摘要
目的探讨推拿治疗常见误诊疾病及误诊原因。方法计算机检索中国知网期刊全文数据库、维普数据库、万方数据库中有关推拿治疗误诊研究的文献,检索截止日期2015年12月1日。设计数据提取表,提取并统计分析纳入文献的发表时间、误诊部位、确诊疾病、误诊疾病及误诊原因等一般资料。结果共纳入文献188篇,涉及确诊疾病91种,误诊疾病89种,误诊原因17项。纳入推拿治疗误诊的颈部误诊文献56篇,误诊例次居前3位的确诊疾病依次为肿瘤、颈椎病和眩晕;腰部误诊文献94篇,误诊例次居前4位的确诊疾病依次为肿瘤、结核、带状疱疹及多发性骨髓瘤;肩背部误诊文献35篇,误诊例次居前2位的确诊疾病依次为肿瘤和胸椎小关节紊乱;四肢部误诊文献12篇,误诊例次最高的确诊疾病为痛风。误诊原因≥17频次共11项,居前5位的依次为不重视体格检查、未详细询问病史、诊断思维局限、影像学检查不完善及过分依赖影像学检查结果。结论近年临床推拿治疗中误诊事件明显增多,不重视体格检查及未详细询问病史是导致其误诊的最主要原因,故推拿医生应从其入手并不断学习和自我反思,建立丰富跨学科知识体系,从而降低误诊率。
Objective To investigate commonly misdiagnosed diseases and misdiagnosed causes of massage therapy. Methods Literature about misdiagnosed cases by massage therapy was searched from CNKI Journals Full-text Database, VIP database and Wanfang database, and the deadline was 1st December 2015. Data extraction table was designed, and then general information such as the publication time of literature, misdiagnosed sites, final diagnosed diseases, misdiagnosed diseases and misdiagnosed causes was extracted and statistically analyzed. Results A total of 188 papers were included in the study, which included 91 kinds of final diagnosis diseases, 89 kinds of misdiagnosed diseases and 17 misdiagnosed causes. There were 56 papers about misdiagnosis in the neck, the final diagnosis diseases of the top 3 misdiagnosed diseases were tumor, cervical spondylosis and vertigo; 94 papers were about misdiagnosis in the waist, and confirmed diagnosis of the top 4 misdiag- nosed diseases were tumor, tuberculosis, herpes zoster and multiple spinal cord disease in turn; 35 papers were about misdi- agnosis in the back and shoulder, and confirmed diagnosis of the top 2 misdiaguosed diseases were tumor and thoracic verte- brae facet joint disorders; 12 papers were misdiagnosed as warm and fragrant in limbs, and confirmed diagnosis of the top one misdiagnosed disease was gout. There were 11 kinds of misdiagnosis which causes were more than 17 times, and the top five were neglecting physical examination, non carefully asking medical history, localized thinking for diagnosis, imperfect in ima- ging examination and over reliance on imaging findings in turn. Conclusion In recent years, misdiagnosed cases by massage therapy increase significantly, and main causes are neglecting physical examination and non carefully asking medical history, and therefore massage doctors should continuously learn and do self reflection and establish interdisciplinary knowledge system in order to decrease misdiagnosed rate.
出处
《临床误诊误治》
2017年第2期48-52,共5页
Clinical Misdiagnosis & Mistherapy
基金
国家自然科学基金面上项目(81273868)
关键词
推拿
文献综述
误诊
Massage
Literature review
Misdiagnosis
