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Journal of Traditional Chinese Medicine >

2023 , Vol. 43 >Issue 1: 181 - 187

DOI: https://doi.org/10.19852/j.cnki.jtcm.20220719.002

Methodology

Consensus on diagnostic criteria for Yin deficiency syndrome in hypertension: a modified Delphi study

  • Yun HE ,
  • Jing HE ,
  • Xiangru XU ,
  • Haixiao LI ,
  • Rongwei SHI ,
  • Junya LIANG ,
  • Ying ZHOU ,
  • Yao ZHU ,
  • Xiaohu CHEN ,
  • Shuhua TANG ,
  • Min XIAO ,
  • Libin ZHAN ,
  • Yinghao PEI ,
  • Weiming JIANG
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  • 1 Department of General Internal Medicine, Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210029, China
    2 Department of Intensive Care Unit, Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210029, China
    3 Department of Hepatology, Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210029, China
    4 Department of Institute of Hypertension, Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210029, China
    5 Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210029, China
    6 Department of Emergency, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
    7 Department of Cardiology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100700, China
    8 School of Traditional Chinese Medicine & School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
PEI Yinghao, Department of Intensive Care Unit, Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210029, China. piaopiao5556@sina.com.Telephone:+86-25-86617141
Prof. JIANG Weiming, Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210029, China. jwm0410@njucm.edu.cn;

Received date: 2022-01-11

  Accepted date: 2022-04-18

  Online published: 2023-01-10

Supported by

Study on Syndrome Differentiation Standard of Yin deficiency Syndrome in Hypertension(2018YFC1704403);National Key R&D Program of China Project: Systematic Study on the Standard of Syndrome Differentiation of Yin Deficiency Syndrome(2018YFC1704400)

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Abstract

OBJECTIVE: To reach consensus on the diagnostic criteria for Yin deficiency syndrome in hypertension (YDSH) patients by a modified Delphi method.
METHODS: Our study was consistent with T/CACM 1032-2017. The methodology of RAND/UCLA appr-opriateness was used to develop consensus guidance statements. A nationwide panel of experienced clinical experts from 19 provinces was constructed. These experts were all prominent in Traditional Chinese Medicine (TCM) of cardiovascular diseases. This con-sensus process consisted of two rounds of ques-tionnaires and a final round of consultation to analyze the weight score of each item. Moreover, the data extraction process is carried out independently by third-party researchers (LIANG Junya, SUN Yang, and DU Xiaona). When there is disagreement in all three rounds, the expert panel group (odd number) are invited to vote, and the one with more votes wins. In the questionnaires, participants were asked to rate the appropriateness of each syndrome item using a nine-point Likert scale. The consensus was defined as a panel median rating 1-3 or 7-9 without disagreement. And then the diagnostic criteria of YDSH were formed according to the weight score in the final round.
RESULTS: Twenty-eight experts (84.8%) participated in the first round, and thirty-one (93.9%) finished the second round. After two rounds, the consensus of YDSH was reached on 11 items (25.6%), including symptoms, signs, and pulse condition. Twenty-one experts (63.6%) com-pleted the final round in which they used a grading system for each item. Red tongue with scanty fur had the highest weighting (22.8%), followed by heat in the palms and soles (20.1%).
CONCLUSIONS: The consensus-based diagnostic criteria for YDSH, formed by a modified Delphi method, can be widely incorporated in TCM. A further clinical study will be conducted to analyze the diagnosis value and cut-off score of our YDSH criteria.

Key words： Yin deficiency syndrome; hypertension; consensus; Delphi technique; weight score

Cite this article

Yun HE , Jing HE , Xiangru XU , Haixiao LI , Rongwei SHI , Junya LIANG , Ying ZHOU , Yao ZHU , Xiaohu CHEN , Shuhua TANG , Min XIAO , Libin ZHAN , Yinghao PEI , Weiming JIANG . Consensus on diagnostic criteria for Yin deficiency syndrome in hypertension: a modified Delphi study[J]. Journal of Traditional Chinese Medicine, 2023 , 43(1) : 181 -187 . DOI: 10.19852/j.cnki.jtcm.20220719.002

References

1 Yang MX, Lao LX. Emerging applications of metabolomics in Traditional Chinese Medicine treating hypertension: biomarkers, pathways and more. Front Pharmacol 2019; 10: 158.
2 Weng WQ. Clinical study on “liver Yang exuberance syndrome”. Zhong Xi Yi Jie He Za Zhi 1989; 5: 266-9, 259.
3 Wu LN, Xie YM, Liu H, Zhang Y, Lu Q, Zhuang Y. Real-world study on syndrome distribution and medication characteristics of colonic malignant tumors. Zhong Guo Zhong Yao Za Zhi 2020; 5: 1174-79.
4 Yu G, He QY. Combination analysis of syndrome elements and syndrome response in 7213 patients with hypertension. Zhong Hua Zhong Yi Yao 2013; 8: 2284-6.
5 Zhang LF. Guidelines for the diagnosis and treatment of hypertension in TCM. Zhong Guo Zhong Yi Yao Xian Dai Yuan cheng Jiao Yu 2011; 23: 108-9.
6 Zheng XY. Guiding principles for clinical research of new chinese medicines. Beijing: China Medical Science and Technology Press, 2002: 73-7.
7 Zhang BY. Chinese internal medicine. Shanghai: Shanghai Science and Technology Press, 1984: 204-7.
8 Zhou ZY. Practical Chinese internal medicine. Beijing: China Traditional Chinese Medicine Press, 2012: 602-12.
9 Hou PH, Chen GL, Gu WL, et al. Distribution laws of chinese medical syndrome types and analyses of risk factors in senile hypertension patients: a clinical study. Zhong Guo Zhong Xi Yi Jie He Za Zhi 2014; 5: 536-40.
10 Ma N, Hou YZ, Wang XL, Mao JY. Analysis of medication laws for chinese medicine treating hypertension patients with Yin deficiency Yang hyperactivity syndrome based on literatures. Zhong Guo Zhong Xi Yi Jie He Za Zhi 2016; 4: 403-10.
11 Du J, Zhong MF, Liu D, et al. Reduced mlh3 expression in the syndrome of gan-shen Yin deficiency in patients with different diseases. Evid Based Complement Alternat Med 2017; 2017: 4109828.
12 van Helsdingen CP, Jongen AC, de Jonge WJ, Bouvy ND, Derikx JP. Consensus on the definition of colorectal anastomotic leakage: a modified delphi study. World J Gastroenterol 2020; 23: 3293-303.
13 Sinha IP, Smyth RL, Williamson PR. Using the delphi technique to determine which outcomes to measure in clinical trials: recommendations for the future based on a systematic review of existing studies. PLoS Med 2011; 1: e1000393.
14 Moossdorff M, van Roozendaal LM, Strobbe LJ, et al. Maastricht delphi consensus on event definitions for classification of recur-rence in breast cancer research. J Natl Cancer Inst 2014; 12: dju288.
15 Jin Y, Hu S, Yan D. Study on molecular mechanism of Ganyang Shangkang syndrome in hypertension. Zhong Guo Zhong Xi Yi Jie He Za Zhi 2000; 2: 87-90.
16 Qing YZ, Zhang X, Zhao JX, Tian YX. Visual analysis of liver and kidney Yin deficiency syndrome diagnostic criteria based on citespace software. Shi Jie Ke Xue Ji Shu-Zhong Yi Yao Xian Dai Hua 2017; 4: 556-62.
17 Wang J, Xiong XJ, Liu W. Traditional Chinese Medicine syndromes for essential hypertension: a literature analysis of 13, 272 patients. Evid Based Complement Alternat Med 2014; 2014: 418206.
18 Wang JB, Jia LQ, Li N, Qu Y, Song N, Zhan LB. Exploration on construction of animal model of combining hypertension and Yin deficiency syndrome. Zhong Hua Zhong Yi Yao Xue Kan 2020; 8: 90-2.
19 Wei JP, Wu R, Zhao DD. Analysis on Traditional Chinese Medicine syndrome elements and relevant factors for senile diabetes. J Tradit Chin Med 2013; 4: 473-8.
20 Dong HY, Zhang SQ, Du WX, Cong HL, Zhang LH. Pharmacodynamics and metabonomics study of tianma gouteng decoction for treatment of spontaneously hypertensive rats with liver-Yang hyperactivity syndrome. J Ethnopharmacol 2020; 253: 112661.
21 McMillan SS, King M, Tully MP. How to use the nominal group and delphi techniques. Int J Clin Pharm 2016; 3: 655-62.
22 Luo H, Liao X, Wang Q. Application of chinese medical syndrome scores in effectiveness evaluation: a critical appraisal of 240 randomized controlled trials. Zhong Guo Zhong Xi Yi Jie He Za Zhi 2015; 10: 1261-6.
23 Wu ZC, Zhang FY, Yu HY, J XM, Liu GW, Ouyang B. Literature analysis on the symptom characteristics of liver-kidney Yin deficiency syndrome in hypertensive patients. Shi Zhen Guo Yi Guo Yao 2015; 3: 746-8.
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