A Study On Agreement Of Chronic Bronchitis Syndrome Differentiation Of Criticality In Clinical Research

Objective:1.To discuss the syndrome differentiation of criticality based on the theory of critical status and set up a standard of chronic bronchitis syndrome differentiation of criticality.2.To evaluate the feasibility of syndrome differentiation of criticality by assessing the agreements of diagnoses made by different physicians using this syndrome differentiation method on same patient.Methods:Syndrome differentiation of criticality study:This thesis standardized the syndrome differentiation of criticality and set up a detailed method of chronic bronchitis syndrome differentiation of criticality by collecting data of the critical status theory, reviewing articles writed by Xu Dihua and Shen Chunti, analysing related literatures, studying some national standards and textbooks such as Chinese internal medicine and Diagnostics of TCM.Clinical research:This thesis adopted a prospective clinical research method to evaluate the agreement of syndrome differentiation of criticality. First, chose one (associate)chief physican and one (resident)attending physician as a group. (5 groups in total.) Second, all physicians made diagnoses on chronic bronchitis patients by this syndrome differentiation method. Two physicians in same group diagnosed same patients.124 chronic bronchitis patients were researched in this study totally. Third, assessed the agreements of results by Kappa check.Results:Syndrome differentiation of criticality study:The syndrome differentiation of criticality includes three parts of content:basis syndrome, critical syndrome and typical syndrome. Physicians first confirm the basis syndrome, and then diagnose critical syndrome and typical syndrome with special symptoms.Clinical research:The agreements of basis syndrome, critical syndrome and typical syndrome were good (Kappa value>0.75). Among 76 items of main TCM symtoms,64 items’ agreements were good,11 were moderate (0.75>Kappa value≥0.4), only 1 was unsatisfactory (Kappa value<0.4).Conclusion:Syndrome differentiation of criticality study:The syndrome differentiation of criticality is a supplement to syndrome differentiation and treatment. It can embody the dynamic of syndrome, and also help early diagnosis, early treatment and differential diagnosis of untypical syndrome. Clinical research:The agreements of diagnoses made by different physicians with the method of syndrome differentiation of criticality were good. So the syndrome differentiation of criticality can be used in clinical practice.