Full
Outline
To screen clinical diagnostic items for hypertension with the syndrome of intermingled phlegm and blood stasis from both macro and micro perspectives using the Delphi method，providing evidence for the development of a diagnostic scale for this syndrome.
Based on the Delphi method and combined with previous literature research results from the working group，two rounds of expert consultations were conducted. The results of the expert consultations were evaluated from multiple perspectives such as the mean，the coefficient of variation and the coordination coefficient. The items were revised based on the clinical experience of the experts to form a consensus on diagnostic items for hypertension with the syndrome of intermingled phlegm and blood stasis.
A total of 30 domestic experts were surveyed，with a response rate of 86.67% for both rounds. The expert authority coefficients for the two rounds were 0.914 and 0.925，respectively. Based on the mean and coefficient of variation of each item，combined with the clinical experience of the experts，the appropriate deletions were made，and ultimately 20 core diagnostic items were determined. These included primary symptoms：a heavy sensation in the head as if wrapped，stabbing pain in the head or chest with a fixed location，dark purple lips and nails，chest distress，obesity，heavy limbs，a swollen tongue with teeth marks on the edges，purple or dark tongue，or tongue with ecchymoses or petechiae or purple and dilated sublingual veins，greasy coating on the tongue，slippery or rough pulse，and abnormal blood lipids；secondary symptoms：dark complexion，excessive sleepiness，fatigue，expectoration of phlegm or sticky sensation in the mouth，thick coating on the tongue，wiry pulse，increased plasma viscosity and increased intima-media thickness of the carotid artery or carotid plaques.
The 20 diagnostic items for the syndrome of of intermingled phlegm and blood stasis in hypertension screened out in this study integrate the macroscopic syndrome differentiation of traditional Chinese medicine with the microscopic syndrome differentiation based on modern biochemical indicators，providing a basis and reference for subsequent research on quantitative assignment of this syndrome and the construction of diagnostic scales.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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