中醫症狀診斷作業標準可行性之研究
張恒鴻
長庚大學
中醫診斷主要是以症狀的採集為基礎，並依據辨證理論進行病機的分析。因此，症狀是中醫辨證的基本元素，也是臨床診療的基礎。中醫診斷規範化的實現必須建立在症狀規範化的基礎上，使醫者臨症時，對病患症狀採集判定的操作過程能有一致的標準，以提高辨病與辨證的精確度。 以氣虛證為例，針對相關症狀判定操作模式相關文獻進行收集整理，並組成專家小組，就中醫氣虛相關症狀操作模式資料進行分析與評論，並舉辦小型研討會，邀請專家提供症狀判定操作經驗，期能形成共識，並將所獲成果，舉辦相關學術專家研討會。 本研究共計邀請8位中醫診斷學者專家，原則上每週一次集會討論，共計約40次，並分別於2006年5月28日、8月27日和11月19日舉行三次專家研討會及2007年4月28日舉辦全國性研討會。另並在研討過程中，共同推舉中醫診斷學代表性之書籍8本，中醫診斷標準化相關期刊44篇，並總結出10個氣虛證症狀術語，包括：疲倦、乏力、自汗、頭暈、目眩、語聲低微、氣短、懶言、舌淡、脈無力等，進行草擬問卷，於本學會之網路平台進行專家意見之調查，結果顯示：中醫臨床常用之症狀術語涵義尚待釐清，有關判定標準方面，專家意見非常紛歧，亟應由各中醫學會、公會等組織，努力形成共識，並訂定作業標準，以提升醫療品質。
關鍵字：症狀；氣虛證；中醫診斷；作業標準
The operational procedure for symptom and sign in traditional chinese medicine
Chang, Hen-Hong
CHANG GUNG UNIVERSITY
The diagnosis of Chinese medicine mainly relies on taking symptoms gathering as the foundation, and carries on the analysis of pathogenesis by the dialectical theory. Therefore, the symptoms are the fundamental elements of Chinese medical dialectical theory, also are the basis of clinical diagnosis and treatment. The standardization of Chinese medical diagnosis must establish on the basis of symptom standardization. Therefore when doctors face the patients, they can have the consistent standard on the process of symptoms gathering and determination to enhance the precision of disease diagnosis and pattern identification. Take the qi vacuity pattern for example. We focused on gathering and organizing the correlated literatures of symptoms diagnosis and determination. Experts group was established to analyze and comment on the data regarding Chinese medical qi vacuity pattern. Small seminars were also held to invite experts for sharing experiences of symptoms diagnosis and determination, and to form the general protocols. Then we held academic experts conferences to discuss the achievements. This research totally invited 8 doctors and scholars with traditional Chinese medical diagnostic expert. Principally, the meetings of discussion were held once a week, and amount to 40 times in total. Three expert conferences were held on May 28th, August 27th, and November 19th of 2006, and a large national seminar was held on April 28th, 2007.
關鍵字：Symptom；qi vacuity pattern；Chinese medical diagnostics；Guideline
