基于德尔菲法的儿童社区获得性肺炎中医证候专家问卷分析

doi:10.20274/j.cnki.issn.1674-3865.2025.05.009

Abstract

Abstract:

Objective To investigate the diagnostic experience of experts on the syndrome of community-acquired pneumonia(CAP) in children by using the Delphi method, screen for the diagnostic indicators of syndromes, evaluate their importance, and provide evidence for the formulation of diagnostic standards for pediatric CAP. Methods Based on literature research, a questionnaire survey was conducted among selected experts using the Delphi method. The results of the questionnaire were statistically processed using Excel and SPSS 27.0 software, and the expert positive coefficient, expert authority coefficient, and the expert opinion coordination degree and concentration degree were calculated. Results A total of 30 domestic experts were selected for the questionnaire survey, with a questionnaire recovery rate of 90%. The expert authority coefficient was 0.905, and the expert coordination coefficient was 0.348(P<0.001). A total of 8 syndrome types were set up in the first round of expert questionnaire survey, including syndrome of heat pathogen blocking the lung, syndrome of lung and spleen-qi deficiency, syndrome of damp-heat blocking the lung, syndrome of wind-cold blocking the lung, syndrome of wind-heat blocking the lung, syndrome of toxic-heat blocking the lung, syndrome of phlegm-heat blocking the lung and syndrome of yin-deficiency with lung-heat, and their syndrome characteristics were analyzed. Conclusion This study initially explores the distribution pattern and characteristics of TCM syndromes in pediatric CAP, laying a foundation for subsequent researches on the diagnostic standards and clinical studies of TCM syndromes in pediatric CAP.

Key words: Community-acquired pneumonia, Delphi method, Syndrome, Expert questionnaire, Child

CLC Number:

R725.6

Qian LIU, Xuefeng WANG, Xiuying ZHANG, Xinran FENG, Yanyan NI, Zhifan TIAN, Hui WANG. Analysis of expert questionnaire on TCM syndromes of community-acquired pneumonia in children based on Delphi method[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(5): 410-417.

Figures/Tables 10

Table 1

Table 2

Table 3

Table 4

Table 5

Table 6

Table 7

Table 8

Table 9

Table 10

References 14

[1]	Meyer Sauteur PM. Childhood community-acquired pneumonia[J]. Eur J Pediatr, 2024, 183(3): 1129-1136.
[2]	McAllister DA, Liu L, Shi T, et al. Global, regional, and national estimates of pneumonia morbidity and mortality in children younger than 5 years between 2000 and 2015: a systematic analysis[J]. Lancet Glob Health, 2019, 7(1): e47-57.
[3]	雷新霞, 王志国, 赵汉青. 中医症状、体征术语规范化研究路径探析[J]. 环球中医药, 2017, 10(3): 340-343.
[4]	柯惠新, 沈浩. 调查研究中的统计分析法[M]. 2版. 北京: 中国传媒大学出版社, 2005: 324.
[5]	曾光.现代流行病学方法与应用[M].北京:北京医科大学、中国协和医科大学联合出版社,1996:255-258．
[6]	罗业飞,杜瑶瑶,徐慧芳,等. 应用德尔菲法构建青年学生HIV感染风险评估指标体系[J]. 中华流行病学杂志,2021,42(11):1918-1922.
[7]	孙振球. 医学综合评价方法及其应用[M]. 北京: 化学工业出版社, 2006:11-13.
[8]	陈希,邹启,甄若楠,等. 构建大规模人群新型冠状病毒核酸筛查指标体系研究[J]. 中华流行病学杂志,2021,42(8):1353-1359.
[9]	张颖, 季聪华, 李秋爽, 等. 中医临床实践指南制修订中德尔菲法的统计分析方法[J]. 中华中医药杂志, 2018, 33(1): 249-251.
[10]	陈任, 秦侠, 胡志, 等. 艾滋病综合防治绩效评价指标体系研究[J]. 中华疾病控制杂志, 2010, 14(10): 1043-1045.
[11]	GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet, 2020, 396(10258): 1204-1222.
[12]	王晗笑, 栾哲宇, 封继宏. 从“肺虚络瘀” 探讨补气活血法在社区获得性肺炎恢复期“瘥后防复” 中的作用[J]. 中国实验方剂学杂志, 2024, 30(14): 232-239.
[13]	王艳, 郑义雪, 霍开明, 等. 五虎汤合清金降火汤加减治疗小儿社区获得性肺炎痰热闭肺证及其机制[J]. 中国实验方剂学杂志, 2020, 26(14): 123-128.
[14]	管慧, 戴国华, 高武霖, 等. 中医药临床研究中应用德尔菲法的系统评价[J]. 中国循证医学杂志, 2021, 21(2): 186-190.

适用度评分	量化值	判断依据（Ca）	对专家判断的影响程度			熟悉程度（Cs）	量化值
适用度评分	量化值	判断依据（Ca）	大	中	小	熟悉程度（Cs）	量化值
很重要	5	理论知识	0.3	0.2	0.1	很熟悉	1.0
重要	4	实践经验	0.3	0.2	0.1	熟悉	0.8
一般	3	参考国内外资料	0.3	0.2	0.1	一般	0.6
不重要	2	个人直觉	0.3	0.2	0.1	不太熟悉	0.4
很不重要	1					不熟悉	0.2

证型	均值	变异系数	满分比（%）
痰热闭肺证	5.00	0.00	100.00
风热闭肺证	4.75	0.11	81.48
肺脾气虚证	3.36	0.54	44.44
风寒闭肺证	3.43	0.28	32.22
阴虚肺热证	3.25	0.57	37.04
毒热闭肺证	4.71	0.14	81.48
湿热闭肺证	3.07	0.46	39.63
热邪闭肺证	3.11	0.59	33.33

指标	均值	标准差	变异系数	满分比（%）	保留情况	指标	均值	标准差	变异系数	满分比（%）	保留情况
发热	4.67	1.04	0.22	88.89	√	面红	3.52	1.87	0.53	40.74	√
高热	4.89	0.42	0.09	96.30	√	唇绀	3.74	1.95	0.52	62.96	√
高热不退	3.93	1.47	0.37	48.15	√	唇干	3.26	1.91	0.59	29.63	√
有汗	3.15	1.63	0.52	29.63	√	口渴	3.59	1.28	0.36	18.52	×
身热	3.52	1.87	0.53	44.44	√	口干	3.19	1.67	0.52	14.81	×
热势反复	3.00	2.08	0.69	40.74	√	大便秘结	4.00	1.21	0.30	44.44	√
咳嗽	4.44	1.60	0.36	92.59	√	小便黄	3.07	1.86	0.61	22.22	√
咳声重浊	4.67	0.88	0.19	88.89	√	咽红	3.81	1.76	0.46	51.85	√
阵咳	3.74	1.77	0.47	55.56	√	胸闷	2.56	1.76	0.69	3.70	×
喉间痰鸣	4.67	1.04	0.22	85.19	√	烦躁不安	3.11	1.58	0.51	18.52	√
痰黄	4.67	0.62	0.13	74.07	√	纳呆	3.07	1.64	0.53	11.11	×
痰黏稠	4.00	1.75	0.44	59.26	√	食欲下降	3.00	1.88	0.63	29.63	√
多痰	3.63	1.80	0.50	48.15	√	舌质红	4.81	0.48	0.10	88.89	√
声如拽锯	3.04	1.87	0.62	25.93	√	苔黄腻	4.52	1.09	0.24	77.78	√
气促	4.30	1.59	0.37	74.07	√	舌苔黄	3.85	1.75	0.45	51.85	√
气喘息粗	4.22	1.45	0.34	66.67	√	脉滑数	4.44	1.34	0.30	74.07	√
喘憋	3.93	1.44	0.37	48.15	√	脉洪数	2.26	1.99	0.88	7.41	×
鼻煽	4.33	1.04	0.24	51.85	√	指纹紫滞	4.00	1.78	0.44	66.67	√

指标	均值	标准差	变异系数	满分比（%）	保留情况	指标	均值	标准差	变异系数	满分比（%）	保留情况
低热	4.56	1.05	0.23	74.07	√	口干	3.15	2.14	0.68	37.04	√
手足心热	4.44	1.34	0.30	74.07	√	大便秘结	3.48	1.67	0.48	29.63	√
潮热	3.59	1.85	0.51	40.74	√	口干欲饮	2.41	2.19	0.91	22.22	×
发热	2.52	1.99	0.79	14.81	×	小便黄	2.33	2.22	0.95	22.22	×
干咳	4.56	1.01	0.22	74.07	√	汗出	1.63	1.84	1.13	7.41	×
咳嗽	3.19	2.32	0.73	55.56	√	盗汗	3.30	2.05	0.62	37.04	√
咳嗽频作	1.78	1.93	1.08	18.52	×	咽干	2.52	2.03	0.80	11.11	×
久咳	4.00	1.62	0.40	59.26	√	咽红	3.32	2.10	0.63	11.11	×
少痰	3.96	1.77	0.45	62.96	√	舌质红	4.11	1.60	0.39	66.67	√
痰黏稠	2.52	2.16	0.86	29.63	×	舌干红	1.78	2.10	1.18	18.52	×
唇干	3.00	2.08	0.69	29.63	√	苔花剥	3.37	2.10	0.62	59.26	√
面色潮红	2.19	2.08	0.95	14.81	×	舌苔少	4.07	1.77	0.44	70.37	√
面红	2.02	2.08	0.88	14.81	×	脉数	1.33	1.86	1.40	14.81	×
口唇红	2.52	2.05	0.81	14.81	×	脉细数	4.19	1.59	0.38	66.67	√
口渴	2.07	2.09	1.01	11.11	×	指纹淡紫	2.07	2.11	1.02	25.93	×

指标	均值	标准差	变异系数	满分比（%）	保留情况	指标	均值	标准差	变异系数	满分比（%）	保留情况
发热	4.70	0.99	0.21	88.89	√	大便秘结	2.96	1.93	0.65	25.93	√
高热	2.89	2.03	0.70	29.63	×	小便黄	3.81	1.62	0.42	40.74	√
持续高热	2.26	1.93	0.86	14.81	×	汗出	2.44	1.91	0.78	18.52	×
身热	2.96	2.05	0.69	25.93	×	微有汗出	2.26	1.95	0.86	14.81	×
咳嗽	4.37	1.60	0.37	85.19	√	鼻塞	2.44	1.93	0.79	14.81	×
咳嗽频作	4.00	1.57	0.39	51.85	√	流黄涕	3.41	1.58	0.46	29.63	√
咳声重浊	2.67	2.08	0.78	29.63	×	流浊涕	3.00	1.82	0.61	22.22	√
咳声气粗	3.81	1.78	0.47	51.85	√	吞咽时咽痛	3.44	2.12	0.62	48.15	√
呛咳	2.15	2.11	0.98	18.52	×	咽干	2.74	1.95	0.71	18.52	×
阵咳	3.19	2.02	0.63	33.33	√	烦躁不安	2.04	1.97	0.97	7.41	×
干咳	1.37	1.69	1.23	3.70	×	纳呆	2.11	1.78	0.85	7.41	×
痰黄	3.78	1.58	0.42	40.74	√	纳少	2.48	1.93	0.78	11.11	×
气促	3.56	1.83	0.51	37.04	√	舌质红	3.26	2.25	0.69	55.56	√
喘息	3.00	1.71	0.57	14.81	×	舌尖红	2.85	2.18	0.76	37.04	×
恶风	3.19	1.90	0.60	33.33	√	苔薄黄	3.63	2.08	0.57	62.96	√
鼻煽	2.59	2.06	0.80	18.52	×	苔黄	2.15	2.21	1.03	25.93	×
面红	3.56	1.85	0.52	40.74	√	脉浮数	4.15	1.63	0.39	70.37	√
口唇红	3.44	1.97	0.57	44.44	√	脉数	2.67	2.25	0.84	37.04	×
唇干	2.04	2.23	1.09	22.22	×	指纹浮紫	2.89	2.26	0.78	48.15	×
口渴	2.85	1.94	0.68	25.93	×	指纹紫滞	2.11	2.10	1.00	22.22	×

Analysis of expert questionnaire on TCM syndromes of community-acquired pneumonia in children based on Delphi method

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 10

References 14

Related Articles 15

Recommended Articles

Metrics

Comments

指标	均值	标准差	变异系数	满分比（%）	保留情况	指标	均值	标准差	变异系数	满分比（%）	保留情况
高热不退	2.96	2.29	0.77	48.15	×	面红	3.23	2.22	0.69	25.93	√
高热	3.54	1.30	0.37	33.33	√	吞咽时咽痛	3.35	2.15	0.64	25.93	√
壮热	2.23	2.18	0.98	22.22	×	咽红	1.62	1.92	1.19	14.81	×
发热	3.42	1.34	0.39	33.33	√	烦躁不安	2.50	2.30	0.92	37.04	×
咳嗽	3.31	1.68	0.51	33.33	√	舌质红	3.19	2.38	0.75	55.56	√
咳嗽频作	2.42	2.35	0.97	37.04	×	舌质绛色	2.04	2.13	1.04	14.81	×
痰质稠	3.42	1.23	0.36	29.63	√	苔黄	3.69	2.43	0.66	44.44	√
质黏难咳	1.77	2.12	0.20	18.52	×	苔黄腻	1.65	1.94	1.17	11.11	×
痰黄或白	1.69	2.02	1.19	7.41	×	舌苔薄黄	0.81	1.58	1.94	3.70	×
气促	3.23	1.36	0.42	33.33	√	苔薄	0.73	1.43	1.96	3.70	×
喘促	2.15	2.28	1.06	29.63	×	脉浮数	1.35	1.90	1.40	11.11	×
口渴	3.02	1.86	0.62	22.22	√	脉数	3.23	2.07	0.64	37.04	√
口干欲饮	2.19	2.19	1.00	18.52	×	脉滑数	2.12	2.36	1.11	25.93	×
大便秘结	3.85	1.33	0.35	40.74	√	指纹青紫	1.85	2.13	1.15	14.81	×
汗出	1.54	1.86	1.21	11.11	×	指纹紫	1.50	2.18	1.45	18.52	×
鼻煽	2.35	2.23	0.95	33.33	×

指标	均值	标准差	变异系数	满分比（%）	保留情况	指标	均值	标准差	变异系数	满分比（%）	保留情况
恶寒	4.19	1.59	0.38	66.67	√	无汗	3.52	2.01	0.57	48.15	√
发热	3.67	1.73	0.47	44.44	√	流清涕	4.07	1.77	0.44	66.67	√
低热	1.74	1.97	1.13	11.11	×	鼻塞	4.30	1.33	0.31	59.26	√
咳嗽	4.67	1.00	0.21	81.48	√	头身痛	3.48	1.78	0.51	29.63	√
呛咳	3.07	2.18	0.71	44.44	√	舌质淡红	3.22	2.28	0.71	55.56	√
咳声重浊	2.52	2.33	0.92	37.04	×	舌质淡	2.33	2.35	1.01	33.33	×
痰清稀	2.85	2.20	0.77	37.04	×	苔白腻	1.33	1.78	1.34	7.41	×
痰白	3.74	1.89	0.51	51.85	√	苔薄白	2.74	2.23	0.81	33.33	×
气促	2.41	2.08	0.86	18.52	×	脉浮紧	3.74	2.07	0.55	62.96	√
面白	2.52	2.23	0.88	29.63	×	指纹浮红	3.44	2.17	0.63	55.56	√
口不渴	3.56	2.03	0.57	51.85	√	指纹红	1.44	1.97	1.37	14.81	×
小便清长	2.26	2.18	0.96	22.22	×

指标	均值	标准差	变异系数	满分比（%）	保留情况	指标	均值	标准差	变异系数	满分比（%）	保留情况
低热	2.37	2.04	0.86	22.22	×	纳呆	3.89	1.78	0.46	59.00	√
发热	1.15	1.63	1.42	7.41	×	形体消瘦	2.96	1.83	0.62	25.93	×
咳嗽无力	4.07	1.82	0.45	74.07	√	睡眠欠佳	2.19	2.11	0.96	18.52	×
咳嗽	2.74	2.11	0.77	29.63	×	反复感冒	4.48	1.09	0.24	70.37	√
久咳	4.07	1.36	0.33	48.15	√	舌质淡	4.56	1.05	0.23	74.07	√
多痰	2.37	2.08	0.88	18.52	×	舌胖大有齿痕	3.48	1.97	0.57	40.74	√
痰清稀	3.67	1.88	0.51	48.15	√	苔薄白	3.33	2.02	0.61	40.74	√
痰白	3.26	1.89	0.58	29.63	√	舌白腻	2.30	2.07	0.90	18.52	×
气短	3.41	1.95	0.57	37.04	√	苔白	2.00	2.00	1.00	11.11	×
面色白	2.59	2.14	0.82	25.93	×	脉细无力	2.89	2.21	0.76	37.04	×
面色少华	3.48	2.01	0.58	48.15	√	脉细弱	3.11	1.99	0.64	29.63	√
面色萎黄	3.52	1.85	0.52	37.04	√	脉弱	1.74	1.97	1.13	11.11	×
大便溏薄	3.89	1.53	0.39	40.74	√	脉沉弱无力	1.44	1.76	1.22	7.41	×
多汗	3.00	2.27	0.76	44.44	√	脉沉细弱	1.67	1.96	1.17	14.81	×
自汗	3.70	1.94	0.52	55.56	√	指纹淡红	3.15	2.07	0.66	33.33	√
恶心	0.89	1.40	1.57	0.00	×	指纹淡	2.41	2.26	0.94	25.93	×
呕吐	0.85	1.29	1.52	0.00	×	指纹淡暗不显	1.26	1.72	1.37	7.41	×

[1]	Shiqin ZHAO, Youqi DONG. Clinical experience of Professor Dong Youqi in treating children's allergic rhinitis with winter ointments [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(5): 369-372.
[2]	Yanyan SU, Jianhui YANG, Zhongfa FENG, Jiaxuan WEI. Case of treating pediatric nasal cavity based on the theory of "Five Depressions" [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(5): 373-377.
[3]	Jiahang LI, Hai WANG. Exploring prevention and treatment strategies for pediatric allergic rhinitis based on the theory of "Preventive Medicine" [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(5): 378-381.
[4]	Yuang LI, Kejin AN, Chuanqi ZHAO, Shirui SUN, Yuran WANG, Changqing SHEN, Na LI. Etiology and pathogenesis of pediatric pneumonia from the perspective of the "Prolonged-Lying-Impairs-Qi" theory and the collaborative strategy of integrated Chinese-western medicine treatment [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(5): 387-391.
[5]	Wei SHAO, Xifan MEI, Feng WANG, Fei YU, Sunjun YIN, Dan HAN. Cost-effectiveness analysis of traditional Chinese medicine and western medicine in the treatment of influenza in children [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(5): 418-423.
[6]	Ruiying PAN. Analysis of clinical related factors of glucocorticoid-induced ocular hypertension in children with primary nephrotic syndrome [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(5): 424-428.
[7]	Yeting JIANG, Oumei HAO, Xuefeng WANG, Kexin ZHANG. Discussion on treatment for adenoid hypertrophy in children based on the theory of "Removing the Earth Stagnation" [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(5): 429-432.
[8]	Defang YUE, Liping SUN. Collection of experience in the treatment of children's tic disorders(activation-by-external-wind syndrome) based on the theory of latent wind [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(5): 433-436.
[9]	Jiayu LI, Yuan SUN, Xin FENG, Ke CHANG. Experience of Professor Chang Ke in treating damp-heat syndrome of mycoplasma pneumoniae pneumonia in children with the method of dredging obstruction and resolving turbidity(Xuanbi Huazhuo) [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(5): 442-446.
[10]	Yunshan LUO, Yuan SUN, Tianyin LUO, Xiangjuan SUN. An initial exploration of the treatment of childhood short stature based on the theory of "One-Qi Circulation" [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(5): 447-450.
[11]	Yi JIANG, Lei XIONG, Ting CAO, Yujiang XI. Professor Xiong Lei's experience in treating pediatric adenoid hypertrophy with aromatic herbs based on the theory of "Deficient Qi and Liquid Stagnation" [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(5): 451-456.
[12]	Jinwei LI, Lei GUO, Lizhong DING. Master Wang Lie's experience in treating children with febrile diseases with the Qinggan prescription of traditional Chinese medicine [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(5): 457-460.
[13]	Mingqing LUO, Shuxin SUN, Jing LI. Clinical research advances in auricular acupoint therapy for pediatric tic disorders [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(4): 277-280.
[14]	Qingmei ZHANG, Baiye XU, Haidao WANG, Zhen CHEN, Tingting CHEN. Investigation and analysis of sleep quality in children with tic disorders [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(4): 287-291.
[15]	Lü GAO, Chi LIU, Zhengyu YAO, Yijue JING, Liping WU, Zhenggang SHI. Exploring the anti-epileptic mechanism of Pingxian granules and its split formula based on neuronal apoptosis [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(4): 292-297.