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1、中医杂志2007年第48卷第9期JournalofTraditionalChineseMedicine,2007,Vol.48,No.9·837·四诊研究颈椎病的耳诊观察与研究1213张向丽管耀辉张录焕王乾娃(1.陕西省扶风县中医医院风湿病科,陕西省扶风县城关镇河滨路007号,722200;2.陕西省宝鸡市绛帐社会福利院;3.陕西省杨凌精神病医院)[摘要]目的探讨耳诊在颈椎病诊断方面的作用。方法凭症状初筛颈椎病疑似病例,耳诊观察患者对耳轮体部下1/5结节,诊断用CR摄影检查。症状、耳诊以及CR检查均使用自拟指标量表;诊断资料的真实性评价采用《实用临床统计学》诊断试验
2、的评价标准。结果50例疑似患者中,耳诊阳性38例(76%),CR阳性43例(86%);43例颈椎病患者和7例非颈椎病患者,耳诊阳性为371,耳诊阴性为66。耳诊与CR一致认为阳性37例,一致认为阴性6例,经一致性检验kappa=0.96,灵敏度86.05%,特异率85.71%,误诊率14.29%,漏诊率13.95%,诊断符合率86%,诊断指数0.7176,似然比6.02。结论耳诊在颈椎病的诊断方面有特征性指标意义。[关键词]颈椎病;耳诊;诊断ObservationandStudyontheEffectofAuricularDiagnosisforCervicalSp
3、ondylosis121ZHANGXiang-li,GUANYao-hui,ZHANGLu-huan,etal.(1.RheumatismDepartmentofTCMHospitalofFufengCounty,ShaanxiProvince,FufengCounty722200;2.JiangzhangSocialWelfareInstituteofBaojiCity;3.YanglingMentalDiseasesHospital,ShaanxiProvince)ABSTRACTObjectiveTostudytheeffectofauriculardiagnos
4、isforcervicalspondylosis.MethodsTheborderlinepatientswereselectedaccordingtothesymptoms.Thelower1/5tuberosityofantihelixofauriclewasobservedanddiagnosedwithCRphotographicexamination.Theself-madeindicesofsymptoms,auriculardiagnosisandCRexaminationwereadopted.TheevaluationcriteriagivenbyPr
5、acticalClinicalStatisticswereadoptedforthetruenessevaluationofdiagnosisdata.ResultsOfthe50borderlinepatients,38(76%)werepositiveinauriculardiagnosisand43(86%)positiveinCRexamination.Ofthe43cervicalspondylosispatientsand7non-cervicalspondylosispatients,theauricularpositivenesswas371andth
6、eauricularnegativeness66.Therewere37patientsdiagnosedpositiveand6diagnosednegativeinbothauriculardiagnosisandCRexamination.Theconsistencycheckshowedkappa=0.96,thesensitivitywas86.05%,thespecificity85.71%,themisdiagnosisrate14.29%,therateofmisseddiagnosis13.95%,thediagnosticaccordancerat
7、e86%,thediagnosticindex0.7176,andthelikelihoodratio6.02.ConclusionTheauriculardiagnosiswascharacteristicallysignificantindiagnosisofcervicalspondylosis.KeyWordsCervicalspondylosis;Auriculardiagnosis;Diagnosis颈椎病为多发病,由于其症状的多样性和体征的2.1初筛方法隐匿性,临证时往往难以寻找具有确诊意义的特征性根据症状表现初筛颈椎病疑似
