Establish The Judgment Of Fatigue Sub-health And The Identification Standard Of TCM Syndromes Based On The Nominal Group Method

BackgroundSuboptimal Health Status is a kind of low physiological function between health and disease.If it can not be corrected in time,it will easily cause physical and mental diseases and seriously affect the quality of people's daily life.In 2006,the Chinese Academy of Traditional Chinese Medicine published the first document of guiding and standardizing Suboptimal Health Status research and intervention,Clinical Guidelines of Suboptimal Health Status Traditional Chinese Medicine,pointing out that Suboptimal Health Status is a state between health and disease.Those in Suboptimal Health Status state can not meet the health standard,which is manifested by the symptoms of decreased vitality and functional and adaptive ability in a certain period of time,but they do not meet the clinical or sub-clinical diagnostic criteria of modern medicine-related diseases.Fatigue is one of the common manifestations of Suboptimal Health Status.On the basis of the Clinical Guidelines of Traditional Chinese Medicine for Suboptimal Health Status,some scholars regard fatigue as the main manifestation of Suboptimal Health Status,which is called Evaluation and Pattern differentiation for Fatigue-Prominent.This study systematically searched and sorted out the related literature of Evaluation and Pattern differentiation for Fatigue-Prominent Suboptimal Health Status,and further summarized the related concepts,judgments and research progress of TCM syndrome differentiation of Evaluation and Pattern differentiation for Fatigue-Prominent Suboptimal Health Status.On the basis of the preliminary draft of the standard formed by the research group,experts and representatives in relevant fields(including patients)are organized to reach consensus on the framework and specific content of the standard,using the Nominal Group Technology(NGT)method on the spot,and further improved through extensive consultation.ObjectiveEstablishment of Criteria of Evaluation and Pattern differentiation for Fatigue-Prominent Suboptimal Health Status based on NGT Method.Method1.Literature ResearchBy using bibliometric method,this paper reviews the research progress of the definition,criteria and common TCM syndromes of Evaluation and Pattern differentiation for Fatigue-Prominent Suboptimal Health Status since the "Clinical Guidelines of Suboptimal Health Status TCM" issued by the Chinese Academy of Traditional Chinese Medicine in 2006.2.Convening the Standard Conference on the Evaluation and Pattern differentiation for Fatigue-Prominent Suboptimal Health Status Based on NGT MethodThe Nominal group technique is a formal consensus method,which brings together a group of people with various abilities,knowledge and skills to make judgments and choices for decision-making.This standard uses the nominal group technique to hold expert consensus meetings,which are conducted by introducing relevant contents,distributing relevant information,expressing written opinions independently,resting,presenting and discussing experts,revising and perfecting consensus,voting and signing.During the meeting,7 experts translated the term "Suboptimal Health Status" in English,defined the definition,criteria and common sense of "Fatigue-Prominent Suboptimal Health Status".The opinions on TCM syndromes and clinical manifestations were put forward and discussed,and the common TCM syndromes of Fatigue-Prominent Suboptimal Health Status were voted,which eventually formed an expert consensus.Research findings1 Literature research results1.1 Definition of Fatigue-Prominent Suboptimal Health StatusThere are 10 literatures about the definition of Fatigue-Prominent Suboptimal Health Status in the literature.The understanding of the definition of fatigue is mainly manifested b y fatigue,with different concurrent symptoms.Most of the manifestations of Fatigue-Prominent Suboptimal Health Status can be divided into physical and spiritual,some refer to the environment,social adaptability and other categories.1.2 Criteria for judging Fatigue-Prominent Suboptimal Health StatusThere are 72 literatures concerning the criteria for judging Fatigue-Prominent Suboptimal Health Status.There are many kinds of criteria for judging Fatigue-Prominent Suboptimal Health Status.Among them,seven main criteria are cited from Wang Tianfang(34,47.22%),Luo ren(10,13.89%),Chen Zhiwei(4,5.56%),Lei Longming(4,5.56%),Xie Yanming(3,4.17%),Cai Ronglin(3,4.17%)and Yang Zhimin's team(2,2.78%).The remaining criteria were derived from 12other literatures(12,16.67%),including 4 criteria for determining mental Fatigue-Prominent Suboptimal Health Status(4,5.56%).1.3 TCM Syndrome Types of Fatigue-Prominent Suboptimal Health Status27 literatures concerning the distribution of TCM syndromes of Fatigue-Prominent Suboptimal Health Status were published.Twenty types of TCM syndromes were classified according to frequency.The top 10 were liver depression and spleen deficiency(10,20.83%),heart-spleen deficiency(5,10.42%),liver-qi stagnation(4,8.33%),Qi deficiency(4,8.33%),Yang deficiency(4,8.33%),kidney-yang deficiency(3,6.25%)spleen and kidney.Qi deficiency syndrome(2,4.17%),spleen and kidney yang deficiency syndrome(2,4.17%),kidney yin deficiency syndrome(2,4.17%)and phlegm dampness syndrome(2,4.17%).2 Convening the Standard Conference on the Evaluation and Pattern differentiation for Fatigue-Prominent Suboptimal Health Status and Identification of TCM Syndrome Based on NGT MethodThe conference lasted 4 hours,and completed its core content,namely,the framework,terminology and definition of "Determination and identification of TCM syndromes of Evaluation and Pattern differentiation for Fatigue-Prominent Suboptimal Health Status",the criteria for determining Evaluation and Pattern differentiation for Fatigue-Prominent Suboptimal Health,and the common TCM syndromes and manifestations of Evaluation and Pattern differentiation for Fatigue-Prominent Suboptimal Health Status,The following are the core elements of consensus.2.1 Definition of Fatigue-Prominent Suboptimal Health Statussub-health state characterized by fatigue.2.2 The criteria for judging Fatigue-Prominent Suboptimal Health Status2.2.1 meeting the criteria for judging sub-health.2.2.2 complaining of fatigue,which lasts or recurs for more than three months,and which reaches a mild or higher level in physical fatigue,mental fatigue,fatigue consequences and general fatigue.2.3 Common TCM syndromes of Fatigue-Prominent Suboptimal Health Statusliver-qi stagnation syndrome,spleen-qi deficiency syndrome,Spleen-Yang deficiency syndrome,lung-qi deficiency syndrome,liver-qi stagnation and spleen-qi deficiency syndrome,spleen deficiency and dampness obstruction syndrome,heart-blood deficiency syndrome and phlegm-dampness internal obstruction syndrome.ConclusionThrough literature review,preliminary drafting of the framework and content,expert consensus meetings,consultation and other work,this study has formed the Evaluation and Pattern differentiation for Fatigue-Prominent Suboptimal Health Status.The main contents include related definitions,criteria and identification of TCM syndromes of Fatigue-Promin-ent Suboptimal Health Status.Through sorting out and summarizing the related literature of fatigue sub-health after 2006,it is found that the definitions,criteria and common TCM syndromes of Fatigue-Prominent Suboptimal Health Status have some perfection,innovation and research progress,which provides a certain basis and basis for the formulation of"Evaluation and Pattern differentiation for Fatigue-Prominent Suboptimal Health Status".By using NGT method to establish the first criterion of Evaluation and Pattern differentiation for Fatigue-Prominent Suboptimal Health Status in China,this study has reached a consensus smoothly,and has been approved by two rounds of experts of the World Federation of China,reflecting the feasibility of NGT method,which is a satisfactory consensus method,and can provide some ideas and methods for the standardization of TCM.