VitalApp/assets/templates/TNB.json

{
  "Key": "TNB",
  "Name": "2型糖尿病",
  "Content": [
    {
      "label": "症状",
      "defaultValue": null,
      "span": 24,
      "key": "symptom",
      "type": "title",
      "border": null,
      "disabledValue": null,
      "options": [],
      "children": [
        {
          "label": "症状",
          "defaultValue": [],
          "span": 24,
          "key": "Symptom",
          "type": "checkbox",
          "border": false,
          "disabledValue": "1",
          "options": [
            {
              "label": "无症状",
              "value": "1"
            },
            {
              "label": "多饮",
              "value": "2"
            },
            {
              "label": "多食",
              "value": "3"
            },
            {
              "label": "多尿",
              "value": "4"
            },
            {
              "label": "视力模糊",
              "value": "5"
            },
            {
              "label": "感染",
              "value": "6"
            },
            {
              "label": "手脚麻木",
              "value": "7"
            },
            {
              "label": "下肢浮肿",
              "value": "8"
            },
            {
              "label": "体重明显下降",
              "value": "9"
            },
            {
              "label": "其他",
              "value": "10"
            }
          ],
          "children": null,
          "append": null,
          "placeholder": null,
          "required": true,
          "show-limit": null,
          "parentKey": "symptom",
          "buttonName": null,
          "childrenKey": null
        }
      ],
      "append": null,
      "placeholder": null,
      "required": null,
      "show-limit": null,
      "parentKey": null,
      "buttonName": null,
      "childrenKey": null
    },
    {
      "label": "体征",
      "defaultValue": null,
      "span": 24,
      "key": "sign",
      "type": "title",
      "border": null,
      "disabledValue": null,
      "options": [],
      "children": [
        {
          "label": "血压",
          "defaultValue": null,
          "span": 24,
          "key": "Blood",
          "type": "bloodPressure",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "mmHg",
          "placeholder": "",
          "required": true,
          "show-limit": false,
          "parentKey": "sign",
          "buttonName": "测量",
          "childrenKey": ["Sbp", "Dbp"]
        },
        {
          "label": "身高",
          "defaultValue": null,
          "span": 12,
          "key": "Height",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "cm",
          "placeholder": "",
          "required": true,
          "show-limit": false,
          "parentKey": "sign",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "心率",
          "defaultValue": null,
          "span": 12,
          "key": "Heart_Rate",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "次/分钟",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "sign",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "体重",
          "defaultValue": null,
          "span": 12,
          "key": "Weight",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "kg",
          "placeholder": "",
          "required": true,
          "show-limit": false,
          "parentKey": "sign",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "下次随访目标",
          "defaultValue": null,
          "span": 12,
          "key": "Goal_Weight",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "kg",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "sign",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "体质指数",
          "defaultValue": null,
          "span": 12,
          "key": "Bmi",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "kg/㎡",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "sign",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "下次随访目标",
          "defaultValue": null,
          "span": 12,
          "key": "Goal_Bmi",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "kg/㎡",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "sign",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "其他",
          "defaultValue": null,
          "span": 24,
          "key": "Sign_Other",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "sign",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "足背动脉搏动",
          "defaultValue": [],
          "span": 24,
          "key": "Pedal_Artery",
          "type": "radio",
          "border": false,
          "disabledValue": null,
          "options": [
            {
              "label": "触及正常",
              "value": "1"
            },
            {
              "label": "双侧减弱",
              "value": "2"
            },
            {
              "label": "左侧减弱",
              "value": "3"
            },
            {
              "label": "右侧减弱",
              "value": "4"
            },
            {
              "label": "双侧消失",
              "value": "5"
            },
            {
              "label": "左侧消失",
              "value": "6"
            },
            {
              "label": "右侧消失",
              "value": "7"
            }
          ],
          "children": null,
          "append": null,
          "placeholder": null,
          "required": true,
          "show-limit": null,
          "parentKey": "sign",
          "buttonName": null,
          "childrenKey": null
        }
      ],
      "append": null,
      "placeholder": null,
      "required": null,
      "show-limit": null,
      "parentKey": null,
      "buttonName": null,
      "childrenKey": null
    },
    {
      "label": "生活方式指导",
      "defaultValue": null,
      "span": 24,
      "key": "lifestyleCoaching",
      "type": "title",
      "border": null,
      "disabledValue": null,
      "options": [],
      "children": [
        {
          "label": "日吸烟量",
          "defaultValue": null,
          "span": 12,
          "key": "Smoking_Daily",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "支",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "下次随访目标",
          "defaultValue": null,
          "span": 12,
          "key": "Goal_Smoking",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "支",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "日饮酒量",
          "defaultValue": null,
          "span": 12,
          "key": "Drinking_Daily",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "两",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "下次随访目标",
          "defaultValue": null,
          "span": 12,
          "key": "Goal_Drinking",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "两",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "运动",
          "defaultValue": null,
          "span": 12,
          "key": "Times_Week",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "次/周",
          "placeholder": "",
          "required": true,
          "show-limit": false,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "下次随访目标",
          "defaultValue": null,
          "span": 12,
          "key": "Goal_Times_Week",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "次/周",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "主食",
          "defaultValue": null,
          "span": 12,
          "key": "Main_Course_Daily",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "克/天",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "下次随访目标",
          "defaultValue": null,
          "span": 12,
          "key": "Goal_Main_Course_Daily",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "克/天",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "心理调整",
          "defaultValue": [],
          "span": 24,
          "key": "Psychol_Adjust",
          "type": "radio",
          "border": false,
          "disabledValue": null,
          "options": [
            {
              "label": "良好",
              "value": "1"
            },
            {
              "label": "一般",
              "value": "2"
            },
            {
              "label": "差",
              "value": "3"
            }
          ],
          "children": null,
          "append": null,
          "placeholder": null,
          "required": true,
          "show-limit": null,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "遵医行为",
          "defaultValue": [],
          "span": 24,
          "key": "Compliance",
          "type": "radio",
          "border": false,
          "disabledValue": null,
          "options": [
            {
              "label": "良好",
              "value": "1"
            },
            {
              "label": "一般",
              "value": "2"
            },
            {
              "label": "差",
              "value": "3"
            }
          ],
          "children": null,
          "append": null,
          "placeholder": null,
          "required": true,
          "show-limit": null,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "空腹血糖值",
          "defaultValue": null,
          "span": 12,
          "key": "Blood_Sugar",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "mol/L",
          "placeholder": "",
          "required": true,
          "show-limit": false,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "糖化血红蛋白",
          "defaultValue": null,
          "span": 12,
          "key": "Hbalc",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "%",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "检查日期",
          "defaultValue": null,
          "span": 24,
          "key": "Exam_Date",
          "type": "date",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "服药依从性",
          "defaultValue": [],
          "span": 24,
          "key": "Compliance_Drug",
          "type": "radio",
          "border": false,
          "disabledValue": null,
          "options": [
            {
              "label": "规律",
              "value": "1"
            },
            {
              "label": "间断",
              "value": "2"
            },
            {
              "label": "不服药",
              "value": "3"
            }
          ],
          "children": null,
          "append": null,
          "placeholder": null,
          "required": false,
          "show-limit": null,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "低血糖反应",
          "defaultValue": [],
          "span": 24,
          "key": "Hypoglycemia",
          "type": "radio",
          "border": false,
          "disabledValue": null,
          "options": [
            {
              "label": "无",
              "value": "1"
            },
            {
              "label": "偶尔",
              "value": "2"
            },
            {
              "label": "频繁",
              "value": "3"
            }
          ],
          "children": null,
          "append": null,
          "placeholder": null,
          "required": true,
          "show-limit": null,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "此次随访分类",
          "defaultValue": [],
          "span": 24,
          "key": "Follow_Up_Classify",
          "type": "radio",
          "border": false,
          "disabledValue": null,
          "options": [
            {
              "label": "控制满意",
              "value": "1"
            },
            {
              "label": "控制不满意",
              "value": "2"
            },
            {
              "label": "不良反应",
              "value": "3"
            },
            {
              "label": "并发症",
              "value": "4"
            }
          ],
          "children": null,
          "append": null,
          "placeholder": null,
          "required": true,
          "show-limit": null,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "药物不良反应",
          "defaultValue": [],
          "span": 24,
          "key": "Adverse",
          "type": "radio",
          "border": false,
          "disabledValue": null,
          "options": [
            {
              "label": "无",
              "value": "1"
            },
            {
              "label": "有",
              "value": "2"
            }
          ],
          "children": null,
          "append": null,
          "placeholder": null,
          "required": true,
          "show-limit": null,
          "parentKey": "lifestyleCoaching",
          "buttonName": null,
          "childrenKey": null
        }
      ],
      "append": null,
      "placeholder": null,
      "required": null,
      "show-limit": null,
      "parentKey": null,
      "buttonName": null,
      "childrenKey": null
    },
    {
      "label": "用药情况",
      "defaultValue": null,
      "span": 24,
      "key": "Drug_Info",
      "type": "title",
      "border": null,
      "disabledValue": null,
      "options": [],
      "children": [
        {
          "label": "用药情况",
          "defaultValue": null,
          "span": 24,
          "key": "Appraisal",
          "type": "gxyAndTnbMedication",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "",
          "placeholder": "",
          "required": true,
          "show-limit": false,
          "parentKey": "Drug_Info",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "胰岛素的种类",
          "defaultValue": null,
          "span": 24,
          "key": "Insulin_Info",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "Drug_Info",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "胰岛素的用法用量",
          "defaultValue": null,
          "span": 24,
          "key": "Insulin_Info_Use",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "Drug_Info",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "转诊机构及科别：",
          "defaultValue": null,
          "span": 24,
          "key": "Referral_Hospital",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "Drug_Info",
          "buttonName": null,
          "childrenKey": null
        },
        {
          "label": "转诊原因：",
          "defaultValue": null,
          "span": 24,
          "key": "Referral_Reason",
          "type": "input",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "Drug_Info",
          "buttonName": null,
          "childrenKey": null
        }
      ],
      "append": null,
      "placeholder": null,
      "required": null,
      "show-limit": null,
      "parentKey": null,
      "buttonName": null,
      "childrenKey": null
    },
    {
      "label": "处方",
      "defaultValue": null,
      "span": 24,
      "key": "Pre",
      "type": "title",
      "border": null,
      "disabledValue": null,
      "options": [],
      "children": [
        {
          "label": "处方",
          "defaultValue": null,
          "span": 24,
          "key": "Prescription",
          "type": "prescriptionType",
          "border": null,
          "disabledValue": null,
          "options": [],
          "children": null,
          "append": "",
          "placeholder": "",
          "required": null,
          "show-limit": false,
          "parentKey": "Pre",
          "buttonName": "DiabetesPrescription",
          "childrenKey": null
        }
      ],
      "append": null,
      "placeholder": null,
      "required": null,
      "show-limit": null,
      "parentKey": null,
      "buttonName": null,
      "childrenKey": null
    }
  ]
}