slippery semen,thin stool,five shifts diarrhea,frequent urination(especially frequent urination at night),long urination,light tongue,white moss,weak pulse.Chest pain,face,lips,claw nail dark or bluish purple,varicose veins or abnormal telangiectasia,inferior riffraff,skin nail error,dark purple tongue,tongue ecchymosis,tortuous sublingual veins and astringent veins in blood stasis syndrome.Dyspnea can not lie down,cough sputum,clear thin foam sputum,dizziness,epigastric fullness,vomiting,nausea,poor appetite,dry mouth do not want to drink,edema,pleural effusion/ascites,general tiredness,adverse urination,dark tongue,fat tongue,tongue with tooth marks,slippery moss,pulse sinking or slippery in water stagnation syndrome expert opinions are concentrated and coordinated.Conclusion: This study uses the method of expert questionnaire to study the standardization of TCM disease name and syndromes of DCM,and initially forms the expert opinions on the disease name of DCM,the distribution law of TCM syndromes and the main points of syndrome differentiation,which lays the foundation for the next step to formulate a complete consensus or guidelines for TCM experts in the diagnosis and treatment of DCM.