VitalApp/assets/templates/LNRZYYJKGLFWJL.json

{
	"Key": "LNRZYYJKGLFWJL",
	"Name": "老年人中医药健康管理服务记录表",
	"Content": [
		{
			"label": "中医体质辨识",
			"span": 24,
			"key": "constitution",
			"type": "title",
			"options": [
				{
					"label": "没有(根本不/从来没有)",
					"value": "1"
				},
				{
					"label": "很少(有一点/偶尔)",
					"value": "2"
				},
				{
					"label": "有时(有些/少数时间)",
					"value": "3"
				},
				{
					"label": "经常(相当/多数时间)",
					"value": "4"
				},
				{
					"label": "总是(非常/每天)",
					"value": "5"
				}
			],
			"children": [
				{
					"label": "(1) 您精力充沛吗？（指精神头足，乐于做事）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition1",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Ping_Score"
					]
				},
				{
					"label": "(2) 您容易疲乏吗？（指体力如何，是否稍微活动一下或做一点家务劳动就感到累）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition2",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Qi_Score",
						"Ping_Score"
					]
				},
				{
					"label": "(3) 您容易气短，呼吸短促，接不上气吗？",
					"defaultValue": [],
					"span": 24,
					"key": "qusition3",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Qi_Score"
					]
				},
				{
					"label": "(4) 您说话声音低弱无力吗?（指说话没有力气）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition4",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Qi_Score",
						"Ping_Score"
					]
				},
				{
					"label": "(5) 您感到闷闷不乐、情绪低沉吗?（指心情不愉快，情绪低落）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition5",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Qiyu_Score",
						"Ping_Score"
					]
				},
				{
					"label": "(6) 您容易精神紧张、焦虑不安吗?（指遇事是否心情紧张）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition6",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Qiyu_Score"
					]
				},
				{
					"label": "(7) 您因为生活状态改变而感到孤独、失落吗？",
					"defaultValue": [],
					"span": 24,
					"key": "qusition7",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Qiyu_Score"
					]
				},
				{
					"label": "(8) 您容易感到害怕或受到惊吓吗?",
					"defaultValue": [],
					"span": 24,
					"key": "qusition8",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Qiyu_Score"
					]
				},
				{
					"label": "(9) 您感到身体超重不轻松吗?(感觉身体沉重)[BMI 指数=体重（kg）/身高²（m）]（BMI<24选1；24≤BMI＜25选2；25≤BMI＜26选3；26≤BMI＜28选4；BMI≥28选5）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition9",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [
						{
							"label": "BMI<24",
							"value": "1"
						},
						{
							"label": "24≤BMI＜25",
							"value": "2"
						},
						{
							"label": "25≤BMI＜26",
							"value": "3"
						},
						{
							"label": "26≤BMI＜28",
							"value": "4"
						},
						{
							"label": "BMI≥28选5",
							"value": "5"
						}
					],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Tan_Score"
					]
				},
				{
					"label": "(10) 您眼睛干涩吗? ",
					"defaultValue": [],
					"span": 24,
					"key": "qusition10",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Yin_Score"
					]
				},
				{
					"label": "(11) 您手脚发凉吗?（不包含因周围温度低或穿的少导致的手脚发冷）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition11",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Yang_Score"
					]
				},
				{
					"label": "(12) 您胃脘部、背部或腰膝部怕冷吗？（指上腹部、背部、腰部或膝关节等，有一处或多处怕冷）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition12",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Yang_Score"
					]
				},
				{
					"label": "(13) 您比一般人耐受不了寒冷吗？（指比别人容易害怕冬天或是夏天的冷空调、电扇等）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition13",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Yang_Score",
						"Ping_Score"
					]
				},
				{
					"label": "(14) 您容易患感冒吗?（指每年感冒的次数，<2次选1；2~4次选2；5~6次选3；>8次选4；几乎每月选5）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition14",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [
						{
							"label": "<2次",
							"value": "1"
						},
						{
							"label": "2~4次",
							"value": "2"
						},
						{
							"label": "5~6次",
							"value": "3"
						},
						{
							"label": ">8次",
							"value": "4"
						},
						{
							"label": "几乎每月",
							"value": "5"
						}
					],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Qi_Score"
					]
				},
				{
					"label": "(15) 您没有感冒时也会鼻塞、流鼻涕吗?",
					"defaultValue": [],
					"span": 24,
					"key": "qusition15",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Te_Score"
					]
				},
				{
					"label": "(16) 您有口粘口腻，或睡眠打鼾吗？",
					"defaultValue": [],
					"span": 24,
					"key": "qusition16",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Tan_Score"
					]
				},
				{
					"label": "(17) 您容易过敏(对药物、食物、气味、花粉或在季节交替、气候变化时)吗?（从来没有选1；1、2次选2；3、4次选3；5、6次选4；每次遇到上述原因都过敏选5）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition17",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [
						{
							"label": "从来没有",
							"value": "1"
						},
						{
							"label": "1、2次",
							"value": "2"
						},
						{
							"label": "3、4次",
							"value": "3"
						},
						{
							"label": "5、6次",
							"value": "4"
						},
						{
							"label": "每次遇到上述原因都过敏",
							"value": "5"
						}
					],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Te_Score"
					]
				},
				{
					"label": "(18) 您的皮肤容易起荨麻疹吗? (包括风团、风疹块、风疙瘩)",
					"defaultValue": [],
					"span": 24,
					"key": "qusition18",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Te_Score"
					]
				},
				{
					"label": "(19) 您的皮肤在不知不觉中会出现青紫瘀斑、皮下出血吗?（指皮肤在没有外伤的情况下出现青一块紫一块的情况）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition19",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Xue_Score"
					]
				},
				{
					"label": "(20) 您的皮肤一抓就红，并出现抓痕吗?（指被指甲或钝物划过后皮肤的反应）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition20",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Te_Score"
					]
				},
				{
					"label": "(21) 您皮肤或口唇干吗?",
					"defaultValue": [],
					"span": 24,
					"key": "qusition21",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Yin_Score"
					]
				},
				{
					"label": "(22) 您有肢体麻木或固定部位疼痛的感觉吗？",
					"defaultValue": [],
					"span": 24,
					"key": "qusition22",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Xue_Score"
					]
				},
				{
					"label": "(23) 您面部或鼻部有油腻感或者油亮发光吗?（指脸上或鼻子）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition23",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Shi_Score"
					]
				},
				{
					"label": "(24) 您面色或目眶晦黯，或出现褐色斑块/斑点吗?",
					"defaultValue": [],
					"span": 24,
					"key": "qusition24",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Xue_Score"
					]
				},
				{
					"label": "(25) 您有皮肤湿疹、疮疖吗？",
					"defaultValue": [],
					"span": 24,
					"key": "qusition25",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Shi_Score"
					]
				},
				{
					"label": "(26) 您感到口干咽燥、总想喝水吗？ ",
					"defaultValue": [],
					"span": 24,
					"key": "qusition26",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Yin_Score"
					]
				},
				{
					"label": "(27) 您感到口苦或嘴里有异味吗?（指口苦或口臭） ",
					"defaultValue": [],
					"span": 24,
					"key": "qusition27",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Shi_Score"
					]
				},
				{
					"label": "(28) 您腹部肥大吗?（指腹部脂肪肥厚，腰围<80cm或2.4尺选1；腰围80-85cm或2.4-2.55尺选2；腰围86-90cm或2.56-2.7尺选3；腰围91-105cm或2.71-3.15尺选4；腰围>105cm或3.15尺选5）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition28",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [
						{
							"label": "腰围<80cm或2.4尺",
							"value": "1"
						},
						{
							"label": "腰围80-85cm或2.4-2.55尺",
							"value": "2"
						},
						{
							"label": "腰围86-90cm或2.56-2.7尺",
							"value": "3"
						},
						{
							"label": "腰围91-105cm或2.71-3.15尺",
							"value": "4"
						},
						{
							"label": "腰围>105cm或3.15尺",
							"value": "5"
						}
					],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Tan_Score"
					]
				},
				{
					"label": "(29) 您吃(喝)凉的东西会感到不舒服或者怕吃(喝)凉的东西吗？（指不喜欢吃凉的食物，或吃了凉的食物后会不舒服）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition29",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Yang_Score"
					]
				},
				{
					"label": "(30) 您有大便黏滞不爽、解不尽的感觉吗?(大便容易粘在马桶或便坑壁上)",
					"defaultValue": [],
					"span": 24,
					"key": "qusition30",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Shi_Score"
					]
				},
				{
					"label": "(31) 您容易大便干燥吗?",
					"defaultValue": [],
					"span": 24,
					"key": "qusition31",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Yin_Score"
					]
				},
				{
					"label": "(32) 您舌苔厚腻或有舌苔厚厚的感觉吗?（如果自我感觉不清楚可由调查员观察后填写）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition32",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Tan_Score"
					]
				},
				{
					"label": "(33) 您舌下静脉瘀紫或增粗吗？（可由调查员辅助观察后填写）",
					"defaultValue": [],
					"span": 24,
					"key": "qusition33",
					"type": "radio",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"children": null,
					"append": null,
					"placeholder": null,
					"required": null,
					"show-limit": null,
					"parentKey": "constitution",
					"buttonName": null,
					"childrenKey": null,
					"groupKeys": [
						"Xue_Score"
					]
				}
			],
			"append": null,
			"placeholder": null,
			"required": null,
			"show-limit": null,
			"parentKey": null,
			"buttonName": null,
			"childrenKey": null
		},
		{
			"label": "中医药保健指导",
			"span": 24,
			"key": "healthGuidance",
			"type": "title",
			"options": [
				{
					"label": "情志调摄",
					"value": "1"
				},
				{
					"label": "饮食调养",
					"value": "2"
				},
				{
					"label": "起居调摄",
					"value": "3"
				},
				{
					"label": "运动保健",
					"value": "4"
				},
				{
					"label": "穴位保健",
					"value": "5"
				},
				{
					"label": "其他",
					"value": "6"
				}
			],
			"children": [
				{
					"label": "气虚质",
					"defaultValue": [],
					"span": 24,
					"key": "Qi_Deficiency_Constitution",
					"type": "healthGuidanceCheckBox",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"parentKey": "healthGuidance",
					"groupKeys": [
						"Qi_Score"
					]
				},
				{
					"label": "阳虚质",
					"defaultValue": [],
					"span": 24,
					"key": "Yang_Deficiency_Substance",
					"type": "healthGuidanceCheckBox",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"parentKey": "healthGuidance",
					"groupKeys": [
						"Yang_Score"
					]
				},
				{
					"label": "阴虚质",
					"defaultValue": [],
					"span": 24,
					"key": "Yin_Deficiency_Substance",
					"type": "healthGuidanceCheckBox",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"parentKey": "healthGuidance",
					"groupKeys": [
						"Yin_Score"
					]
				},
				{
					"label": "痰湿质",
					"defaultValue": [],
					"span": 24,
					"key": "Phlegm-dampness_constitution",
					"type": "healthGuidanceCheckBox",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"parentKey": "healthGuidance",
					"groupKeys": [
						"Tan_Score"
					]
				},
				{
					"label": "湿热质",
					"defaultValue": [],
					"span": 24,
					"key": "Damp-heat_constitution",
					"type": "healthGuidanceCheckBox",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"parentKey": "healthGuidance",
					"groupKeys": [
						"Shi_Score"
					]
				},
				{
					"label": "血瘀质",
					"defaultValue": [],
					"span": 24,
					"key": "Blood_Stasis_Substance",
					"type": "healthGuidanceCheckBox",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"parentKey": "healthGuidance",
					"groupKeys": [
						"Xue_Score"
					]
				},
				{
					"label": "气郁质",
					"defaultValue": [],
					"span": 24,
					"key": "Qi_Stagnation_Constitution",
					"type": "healthGuidanceCheckBox",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"parentKey": "healthGuidance",
					"groupKeys": [
						"Qiyu_Score"
					]
				},
				{
					"label": "特禀质",
					"defaultValue": [],
					"span": 24,
					"key": "Idiosyncratic_Quality",
					"type": "healthGuidanceCheckBox",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"parentKey": "healthGuidance",
					"groupKeys": [
						"Te_Score"
					]
				},
				{
					"label": "平和质",
					"defaultValue": [],
					"span": 24,
					"key": "Peaceful_Quality",
					"type": "healthGuidanceCheckBox",
					"border": false,
					"disabledValue": "1",
					"options": [],
					"parentKey": "healthGuidance",
					"groupKeys": [
						"Ping_Score"
					]
				}
			]
		}
	]
}