Development Of The TCM Syndrome Diagnosis Scale Of Polycystic Ovary Syndrome

Objective: Under the guidance of the theory of TCM,the development of the syndrome diagnosis scale of polycystic ovary syndrome provides an objective and rigorous way for the diagnosis and treatment of the syndrome of polycystic ovary syndrome,and a new method and idea for the diagnosis and treatment of the syndrome differentiation of traditional Chinese medicine.Methods:1.Study on syndrome distribution(1)Literature related to TCM syndrome studies on polycystic ovary syndrome were searched from CNKI,Wanfang and VIP databases from April2012 to mid-April 2022.Such as CNKI search: SU =(" polycystic ovary syndrome " + " PCOS ")AND TI =(" TCM " + " symptoms ","type" + "card type" + "syndrome" + "differentiation")is NOT SU =(" insulin " + " threatened abortion " + " constitution ","quickening uneasy")to extract the four diagnostic information to establish PCOS in TCM syndromes,symptom database.(2)SPSS25.0 software was used to calculate the frequency of syndrome types and symptoms.2.Scale developmentBased on the previous research on syndrome distribution,combined with patient interviews and mentors’ clinical experience,related syndromes of polycystic ovary syndrome were selected for the development of diagnostic scale.(1)Establishing a research working group and determining the relevant theoretical framework.(2)Through literature retrieval of the three major Chinese literature libraries,a pool of items that fit the literature was selected and summarized,and then combined with clinical symptoms of PCOS to form a scale.On this basis,questionnaires for experts and clinical questionnaires for patients were preliminarily prepared.(3)Comprehensive using Delphi method,discrete trend method,discrimination analysis method,correlation coefficient method,and Cronbach coefficient method to analyze and screen the scale items.(4)Using the Fisher discriminant method to weight the selected items,and using the discriminant function as the weight coefficient to construct the diagnosis scale.(5)Through ROC curve analysis,the point with the largest Youden index was taken as the diagnostic threshold.(6)The measurement coefficients of scale items were integer processed,and the PCOS TCM syndrome and diagnosis scale was initially formed.(7)The scale was comprehensively evaluated by sensitivity,specificity,Youden index,syndrome differentiation accuracy,positive predictive value,negative predictive value and Kappa value.Results: Polycystic ovary syndrome TCM syndrome diagnosis scale.Syndrome of kidney yang deficiency:2 points for the waist and knees are sore and weak,12 points for chills,2 points for Pale menstruation,4 points for cold pain in the lower abdomen,1 point for hypolibido,4 points for frequent nocturnal urination,3 points for pale face,7 points for tongue mauve,8 points for sinking pulse.Evidence of Kidney Yin Deficiency:3points for hypomenorrhea,14 points for five upset fever,dry mouth and throat 2 points,dizziness 2 points,2 points for tinnitus,hot flash night sweat 4 points,thin body 5 points,5 points for thin pulse.Syndrome of kidney qi deficiency: 3 points for the waist and knees are sore and weak,3 points for mental fatigue,urination frequency 12 points,loss of libido2 points.Spleen deficiency syndrome:6 points of fatigue,5 points of abdominal distension,3 points of loose stool,7 points of loss of appetite,pale tongue 8 points.Dampness-heat syndrome of liver meridian:menstruation impurity 4 points,more or less menstruation 4 points,1 point for Premenstrual breast tenderness,3 points for premenstrual distending pain in the chest and hypochondriac,7 points for leucorrhea multi-color yellow,face red 1 point,body strong 8 points,tongue red 1 point,moss yellow greasy 11 points,pulse number 5 points,chordal pulse 4 points.Sputum and Dampness syndrome: 13 points for leucorrhea polychromatic white,sticky mouth 2 points,7 points ofhypersputum,4 points for body obesity,7 points for white and greasy tongue,8 points for the tongue is marked with teeth,pulse slippery 3 points.Syndrome of liver depression:3 points for menstruation comes early or late,6 points emotional depression,7 points for frequent sighs,pain in the lower abdomen 5 points,2 points for the mouth is dry and bitter,2 points for dark and red tongue,4 points for the veins at the base of the tongue,and chordal pulse 5 points.Syndrome of blood stasis:10 points for menstruation is dark red in color,menstrual abdominal pain accompanied by clots、clot down pain relief 8points,Stabbing pain in the lower abdomen 9 points,dry mouth with no desire to drink 1 point,1 point for dull face,acanthosis nigricans 3points,4 points for petechial spots on the tongue,3 points for the veins under the tongue are tortuous,and astringent pulse 5 points.Evidence of damp-heat: 3 points for the amount of leucorrhea is large and the color is yellow,3 points for acne,5 point for sticky stools,12 points for oily skin,7 points for red tongue,8 points for thin or greasy tongue coating and 4 points for counted pulse.In the case of Shanghai syndrome,the total score of syndrome reaches 20 points.After testing,the sensitivity,specificity and accuracy of the scale were 88.37%-96.55%,62.22%-97.37% and 66.27%-94.94%,indicating that the PCOS TCM syndrome diagnosis scale has high accuracy and specificity.In addition,the kappa value of all the syndromes except the syndrome of kidney qi deficiency was above 0.4,indicating that the results obtained by PCOS TCM syndrome diagnosis and disorder scale were moderately consistent with the diagnosis results of doctors with senior professional titles.On the whole,the test results of PCOS TCM syndrome diagnosis scale have good satisfaction.Conclusion: Through literature retrieval,expert consultation,clinical information collection,and a variety of statistical methods,this study developed a TCM syndrome diagnosis scale for polycystic ovary syndrome.The scale’s sensitivity,specificity and accuracy were satisfactory,providing certain reference value for the standardization and standardization of syndromes,and providing certain guiding significance for the scientific research and clinical diagnosis and treatment of PCOS.