刘师佺 周玉碧 李啟恩 佟海英 黄先菊

中图分类号 R29;[R932] 文献标志码 A 文章编号 1001-0408（2021）12-1416-05

DOI 10.6039/j.issn.1001-0408.2021.12.02

摘 要 目的：为促进藏药“蒂达”的药用资源开发和临床应用提供参考。方法：采用德尔菲法。查阅文献资料，确定咨询问题，采用线上函询和现场发放调查问卷两种方式向从事藏医药临床、科研、教学及生产的专家进行咨询，对目前“蒂达”药材资源及其使用中存在的分歧和问题进行评价，直至基本达成一致，最终确定藏药“蒂达”药用资源和临床应用专家共识条目。结果与结论：两轮函询共有33位专家参与。根据文献调研结果，第1轮设置函询指标16个;之后根据专家意见修改指标体系，第2轮设置函询指标18个。经过两轮函询，最终在藏药“蒂达”的基原名称、质量标准和临床应用等3方面的16个条目达成共识，2个关于“蒂达”的特征以及配伍用药的条目暂未达成共识。达成共识的16项内容涵盖了“蒂达”基原名称及地理信息的流变、“蒂达”药材的合理选药、“蒂达”临床用药有效性与安全性等主要内容。

关键词 德尔菲法;藏药;蒂达;药用资源;临床应用;专家共识

ABSTRACT   OBJECTIVE： To provide reference for the medicinal resources and clinical application of Tibetan medicine “Dida”. METHODS： Delphi method was adopted. By reviewing literatures， confirming consultation scope， inviting experts engaged in clinical， scientific research， teaching and production of Tibetan medicine. Two methods， online inquiry and on-site questionnaire， were used for expert consultation to evaluate the differences and problems existing in the utilization of “Dida” medicinal resources until a consensus was reached， consensus on the medicinal resources and clinical application of Tibetan medicine “Dida” was determined finally. RESULTS & CONCLUSIONS： A total of 33 experts participated in the two rounds of consultation. According to the results of literature research， the first round set up 16 inquiry indicators; and then according to expert opinions to modify the index system， the second round set up 18 inquiry indicators. After two rounds of inquiry， a consensus was finally reached on 16 items on the original name， quality standards and clinical application of Tibetan medicine “Dida”， and 2 items related to the characteristics and compatibilities of “Dida” had not reach common views. The consensuses of 16 items mainly cover the original name of “Dida” and the evolution of geographic information， the rational selection of “Dida” medicinal materials， the effectiveness and safety of clinical use of “Dida”.

KEYWORDS   Delphi method; Tibetan medicine; Dida; Medicinal resources; Clinical application; Expert consensus

藏醫药作为我国传统的民族医药，以其完整的理论体系和独特的疗效而越来越被重视。多基原藏药“蒂达”是一类治疗肝胆疾病的代表性藏药的总称[1]。现有文献报道其基原复杂，主要来源于龙胆科獐芽菜属、花锚属、扁蕾属、肋柱花属，以及虎耳草科虎耳草属等多种植物[2-3]。“蒂达”类药物基本以干燥全草入药，具有清热利胆、舒肝健胃、解毒等功效，临床上常用于治疗急性黄疸型肝炎、胆囊炎、流感等疾病[3]。……