Exploratory Study on Quantitative Diagnostic of Dampness Syndrome of Colorectal Adenoma / 中医杂志

ABSTRACT

ObjectiveTo preliminarily establish and verify the quantitative diagnosis method of dampness syndrome of colorectal adenoma， so as to provide evidence for the diagnosis of colorectal adenoma syndrome. MethodsThis study included 334 patients with colorectal adenoma， who were grouped into 200 in the training group and 134 in the validation group by clinical visits chronologically. According to the data from the four examinations of traditional Chinese medicine， patients in training group were subgrouped into dampness syndrome subgroup and non-dampness syndrome subgroup. After eliminating items with response rate less than 3%， the factors showed statistical difference in frequency between the subgroups were screened as diagnostic items. The diagnostic items were assigned scores using the conditional probability formula conversion method， and the diagnostic thresholds and grading criteria were determined by the maximum likelihood discriminant method， so as to establish the quantitative criteria preliminarily. Retrospective and prospective tests were conducted respectively on patients in training group and validation group， including the sensitivity， specificity， accuracy， positive likelihood ratio and other indexes， to evaluate the quantitative criteria. ResultsThe training group included 176 participants as dampness syndrome subgroup and 24 participants as non-dampness syndrome subgroup， who applied 40 diagnostic items， and 19 related factors were identified as significant differences. After assigning the scores in turn， the quantitative diagnostic threshold was determined as 45， and the quantitative diagnostic criteria for colorectal adenoma with dampness syndrome were as follows： greasy coating （7 scores）， thick coating （8 scores）， heaviness of head （9 scores）， heaviness of whole body （6 scores）， heaviness of limbs （6 scores）， sticky and greasy stool （6 scores）， sticky and greasy mouth （10 scores）， obesity （6 scores）， sleepiness （12 scores）， laziness （13 scores）， epigastric fullness （8 scores）， abdominal distension and pain （11 scores）， lumbar and knee aches and heaviness （8 scores）， joint and muscle aches and pains （9 scores）， loose stools （12 scores）， fetid mouth odor （15 scores）， slippery pulse （8 scores）， overabundance of eye secretion （7 scores）， and large touge （10 scores）. Grading criteria： 45 ≤ points ＜ 61 as mild， 61 ≤ points ≤ 104 as moderate， points ＞ 104 as severe. In the test retrospective of the training group involving 200 patients， the sensitivity， specificity， accuracy， and positive likelihood ratio were 86.36%， 95.83%， 87.50%， and 20.73 respectively； In the test prospective of the verification group involving 134 patients， the sensitivity， specificity， accuracy， and positive likelihood ratio were 76.64%%， 96.30%， 80.60%， and 20.69， respectively. ConclusionIt is effective to diagnose and identify the dampness syndrome of colorectal adenoma by preliminarily establish a quantitative diagnostic method with a combined model of disease and evidence， and the method may provide support for future related studies.