A Preliminary Study On Establishing A Chronic Cough Syndrome Diagnosis Model Based On Literature Research And Modified Delphi Metho

This paper is composed by review and the main content of clinical research is to establish the diagnosis model of chronic cough syndrome.ReviewThis review summarizes the application of Delphi method,clarifies the implementation steps,analyzes the advantages and disadvantages of Delphi method,and provides methodological guidance for the research;This paper summarizes the theoretical origin of chronic cough syndrome differentiation in traditional Chinese medicine,systematically introduces the viewpoints of ancient and modern doctors on syndrome differentiation,and discusses the deficiency and prospect of chronic cough syndrome differentiation at present,so as to provide theoretical basis for the subject research.Clinical research:To establish the diagnosis model of chronic cough syndromeObjectiveTo obtain the common syndrome elements and four diagnostic information of chronic cough;On this basis,the diagnostic model of chronic cough was established to provide the model basis for the development of chronic cough syndrome differentiation scale.Methods1.Literature research:Searching the domestic periodical literature database systematically,and sorted out the related literatures of chronic cough in the last 15 years,then classifiy,evaluate,and analyzed statistics of literature.According to the statistical results,the common elements of chronic cough syndrome and four diagnostic information in the literature were summarized and standardized.2.Expert questionnaire survey:According to the results of previous literature studies,using delphi method to compile the expert questionnaire,in the form of an electronic questionnaire,to seek expert advice and obtain expert experience.A total of three rounds of questionnaires were issued.The items with diagnostic significance to the factors of chronic cough syndrome were screened from the angle of importance as the reference item of the chronic cough syndrome differentiation scale.3.Subjective empowerment:multiple related subjective empowerment of expert combination was carried out on the selected items,and the diagnosis model of chronic cough syndrome was preliminarily established.Results1.The Chinese journal full-text database,wanfang database and weipu full-text database were searched by computer,and a total of 2,248 literatures were retrieved from 1999 to 2016,including35 literatures that met the standards.Data were extracted from relevant literatures,including 10 pathogenic factors,7pathogenic factors and 39 pieces of four diagnostic information.2.Delphi method2.1 Syndrome elements11 elements of disease syndrome:Wind,cold,heat,dryness,phlegm,dampness,rheum,stasis,Qi deficiency,Yin deficiency,Yang deficiency.4 disease location syndrome factors:Lung,spleen and stomach,liver,kidney.2.2 Diagnostic information2.2.1 WindPharyngeal itching for cough,nose itching,pharyngeal itching,sneezing,spring induced2.2.2 ColdExpectorant thin,cold induced,expectorant white color,aversion to cold2.2.3 HeatMoss yellow,cough phlegm color yellow,cough phlegm thick,pharyngeal pain,dry,heat induced,spicy stimulation food induced,cough hyperactivity,thirst,face red,tongue red,cough phlegm color yellow green,pulse,nose dry2.2.4DrynessDry nose,dry cough,autumn induced,dry throat,dry tongue,less phlegm,dry moss,thirst2.2.5 PhlegmCough sound heavy turbid,greasy moss,phlegm,greasy food induced,cough phlegm viscous,heavy body sleepy,wan PI,throat in phlegm,chest tightness,smooth pulse2.2.6 RheumLimb edema,coughing up phlegm clear2.2.7 StasisTongue stasis,chest pain,dark tongue color,astringent pulse,cough lead to chest pain2.2.8 Qi deficiencyFatigue,shortness of breath,spontaneous sweating,easy to catch a cold,cough sound low,pale tongue,complexion white,weak pulse2.2.9 Yin deficiencyPharynx is dry,brothers is hot,tongue is qualitative red,long cough,moss is little,night sweat,mouth is dry2.2.10Yang deficiency.Cold,cold extremities,complexion white,even diarrhea,cold induced,lower limb swelling2.2.11 LungSpring induced,runny nose,weak pulse,autumn induced,odor,induced thermal induced,nasal congestion,chest pain,nasal itching,nasal dryness,sore throat,dry throat,pharyngeal itching,tender tongue,winter induced,voice hoarse,the number of pulses,is that fine vein,hoarse cough,chest pain,cough,cold induced chest tightness,shortness of breath,less moss,the tip of the tongue is red,floating pulse,continuous cough sound,sputum thin,white moss,greasy moss,pale tongue,red tongue,cough heavy turbidity,color white,sputum expectoration color yellow,sputum color yellow,green,color blood in phlegm,sputum expectoration sticky stiff,coughing up phlegm foam sample,phlegm cough up easily,phlegm cough up out of the difficulty,phlegm in the throat,yellow moss,asthma,pulse,sneeze2.2.12 Spleen and stomachHeavy eating,sour belching,belching,epigastric pain,noise,hiccup,greasy food,and after meals2.2.13LiverAnger induced,rib swelling pain,rib channeling pain,anxiety induced2.2.14KidneySoft waist and knee,tinnitus,deafness,edema,asthma3.Establishment of subj ective empowerment model(1)Y wind=25 pharynx itch for cough+30 pharynx itch+23 nose itch+15 sneeze+6 spring induced(2)cold Y=14 thin expectorant+19 cold induced+32 white expectorant+35 cold(3)Y heat/fire=2 high cough sound+10 heat inducement+9 spicy food inducement+2 yellow cough phlegm+18 yellow green cough phlegm+6 sticky cough phlegm+8 dry nose+9 sore throat+3 thirsty+5 red tongue+3 yellow moss-3+19 pulse+3 red face+3 dry(4)dry Y=5 dry nose+9 dry cough+3 autumn induced +19 dry pharynx+4 dry tongue+17 dry sputum+12 dry moss+10 thirsty(5)Y phlegm-dampness=2 heavy cough sound+10 greasy coating+7 much phlegm+0.3 greasy food induces+37 thick cough phlegm+3 heavy limb sleepiness+7 wan PI+26 throat phlegm+3 chest tightness+6 smooth pulse(6)Y drink=52 limb swelling+48 expectorant thin(7)Y stasis=10 tongue petechiae+4 chest pain+34 dark tongue color+28 astringent veins+25 cough leading to chest painQi deficiency(8)Y=15 fatigue+10 shortness of breath,spontaneous perspiration 6+13 easy cold+21 cough sound humble+8+25 pale tongue complexion 晄 white+3 weak pulse(9)Y Yin deficiency=5 dry pharynx+8 hand and foot heat+7 red tongue+34 cough+15 moss less+24 night sweat+7 dry mouth(10)Y Yang deficiency cold+11=30 form cold limbs was 晄 even diarrhea+white+9+9 42 cold induced edema of lower limbs(11)Y spleen and stomach=6 satiation aggravation+9 fulgus-belching acid+11 belching+9 epigastric pain+9 noise+35 hiccup+4 greasy food inducement+19 post-meal inducement(12)Y liver=25 angst-induced+34 rib swelling pain+30 rib channeling pain+11 anxiey-induced(13)Y kidney=4 waist and knee tenderness+15 tinnitus+1 deafness+50 edema+31 asthmaConclusionAccording to literature search,syndrome standardization,expert questionnaire survey,statistical analysis,subjective empowerment and other studies,the diagnosis model of chronic cough syndrome was preliminarily established to provide the main symptoms,signs and the quantitative number of the proportion in the diagnosis of chronic cough syndrome,and to provide the theoretical basis for simplification,standardization and quantitative syndrome differentiation.Further exploration of syndrome diagnosis model still needs expert investigation and clinical verification.