The Study Of Practice Guidelines To Prevent Disease For Gastroesophageal Reflux Disease(GERD) In Traditional Chinese Medicine(TCM)

ObjectiveThe aim of the study is to develop a practice guideline to prevent GERD onset or hold back disease from exacerbating in TCM by literature research and experts consultation.Methods1.Collecting ancient literature in Chinese Medical Dictionary and modern Chinese literature in CNKI,WangFang Database,VIP,Sinomedand modern foreign literature in Pubmed and Cochrane Library,we studied and summarized TCM name of GERD,etiology and pathogenesis of disease in TCM,as well as diagnostic criteria,pathogenesis in western medicine,risk factors,physique characteristics of high risk groups,therapeutic measures and suggestions of health maintenance.Thus a preliminary draft of TCM prevention of GERD was drew up.Delphi method and consensus conference method were adopted later to repeated investigation and modification.2.100 cases of GERD were collected in the First Affiliated Hospital of Guangzhou University of TCM,Guangdong Province Hospital of Chinese Medicine,Wangjing Hospital of Capital Medicine University,the First Affiliated Hospital of Henan University of TCM and Shenzhen University of Chinese Medicine to access the consistency between the draft and clinical practice,providing amendments for the program.Results1.Totally 4 rounds of expert investigations and once consensus conference were conducted.All of the experts participated in investigation and consultation have titles of senior professional posts.In the first round,12 experts participated and the expert positive coefficient was 80%.In the second,third and fourth round,12 experts,11 experts and 12 experts took part in the inquiry,and the expert positive coefficient were 75%,73.33%,75%respectively.Four experts participated in consensus conference.All experts had good representative of region and authority in the TCM digestive field.Finally,a program of TCM prevention of GERD was drew up included TCM name of GERD,etiology and pathogenesis of disease in TCM,TCM diagnostic criteria,pathogenesis in western medicine,risk factors,physique characteristics of high risk groups,improvement of life style before or after disease onset,diet therapy,acupressure,music therapy,psychotherapy as well as treatment using herbs and acupuncture and moxibustion,scale and measures preventing disease relapse.The mean of the items were between 4.75-5.0,and the sum of level were between 0-0.13.The coefficient of variation was 0.416,P<0.001.Cronbach's alpha was 0.931,indicating the reliability of the investigative scale is good.2.In the consistency analysis,the concordance rate of physique characteristics of high risk groups was 35%,whereas diagnostic criteria was 65%.In high risk group,it was 35%of concordance rate to carry out health education of life style and diet,while 10%of acupressure,0 of music therapy,21%of psychotherapy.For people diagnosed with GERD,the concordance rate of life style modification was 65%,as well as diet 47%,Chinese herb 54%,Chinese patent medicine 29%,distinctive TCM therapy 17%and scale and psychotherapy 35%respectively.ConcluSionA program of practice suggestions to prevent disease for GERD in TCM was developed by Delphi method and consensus conference method.However,the concordance rates of the suggestions were low resulted from the options of doctors,patients and circumstances,indicating the necessity for further study.