Abstract: Background The occurrence and development of osteoporosis experience a long process, therefore, attention should be paid to bone health throughout the whole life cycle of human, early prevention and treatment of osteoporosis is of positive significance. There is a relative lack or insufficiency of research on TCM symptom assessment in the high risk population of osteoporosis in Ling-nan region.Objective To conduct expert questionnaire analysis on the assessment of TCM symptoms in high risk population of osteoporosis in Ling-nan region and form expert consensus opinions.Methods Based on the previous literature review and the first round of "Questionnaire for TCM symptom assessment in high risk population of osteoporosis in Ling-nan region", the Delphi method was adopted to optimize the second round of expert questionnaire from October 2021 to September 2022, in combination with the expert opinions of the first academic conference of Ling-nan bone and joint disease in December 2021 and the expert group of Guangdong Provincial Association of Chinese Medicine concerned Specialist Committee on Bone and Joint Degeneration and Injury. The experts in the department of orthopedics in Ling-nan region were consulted for their opinions, and the data of the investigation results were statistically analyzed.Results 192 experts with solid theoretical knowledge and clinical diagnosis and treatment skills in TCM or Chinese and western integrative medicine were selected from various provinces and cities in the Ling-nan region. The research fields of the surveyed experts included orthopedics and traumatology of Chinese medicine, orthopedics and traumatology of Chinese and western integrative medicine and clinical rehabilitation, etc. involving TCM clinical practice, Chinese and western integrative medicine clinical practice and scientific research, etc. Among them, there were 115 male experts, 77 female experts, 31 experts with senior professional titles, 76 experts with associate senior professional titles and 85 experts with intermediate professional titles, with the duration of carrying out specialty not less than 6 years. The expert positive coefficient was 100%, and the average authority coefficient was (0.81±0.04) . The concentration and coordination degree of the surveyed experts' opinions were relatively higher, that is, the sample mean±coefficient variation of the TCM symptom items of high risk population of osteoporosis in Ling-nan region included " humpback deformity" (88.93±13.46, 15.14%) , "generalized bone pain" (89.45±14.56, 16.28%) , "fracture occurred in recent 5 years" (85.68±17.44, 20.36%) , "low back pain" (84.51±15.27, 18.07%) , "shortened height" (82.94±16.14, 19.46%) , "heavy joints unable to bend or extend" (80.21±14.43, 17.99%) , "heavy body trapped" (76.17±17.22, 22.60%) , "tiredness" (75.26±14.69, 19.52%) , "tooth shaking and hair loss" (74.87±15.87, 21.20%) , etc.Conclusion The motivation and professionalism of experts surveyed by "Questionnaire for TCM symptom assessment in high risk population of osteoporosis in Ling-nan region" are good with a wide distribution region and good representation. The preferred items of TCM symptoms of high risk population of osteoporosis in Ling-nan region were "humpback deformity" , "generalized bone pain" , "fracture occurred in recent 5 years" , "low back pain" , "shortened height" , "heavy joints unable to bend or extend" , "heavy body trapped" , "tiredness" , "tooth shaking and hair loss" , etc. The recommendations of experts in this field on the TCM symptoms assessment in high risk population of osteoporosis in Lingnan region can be better summarized based on Delphi method, which can provide references for the subsequent early diagnosis of osteoporosis and the development of the assessment scale.

Key words: Osteoporosis, High risk population of osteoporosis, Ling-nan region, Surveys and Questionnaires, TCM symptom assessment, Delphi studies

摘要： 背景 骨质疏松的发生、发展经历了漫长的过程，故人的全生命周期均应关注骨骼健康，及早防治骨质疏松具有积极意义。岭南地区骨质疏松高危人群的中医症状评估研究相对欠缺或不足。目的 针对岭南地区骨质疏松高危人群中医症状评估进行专家问卷调查分析，形成专家共识意见。方法 2021年10月—2022年9月，采取德尔菲法，在既往文献梳理以及第一轮"岭南地区骨质疏松高危人群中医症状评估调查问卷"基础上，结合2021年12月首届岭南骨与关节疾病学术会议及广东省中医药学会骨关节退变与损伤专业委员会专家组等专家建议，对第二轮专家问卷进行编制优化；对岭南地区骨伤科专家予以征询意见，并对调研结果数据分析统计。结果 在岭南地区选择192位具有扎实的中医/中西医结合理论知识和临床诊治技能的专家。受访专家从事的研究方向包括中医骨伤科学、中西医结合骨伤科学、临床康复学等，覆盖中医临床、中西医结合临床与科研等；其中男性专家115位、女性专家77位，正高级职称31位、副高级职称76位、中级职称85位，开展本专业时间跨度均≥6年。专家积极系数为100%，平均权威系数为（0.81±0.04）。调研专家的意见集中程度以及意见协调程度比较高，即岭南地区骨质疏松高危人群的中医症状条目的样本均数与变异系数"畸形驼背"为（88.93±13.46，15.14%），"全身骨痛"为（89.45±14.56，16.28%），"近5年发生过骨折"为（85.68±17.44，20.36%），"腰背疼痛"为（84.51±15.27，18.07%），"变矮身高"为（82.94±16.14，19.46%），"关节重着"为（80.21±14.43，17.99%），"身体困重"为（76.17±17.22，22.60%），"倦怠"为（75.26±14.69，19.52%），"齿摇发脱"为（74.87±15.87，变异系数21.20%）等。结论 岭南地区骨质疏松高危人群中医症状评估专家问卷调研专家的积极性和专业水平均较佳，且分布区域较广，有着较好的代表性。岭南地区骨质疏松高危人群的中医症状优选条目依次为："畸形驼背""全身骨痛""近5年发生过骨折""腰背疼痛""变矮身高""关节重着""身体困重""倦怠""齿摇发脱"等。采取德尔菲法可以较好地总结本领域专家对岭南地区骨质疏松高危人群中医症状评估的建议，为后续疾病早期诊断以及评估量表研制提供合理的依据。

关键词: 骨质疏松, 骨质疏松高危人群, 岭南地区, 调查和问卷, 中医症状评估, 德尔菲研究法