• <tr id="yyy80"></tr>
  • <sup id="yyy80"></sup>
  • <tfoot id="yyy80"><noscript id="yyy80"></noscript></tfoot>
  • 99热精品在线国产_美女午夜性视频免费_国产精品国产高清国产av_av欧美777_自拍偷自拍亚洲精品老妇_亚洲熟女精品中文字幕_www日本黄色视频网_国产精品野战在线观看 ?

    Consensus on diagnostic criteria for Yin deficiency syndrome in hypertension: a modified Delphi study

    2023-02-15 13:45:06HEYunHEJingXUXiangruLIHaixiaoSHIRongweiLIANGJunyaZHOUYingZHUYaoCHENXiaohuTANGShuhuaXIAOMinZHANLibinPEIYinghaoJIANGWeimin

    HE Yun,HE Jing,XU Xiangru,LI Haixiao,SHI Rongwei,LIANG Junya,ZHOU Ying,ZHU Yao,CHEN Xiaohu,TANG Shuhua,XIAO Min,ZHAN Libin,PEI Yinghao,JIANG Weimin

    HE Yun,LI Haixiao,SHI Rongwei,Department of General Internal Medicine,Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese Medicine,Nanjing 210029,China

    PEI Yinghao,Department of Intensive Care Unit,Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese Medicine,Nanjing 210029,China

    HE Jing,Department of Hepatology,Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese Medicine,Nanjing 210029,China

    LIANG Junya,Department of Institute of Hypertension,Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese Medicine,Nanjing 210029,China

    ZHOU Ying,ZHU Yao,CHEN Xiaohu,TANG Shuhua,JIANG Weiming,Department of Cardiology,Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese Medicine,Nanjing 210029,China

    XU Xiangru,Department of Emergency,Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China

    XIAO Min,Department of Cardiology,Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine,Beijing 100700,China

    ZHAN Libin,School of Traditional Chinese Medicine &School of Integrated Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210023,China

    Abstract OBJECTIVE: To reach consensus on the diagnostic criteria for Yin deficiency syndrome in hypertension(YDSH) patients by a modified Delphi method.METHODS: Our study was consistent with T/CACM 1032-2017.The methodology of RAND/UCLA appropriateness was used to develop consensus guidance statements.A nationwide panel of experienced clinical experts from 19 provinces was constructed.These experts were all prominent in Traditional Chinese Medicine (TCM) of cardiovascular diseases.This consensus process consisted of two rounds of questionnaires and a final round of consultation to analyze the weight score of each item.Moreover,the data extraction process is carried out independently by third-party researchers (LIANG Junya,SUN Yang,and DU Xiaona).When there is disagreement in all three rounds,the expert panel group (odd number) are invited to vote,and the one with more votes wins.In the questionnaires,participants were asked to rate the appropriateness of each syndrome item using a nine-point Likert scale.The consensus was defined as a panel median rating 1-3 or 7-9 without disagreement.And then the diagnostic criteria of YDSH were formed according to the weight score in the final round.RESULTS: Twenty-eight experts (84.8%) participated in the first round,and thirty-one (93.9%) finished the second round.After two rounds,the consensus of YDSH was reached on 11 items (25.6%),including symptoms,signs,and pulse condition.Twenty-one experts (63.6%) completed the final round in which they used a grading system for each item.Red tongue with scanty fur had the highest weighting (22.8%),followed by heat in the palms and soles (20.1%).CONCLUSIONS: The consensus-based diagnostic criteria for YDSH,formed by a modified Delphi method,can be widely incorporated in TCM.A further clinical study will be conducted to analyze the diagnosis value and cut-off score of our YDSH criteria.We have registered this study at http://www.guidelinesregistry.org (No.IPGRP-2021CN350).

    Keywords: Yin deficiency syndrome;hypertension;consensus;Delphi technique;weight score

    1.INTRODUCTION

    Hypertension is a progressive cardiovascular syndrome according to literature and clinical research,which mostly belongs to "vertigo" and "headache" in Traditional Chinese Medicine (TCM).1Up to now,it has been agreed that liver-kidneyYindeficiency and ascendant hyperactivity of liverYangare essential of this disease in the field of TCM.Ascendant hyperactivity of liverYang,the pattern ofYindeficiency withYanghyperactivity,and dual deficiency ofYinandYangwere particular TCM syndromes in the early,middle,and late stage of hypertension,respectively.2,3

    A study of 7213 cases involving 11 syndrome elements concluded that the syndrome ofYanghyperactivity andYindeficiency were the major two syndromes in hypertension patients.4The current diagnosis of YDSH is usually based on the nature of the disease (Yindeficiency)and the location of the disease (liver and/ or kidney).Althoughtheguidelines for the diagnosis and treatment of hypertension in TCM 5were published by the Chinese Society of TCM in 2011,there was still lack of unified clinical diagnostic criteria for YDSH.As is known to all,the clinical diagnosis of YDSH was subjectively judged by dizziness,tinnitus,soreness and weakness of the lumbus and knees,etc.,according toGuiding Principles for Clinical Research of New Chinese Medicine,6Chinese Internal Medicine7orPractical Chinese Internal Medicine.8Many studies were based on the different diagnosis standards to explore YDSH patients.9-11Regrettably,there is not a unified clinical definition for YDSH.

    The diversity of YDSH definitions impeded further investigation and clinical studies.As the lack of diagnostic criteria of YDSH,it is difficult to compare clinical study outcomes and the quality of hospital care in YDSH patients.Consequently,it is an urgent need to identify a widely accepted diagnostic definition of YDSH,enhancing the understanding between clinicians and the comparability of different clinical trials.This study aims to minimize the variation in the diagnostic criteria of YDSH by reaching a consensus on the YDSH definition,with a sub aim to gain more insight into the weight value of syndrome items.The Delphi approach is a remarkably applied consensus method based on experts' views,and will allow us to formulate the diagnostic criteria of YDSH that is eventually supported by a panel of TCM experts.

    2.METHODS

    2.1.Consensus method

    This study used the RAND/UCLA appropriateness method (RAM).12Briefly,the process consisted of two rounds of questionnaires followed by a final round of consultation to analyze the weight score of each item.In the first and second rounds,the ratings are made individually by We-chat to select appropriate rating scores for each item,with no interaction among panelists.In the final round,top-ranking items were selected and performed a weight score evaluation by pairwise comparison among these items.This Delphi study occurred from November 20,2019 to July 27,2020.A summary of the consensus process is shown in Figure 1.

    Figure 1 Flow diagram of the consensus process

    2.2.Establish an item pool for YDSH

    The workflow of the screening in Figure 2 was operated by two independent personnel simultaneously,and a panel of experts agrees upon inconsistencies.Firstly,we conducted a literature search by keywords hypertension andYin-deficiency syndrome in China National Knowledge Infrastructure Database (CNKI),China Science and Technology Journal Database (VIP),Wanfang,and Pubmed.A total of 98 pieces of Chinese literature in the past ten years were found on CNKI by using the search expression "Chinese Library classification number=R2 plus subject=hypertension plus keywords=syndrome".A total of 856 Chinese articles in the past ten years were also detected by using the expression "Classification number=R2 and title or keywords=hypertension,and title or keywords=syndrome differentiation".A total of 133 pieces of Chinese literature were detected with the search expression "subject=hypertension with keywords=Yindeficiency syndrome" in Wanfang database.In PubMed,a total of 66 pieces of Chinese literature were detected with the search expression "subject=hypertension with keywords=Yindeficiency syndrome" finally,we screened a total of 1087 pieces of literature.After comparison and screening,74 papers meet the requirements of the study.Secondly,we reanalyzed these pieces of literature and divided YDSH into different subtypes,including liver-kidneyYindeficiency,kidneyYindeficiency,dual deficiency ofYinandYang,syndrome ofYindeficiency with effulgent fire,the pattern ofYindeficiency withYanghyperactivity,andYindeficiency with hysteria.A total of 1036 valid syndrome items were extracted from the pieces of literature as mentioned above,made into an Excel syndrome items pool and summarized statistically,which includes 51 items according to symptoms,signs,tongue fur,and pulse condition by removing duplicated items (For example,88 times of dizziness,76 times of soreness and weakness of lumbus and knee,72 times of tinnitus,53 times of insomnia,47 times of red tongue,scanty fur 36 times,and so on).Then,after the leader expert panel’s (Chinese Medicine master Zhou Zhongying and famous Chinese medicine professor Tang Shuhua) further revising according to TCM clinical experience,8 items were deleted (forgetfulness,dry mouth and throat,fear of cold and cold limbs,nocturia increased,white fur,chest tightness with chest pain,red tongue with less fluid and humor and Others (less than 2 occurrences)),Among them,red tongue with less fluid and humor was deleted for overlapping with red tongue,another 6 items (fear of cold and cold limbs,nocturia increased,white fur,chest tightness with chest pain,and Others (less than 2 occurrences))were deleted by expert panel discussion according to Internal Medicine of Chinese Medicine and Guidelines for Diagnosis and Treatment of Common Internal Diseases in Chinese Medicine Symptoms in Chinese Medicine(ZYYXH/T4-49.2008),and 1item (dry mouth and throat)was deleted,because which is overlapped with general scale ofYindeficiency syndrome of non-specific diseases in another research group.Finally,a total of 43 items was built as the pool of YDSH syndromes,including symptoms,signs,tongue manifestation,and pulse condition was formed.

    Figure 2 Workflow of Screening

    2.3.Expert panel

    A nationwide experienced clinical panel experts from 19 provinces was constructed.These experts were all prominent in TCM of cardiovascular diseases.All experts were selected from cardiovascular diseases of the Chinese Society of Integrated Traditional Chinese and Western Medicine and China Association of Traditional Chinese Medicine.The number of experts was determined according to the research theme and scale generally 30-50 persons were appropriate.13

    2.4.Round 1

    The questionnaires in all three rounds were completed by Fa MaiSheng Medical Technology Co.,Ltd.(Nanjing,China),through scan QR codes in We-chat applets.The first round was consisted of 43 items,including symptoms,signs,tongue manifestation,and pulse condition.Participants were asked to select an appropriate rating score for each item using a 9-point Likert scale (0 meant not needed,1 suggested the weakest need,and 9 indicated the strongest need).The end of questions was followed by a text field,where the participants could provide remarks and arguments.We also analyzed experts' self-evaluation of familiarity and basis.

    2.5.Round 2

    All participants completed the first round received the mean marks and their scores of each item by We-chat,while they did not receive any particular scores of other members.The message also contained the link (QR code)to the second round questionnaire,which consisted of 22 items after the first round screening.The second round's rating rule was identical to the first round.The highest score of tongue manifestation and pulse condition were directly selected for the following questionnaire.Similar symptoms or signs were evaluated by scores and experts’opinion or consensus.Familiarity and basis induced by self-evaluation were also analyzed.

    2.6.Round 3

    The top 11 ranking items were selected after two rounds of investigations.We performed a weight score evaluation by pairwise comparison among these 11 items in the final round.Therefore,a total of 55 questions,such as Do you prefer red tongue with scanty fur or soreness and weakness of lumbus and knees as items of YDSH,were evaluated by a 9-points scale,which-9 or 9,-7 or 7,-5 or 5,-3 or 3 mean absolute,apparent,slight preference,respectively,for the latter or former and 1 implies no preference.A legend description was built to help experts understand and rate scores accurately.

    2.7.Statistical analysis

    The consensus was reached if statements were rated appropriate (panel median 7-9 and mean ≥ 6.5) or inappropriate (panel median 0-3 and mean ≤ 2.5) without disagreement.Disagreement was measured by the interpercentile range adjusted for symmetry.This was according to the method used by Moossdorffet al.14MS Excel 2017 (Microsoft Corp,Redmond WA,United States) and SPSS 24.0 (IBM Corp.,Armonk,NY,USA)were applied to conduct the analyses.The final round questionnaire was analyzed by the analytic hierarchy process (AHP).The paired comparison matrix and the consistency check were conducted.If the consistency check is passed,this expertise will be included for TCM symptom weight analysis,and those who failed will not participate in the analysis.The statistical section for this study was completed by the Institute of Hypertension Research,Jiangsu Provincial Hospital of Chinese Medicine.

    3.RESULTS

    3.1.Expert panel

    According to relevant pieces of literature,academic achievement,visibility,and other factors,50 experienced experts were invited to this study.They came from 19 provinces and engaged in the cardiovascular major of TCM for more than 30 years.Twelve experts (24%) did not respond,and five (10%) could not participate due to lack of time.Then a total of the 33-expert panel was built.Twenty-eight (84.8%),thirty-one (93.9%),and twentyone (63.6%) experts completed the first,second,and final round,respectively.The list of panel members,including thirty-two clinicians and one researcher were shown in Table S1.

    3.2.Questionnaire round one

    As shown in Table 1,the first questionnaire consisted of 43 items.Ten items (23.3%) were rated appropriately without disagreement.Two items (4.7%) were rated inappropriate without dispute.Thirty-one items (72.1%)were voted uncertain in which 12 items were evaluated for the following questionnaire by our leader expert panel (Chinese Medicine master Zhou Zhongying and famous Chinese medicine professor Tang Shuhua).Then,22 out of 43 items (51.2%) were selected for the next round.The mean coefficient of expert authority and item score were 0.88 and 0.36,respectively.Kendall's coefficient of concordance was 0.363 (χ2=426.711,P<0.001).

    3.3.Questionnaire round two

    As shown in Table 2,the second questionnaire was an adjusted version of the first round survey.The newly formulated questions contained 22 ranking items.Twelve items (54.5%) were rated appropriate,and ten items (45.5%) were uncertain.Based on expert opinions and voting scores,we selected the item of heat in the palms and soles rather than the item of vexing heat in the chest,palms,and soles.Red tongue and scanty fur and string-like and fine pulse were chosen as the tongue manifestation and pulse condition for consensus,respectively.In conclusion,after two rounds of consensus,it was reached on 12 out of 43 items (27.9%)without disagreement.Then red tongue and scanty fur were merged into one item.Finally,we got 11 items.The mean coefficient of expert authority and item score were 0.89 and 0.25,respectively.Kendall's coefficient of concordance was 0.225 (χ2=97.753,P< 0.001).

    3.4.Final round

    In the final round,we performed a weight score evaluation by pairwise comparison among these 11 items.First,we test the consistency value of 21 expert's questionnaires.The results indicated that eight questionnaires (consistency ratio ranged from 0.101 to 0.481) were eliminated,and 13 consultation forms remained with further weight score analysis.The resultsof the weight score of each item are shown in Table 2.Red tongue with scanty fur had the highest weighting(22.8%),followed by heat in the palms and soles (20.1%).The final diagnostic criteria of YDSH are presented in Table 3.

    Table 1 Items in questionnaire round one

    Table 2 Items in questionnaire round two

    Table 3 Weight score of each item (%)

    4.DISCUSSION

    The past few years,thanks to a spurt of progress in technology,have seen the standardization and normalization in TCM studies.4,9,15,16YDSH is a kind of pervasive syndrome in hypertension patients.4,9,17,18YDSH patients are major presented withYindeficiency syndrome,such as dry eye,tinnitus,soreness and weakness of the lumbus and knees,etc.11,19,20However,it is still ambiguous about the definition of YDSH and diagnosis weight ofYindeficiency syndrome in YDSH.Consequently,it is a conspicuous work to formulate and revise the standards of YDSH,establishing a standardized theoretical support system for YDSH related scientific research services.In this study,we performed a modified Delphi analysis and reached a consensus on the diagnostic criteria of YDSH after three questionnaire rounds from 33 TCM experts.

    The evaluation objects were based on the comprehensive opinions of experts by a quantitative and qualitative prediction-evaluation method,in which expert factors were mainly technical points of application.21In this study,we built an expert panel of 33 domestic cardiovascular TCM experts.The regional and hierarchical differences were calculated and fitted the requirements in Delphi method.The inclusive criteria of experts was based on scholastic achievement and clinical experience,and thus ensured the reliability and authority of this consulting content.The response rates of the first two round questionnaires were 84.8% and 93.9%,respectively,indicated their enthusiasm about this research.We first formed a draft of 43 items after a review of the pieces of literature.Then we performed two rounds of questionnaires using a nine-point Likert scale.The average coefficients of the expert authority were 0.88 and 0.89 in these two rounds,respectively.Meanwhile,Kendall's coefficients of concordance were 0.363 and 0.225 in these two rounds,respectively,indicated a high degree of expert authority,and the follow-up modification plan could be established for the highly coordinated group.After two rounds of results,it reached a more unified recognition,and 11 of 43 items were determined as criteria of YDSH.

    In the Guidelines for Clinical Research of New Chinese Medicines (2002 version),6the definition of the pattern ofYindeficiency withYanghyperactivity included five main symptoms and six secondary symptoms.These symptoms were classified into mild,moderate,or severe levels.Unfortunately,these symptoms did not have scoring standards and could not identify the weight value of each item.It is convinced that the grading system promotes the comparing values of hospital care and clinical studies.22Evidence-based practice principles and specific quantitative methods are two main approaches to evaluate and grade TCM syndrome.In this study,we performed a weight score evaluation by pairwise comparison.Red tongue with scanty fur,heat in the palms and soles,and dry eyes had top 3 weight scores with 22.8%,20.1%,and 10.6%,respectively.One study included a total of 104 standard literature that analyzed 104 symptoms characteristics of liver-kidneyYindeficiency syndrome in hypertension.23After screening and comparison,18 symptoms were included in the regression model,among which red tongue with scanty fur (87.5%),heat sensation (59.6%),and dry eyes (25%)are three of the key symptoms of liver-kidneyYindeficiency syndrome in hypertension.There is still lack of reports regarding the value of our top 3 syndromes in YDSH patients.Therefore,we believe that YDSH criteria with weight score would be a better application for clinical and scientific research.

    There are some limitations in this study.First,the number of panel members is an inherent limitation of any consensus method.According to the RAM,the panel should consist of a minimum of seven members.13Our panel of 33 experts met the advised panel size.Secondly,due to COVID-19 pandemic,our three-round consultations were performedviathe mobile applet rather than the paper letter that was the initially designed approach.Considering the age of our participants (some experts over 65),they might not be familiar with the process of answering questions on smartphones,especially a large number of questions in the third round.Therefore,11 experts failed to pass the consistency test due to the longer answer time.

    Furthermore,the heterogeneous clinical presentation of YDSH remained a challenge for clinical diagnosis.There was not a uniform standard for identifiedYinpulse condition in TCM.Clinicians often recognize each pulse condition by their own experience and comprehension,which would bring reporting bias.The last limitation was that our panel consisted mainly of Chinese medicine clinicians (96.8%),so the homogeneity of our group might cause information bias.Given the clinician as a primary user,we held the idea that our panel composition was appropriate.The diagnostic value of the final 11 items will be evaluated in our further clinical study.

    In conclusion,after three rounds of Delphi consultation,we reached the consensus regarding 11 items and their weight scores of YDSH.Moreover,a further clinical study will be conducted to analyze the diagnosis value and cut-off score of our YDSH criteria.

    5.ACKNOWLEDGMENTS

    We thank Mr.Tao Liyuan,Mr.Yin Qingfeng and Sun Yang,Ms.Du Xiaona for the study assistance.The authors gratefully acknowledge our panel members for their active participation and valuable contribution to this study.

    黑人猛操日本美女一级片| 国产又爽黄色视频| 亚洲国产精品国产精品| 久久亚洲国产成人精品v| 黑人巨大精品欧美一区二区蜜桃 | 狠狠精品人妻久久久久久综合| 黄色毛片三级朝国网站| 成人18禁高潮啪啪吃奶动态图| av免费在线看不卡| 搡女人真爽免费视频火全软件| 一级,二级,三级黄色视频| 亚洲激情五月婷婷啪啪| 母亲3免费完整高清在线观看 | 久久久久久久久久成人| 亚洲人成77777在线视频| 免费人妻精品一区二区三区视频| 亚洲国产欧美在线一区| 国产精品熟女久久久久浪| 亚洲美女搞黄在线观看| 国产av精品麻豆| 免费播放大片免费观看视频在线观看| 亚洲欧美日韩卡通动漫| 内地一区二区视频在线| 精品酒店卫生间| 观看av在线不卡| 黄色怎么调成土黄色| 久久人人爽人人片av| tube8黄色片| 全区人妻精品视频| 久久这里只有精品19| 一二三四中文在线观看免费高清| 99热这里只有是精品在线观看| 久久狼人影院| 亚洲精品乱码久久久久久按摩| av又黄又爽大尺度在线免费看| 日日摸夜夜添夜夜爱| 最近手机中文字幕大全| 中文字幕亚洲精品专区| 五月开心婷婷网| 欧美日韩精品成人综合77777| 精品午夜福利在线看| 国产精品久久久久久av不卡| 在线免费观看不下载黄p国产| 欧美成人午夜免费资源| 精品国产露脸久久av麻豆| 国产极品粉嫩免费观看在线| 精品第一国产精品| 少妇人妻精品综合一区二区| 久热这里只有精品99| 满18在线观看网站| 国国产精品蜜臀av免费| 美女国产高潮福利片在线看| 男女无遮挡免费网站观看| 亚洲国产精品一区二区三区在线| 色吧在线观看| 美女国产高潮福利片在线看| 国产淫语在线视频| 成人毛片60女人毛片免费| 各种免费的搞黄视频| 又黄又粗又硬又大视频| 日本欧美视频一区| 国产福利在线免费观看视频| 一级片'在线观看视频| 国产精品嫩草影院av在线观看| 欧美成人午夜精品| 欧美日本中文国产一区发布| 久久精品国产自在天天线| 9色porny在线观看| 亚洲国产精品成人久久小说| 99热这里只有是精品在线观看| 麻豆精品久久久久久蜜桃| 丝袜脚勾引网站| 人妻少妇偷人精品九色| 我要看黄色一级片免费的| 国产精品久久久久久精品电影小说| 成年人午夜在线观看视频| 99热6这里只有精品| 中文字幕亚洲精品专区| 精品亚洲乱码少妇综合久久| 免费人成在线观看视频色| 精品亚洲成国产av| 午夜免费观看性视频| 国产精品.久久久| 只有这里有精品99| 婷婷色综合大香蕉| 99热国产这里只有精品6| 久久久久久久精品精品| 涩涩av久久男人的天堂| 日本免费在线观看一区| 国产精品欧美亚洲77777| 狂野欧美激情性bbbbbb| 91精品三级在线观看| 一区在线观看完整版| 高清不卡的av网站| 日本欧美视频一区| 久久99蜜桃精品久久| 最近中文字幕高清免费大全6| 建设人人有责人人尽责人人享有的| 18+在线观看网站| 91午夜精品亚洲一区二区三区| 亚洲av.av天堂| 美女福利国产在线| 免费少妇av软件| av网站免费在线观看视频| 欧美另类一区| 亚洲国产欧美日韩在线播放| 久久精品人人爽人人爽视色| 色吧在线观看| 亚洲精品成人av观看孕妇| 国产成人一区二区在线| 欧美日韩精品成人综合77777| 一区二区三区四区激情视频| 亚洲少妇的诱惑av| 久久久亚洲精品成人影院| 久久久久人妻精品一区果冻| 如何舔出高潮| 亚洲成人av在线免费| 搡女人真爽免费视频火全软件| 99久久综合免费| 一个人免费看片子| 汤姆久久久久久久影院中文字幕| 制服人妻中文乱码| 亚洲伊人色综图| 天堂中文最新版在线下载| 少妇的逼好多水| 肉色欧美久久久久久久蜜桃| 精品午夜福利在线看| 大香蕉97超碰在线| 尾随美女入室| 又大又黄又爽视频免费| 精品国产国语对白av| 国产乱人偷精品视频| 99精国产麻豆久久婷婷| 国产国拍精品亚洲av在线观看| 2021少妇久久久久久久久久久| 久久久a久久爽久久v久久| 熟女av电影| 99热国产这里只有精品6| 午夜福利影视在线免费观看| 一区二区日韩欧美中文字幕 | 少妇猛男粗大的猛烈进出视频| 天天躁夜夜躁狠狠躁躁| 成人毛片a级毛片在线播放| 伦理电影免费视频| 久久久久久久大尺度免费视频| 欧美激情国产日韩精品一区| 91aial.com中文字幕在线观看| 日本猛色少妇xxxxx猛交久久| 黄色视频在线播放观看不卡| 国产成人一区二区在线| 亚洲熟女精品中文字幕| 中文乱码字字幕精品一区二区三区| 久久精品aⅴ一区二区三区四区 | 欧美日韩精品成人综合77777| 国产成人av激情在线播放| a级毛色黄片| 亚洲丝袜综合中文字幕| 亚洲精品自拍成人| 国产av国产精品国产| 91成人精品电影| av网站免费在线观看视频| 人人妻人人添人人爽欧美一区卜| 女的被弄到高潮叫床怎么办| 久久精品人人爽人人爽视色| 欧美精品国产亚洲| 国产乱来视频区| 国产精品.久久久| 啦啦啦在线观看免费高清www| 最近的中文字幕免费完整| 欧美老熟妇乱子伦牲交| 人人妻人人澡人人看| 亚洲av免费高清在线观看| 国产精品久久久av美女十八| 国产精品成人在线| 夜夜骑夜夜射夜夜干| 欧美变态另类bdsm刘玥| 草草在线视频免费看| 亚洲精品日本国产第一区| 亚洲性久久影院| 男人操女人黄网站| 精品一区二区三区视频在线| 久热这里只有精品99| 久久精品国产自在天天线| 午夜免费鲁丝| 国产亚洲av片在线观看秒播厂| 狠狠婷婷综合久久久久久88av| www.色视频.com| 亚洲综合精品二区| 国产欧美亚洲国产| 多毛熟女@视频| 性色av一级| 欧美日韩综合久久久久久| 午夜日本视频在线| 久久国产亚洲av麻豆专区| 亚洲精品一区蜜桃| 1024视频免费在线观看| 高清不卡的av网站| tube8黄色片| 男女边摸边吃奶| 亚洲av电影在线观看一区二区三区| 久久精品夜色国产| 久久久精品免费免费高清| 欧美日韩成人在线一区二区| 一二三四中文在线观看免费高清| 久久久精品区二区三区| videosex国产| av天堂久久9| 在线亚洲精品国产二区图片欧美| 国产精品一区二区在线观看99| 亚洲国产欧美在线一区| 久久精品国产鲁丝片午夜精品| 成人毛片60女人毛片免费| 9色porny在线观看| 丝袜喷水一区| 成人毛片60女人毛片免费| 啦啦啦中文免费视频观看日本| 亚洲图色成人| 寂寞人妻少妇视频99o| 欧美性感艳星| 免费黄网站久久成人精品| 亚洲av日韩在线播放| 校园人妻丝袜中文字幕| 激情五月婷婷亚洲| 久久久久久久国产电影| 成人毛片60女人毛片免费| 午夜免费鲁丝| 国产精品麻豆人妻色哟哟久久| 久久久欧美国产精品| 欧美日韩一区二区视频在线观看视频在线| 亚洲精品,欧美精品| 亚洲伊人久久精品综合| 欧美 亚洲 国产 日韩一| 纯流量卡能插随身wifi吗| 久热这里只有精品99| 亚洲av欧美aⅴ国产| 日本猛色少妇xxxxx猛交久久| av卡一久久| 国产一级毛片在线| 考比视频在线观看| 国产极品天堂在线| 丰满迷人的少妇在线观看| 超碰97精品在线观看| 尾随美女入室| av在线观看视频网站免费| 精品久久蜜臀av无| 欧美国产精品va在线观看不卡| 免费少妇av软件| 久久免费观看电影| 嫩草影院入口| 欧美老熟妇乱子伦牲交| 黑人高潮一二区| 国产无遮挡羞羞视频在线观看| 国产精品久久久久久久电影| 制服人妻中文乱码| 久久久久久久亚洲中文字幕| 黄片无遮挡物在线观看| 亚洲精品日本国产第一区| 久久女婷五月综合色啪小说| 在线观看国产h片| 少妇精品久久久久久久| av福利片在线| 亚洲五月色婷婷综合| 免费女性裸体啪啪无遮挡网站| 青青草视频在线视频观看| 国产免费又黄又爽又色| 日本wwww免费看| 另类精品久久| 黄色毛片三级朝国网站| 少妇的逼水好多| 十分钟在线观看高清视频www| 啦啦啦啦在线视频资源| 久久人妻熟女aⅴ| 国产免费视频播放在线视频| 久久亚洲国产成人精品v| 一本色道久久久久久精品综合| 亚洲欧美日韩另类电影网站| 国产av码专区亚洲av| 色视频在线一区二区三区| 久热这里只有精品99| 最近最新中文字幕免费大全7| 另类精品久久| 日韩人妻精品一区2区三区| 最近手机中文字幕大全| 精品人妻熟女毛片av久久网站| 国产国拍精品亚洲av在线观看| 狠狠精品人妻久久久久久综合| 男女啪啪激烈高潮av片| 亚洲色图综合在线观看| 欧美老熟妇乱子伦牲交| 九色成人免费人妻av| av在线app专区| 男人操女人黄网站| 亚洲欧美日韩另类电影网站| 亚洲欧美一区二区三区黑人 | 国产精品一二三区在线看| 亚洲第一区二区三区不卡| 久久青草综合色| 日韩在线高清观看一区二区三区| 少妇的丰满在线观看| 免费黄网站久久成人精品| 国产极品天堂在线| 丝袜脚勾引网站| 成年美女黄网站色视频大全免费| av国产精品久久久久影院| 18禁国产床啪视频网站| 午夜激情久久久久久久| 久久久国产欧美日韩av| 日韩不卡一区二区三区视频在线| 人妻系列 视频| 国产女主播在线喷水免费视频网站| 美女内射精品一级片tv| 尾随美女入室| 国产国拍精品亚洲av在线观看| 久热久热在线精品观看| freevideosex欧美| 亚洲欧美中文字幕日韩二区| 老司机影院毛片| 免费观看性生交大片5| 亚洲精华国产精华液的使用体验| 国产男人的电影天堂91| 欧美成人午夜免费资源| 免费观看a级毛片全部| 建设人人有责人人尽责人人享有的| 男女免费视频国产| 国产免费一区二区三区四区乱码| 欧美+日韩+精品| 亚洲内射少妇av| 精品亚洲成a人片在线观看| 久久精品国产自在天天线| 麻豆乱淫一区二区| 亚洲精品aⅴ在线观看| 欧美日韩国产mv在线观看视频| 久久久精品免费免费高清| 国产麻豆69| 黄网站色视频无遮挡免费观看| videosex国产| 午夜激情久久久久久久| 丝袜在线中文字幕| 国产精品成人在线| 三级国产精品片| 这个男人来自地球电影免费观看 | 热re99久久国产66热| 免费看光身美女| 丰满迷人的少妇在线观看| 国产成人午夜福利电影在线观看| 亚洲国产欧美在线一区| tube8黄色片| 18禁裸乳无遮挡动漫免费视频| 免费黄网站久久成人精品| 中文欧美无线码| 国产精品一二三区在线看| 22中文网久久字幕| 又黄又粗又硬又大视频| 在线天堂最新版资源| 国产精品久久久久久av不卡| 免费看光身美女| 色视频在线一区二区三区| 久久久久久久久久成人| 久久午夜综合久久蜜桃| 国产不卡av网站在线观看| 一级毛片电影观看| 久热这里只有精品99| 大码成人一级视频| 纯流量卡能插随身wifi吗| 一级片免费观看大全| 99九九在线精品视频| 少妇的逼水好多| 精品久久久久久电影网| 国产 精品1| 国产成人精品福利久久| 国产成人精品婷婷| 亚洲国产欧美日韩在线播放| 永久网站在线| 狂野欧美激情性xxxx在线观看| 国产爽快片一区二区三区| 美女大奶头黄色视频| 日日摸夜夜添夜夜爱| 天天影视国产精品| 69精品国产乱码久久久| 男人爽女人下面视频在线观看| 深夜精品福利| 亚洲国产欧美在线一区| 亚洲国产成人一精品久久久| 亚洲精品视频女| 国产黄色视频一区二区在线观看| 在线看a的网站| 曰老女人黄片| 国产免费福利视频在线观看| 精品一区二区三区视频在线| 男女免费视频国产| 亚洲欧美中文字幕日韩二区| 国产免费一级a男人的天堂| 美国免费a级毛片| 欧美激情极品国产一区二区三区 | 精品国产露脸久久av麻豆| 婷婷色综合www| 人体艺术视频欧美日本| 最近中文字幕高清免费大全6| 亚洲国产看品久久| 欧美日韩视频精品一区| av女优亚洲男人天堂| 亚洲精品美女久久久久99蜜臀 | 国国产精品蜜臀av免费| 97精品久久久久久久久久精品| 国产免费现黄频在线看| 在线观看国产h片| 少妇精品久久久久久久| 蜜臀久久99精品久久宅男| 国产成人a∨麻豆精品| 久久婷婷青草| 桃花免费在线播放| 亚洲国产欧美日韩在线播放| a级毛片在线看网站| av电影中文网址| 捣出白浆h1v1| 亚洲欧洲日产国产| 精品亚洲成国产av| 99热国产这里只有精品6| 麻豆精品久久久久久蜜桃| 香蕉丝袜av| 亚洲色图综合在线观看| 久久久欧美国产精品| 桃花免费在线播放| 欧美 日韩 精品 国产| 这个男人来自地球电影免费观看 | 一二三四中文在线观看免费高清| 亚洲性久久影院| 免费久久久久久久精品成人欧美视频 | 日韩成人伦理影院| 欧美人与性动交α欧美精品济南到 | 国产精品成人在线| 美女国产高潮福利片在线看| 免费高清在线观看日韩| 免费观看性生交大片5| 国产伦理片在线播放av一区| 亚洲欧洲日产国产| 夜夜爽夜夜爽视频| 国产成人91sexporn| 狠狠精品人妻久久久久久综合| 亚洲美女黄色视频免费看| 丰满饥渴人妻一区二区三| 亚洲精品,欧美精品| 麻豆精品久久久久久蜜桃| 最近最新中文字幕大全免费视频 | 国产片内射在线| 丝袜喷水一区| 国产欧美日韩综合在线一区二区| 国产免费视频播放在线视频| 久久精品aⅴ一区二区三区四区 | 国产一区二区在线观看av| 欧美3d第一页| 一区在线观看完整版| 韩国高清视频一区二区三区| 99视频精品全部免费 在线| 午夜福利视频精品| 久久久久久久久久久免费av| 日本av手机在线免费观看| 亚洲久久久国产精品| 日本爱情动作片www.在线观看| 人妻一区二区av| 男女高潮啪啪啪动态图| 午夜福利乱码中文字幕| 国产精品人妻久久久影院| tube8黄色片| 亚洲精品色激情综合| 国产xxxxx性猛交| 自拍欧美九色日韩亚洲蝌蚪91| 极品少妇高潮喷水抽搐| 日产精品乱码卡一卡2卡三| 欧美xxxx性猛交bbbb| 日本免费在线观看一区| 色视频在线一区二区三区| 岛国毛片在线播放| 国产亚洲最大av| 18禁国产床啪视频网站| 在线观看美女被高潮喷水网站| 免费看不卡的av| 黑人猛操日本美女一级片| 成年女人在线观看亚洲视频| 国产一区亚洲一区在线观看| videos熟女内射| 自拍欧美九色日韩亚洲蝌蚪91| 丝袜喷水一区| 亚洲av成人精品一二三区| 成年av动漫网址| 视频区图区小说| 精品亚洲成a人片在线观看| 各种免费的搞黄视频| 日韩电影二区| 国产高清国产精品国产三级| 亚洲在久久综合| 毛片一级片免费看久久久久| 亚洲成色77777| 高清欧美精品videossex| 人成视频在线观看免费观看| 亚洲欧美日韩另类电影网站| 91午夜精品亚洲一区二区三区| 精品一区在线观看国产| 午夜免费观看性视频| 成人18禁高潮啪啪吃奶动态图| 国产精品人妻久久久久久| 欧美另类一区| 午夜免费男女啪啪视频观看| 伦理电影免费视频| 欧美激情 高清一区二区三区| 黄片播放在线免费| 伦理电影大哥的女人| av卡一久久| 国产精品一区二区在线观看99| videossex国产| 久久久国产精品麻豆| 国精品久久久久久国模美| 久久鲁丝午夜福利片| 中国国产av一级| 考比视频在线观看| www.熟女人妻精品国产 | 99久久中文字幕三级久久日本| 狠狠精品人妻久久久久久综合| 日本色播在线视频| 超碰97精品在线观看| 哪个播放器可以免费观看大片| 99热这里只有是精品在线观看| 亚洲精品自拍成人| 国产精品国产三级国产专区5o| 亚洲精品自拍成人| 麻豆精品久久久久久蜜桃| 亚洲精品日韩在线中文字幕| 少妇熟女欧美另类| 视频在线观看一区二区三区| 国产精品国产三级国产专区5o| 日韩av不卡免费在线播放| 夜夜骑夜夜射夜夜干| 寂寞人妻少妇视频99o| 在现免费观看毛片| 午夜福利网站1000一区二区三区| 建设人人有责人人尽责人人享有的| 人人妻人人澡人人看| 两个人免费观看高清视频| 国产精品久久久久久av不卡| 成人毛片a级毛片在线播放| 999精品在线视频| 精品午夜福利在线看| 尾随美女入室| 欧美日韩国产mv在线观看视频| 国产精品 国内视频| 天天躁夜夜躁狠狠躁躁| 激情五月婷婷亚洲| 99精国产麻豆久久婷婷| 久久精品久久久久久久性| 各种免费的搞黄视频| 国产探花极品一区二区| 2021少妇久久久久久久久久久| 大香蕉久久成人网| 免费黄频网站在线观看国产| 日韩成人av中文字幕在线观看| 全区人妻精品视频| 国产成人欧美| 日韩av免费高清视频| 岛国毛片在线播放| 久久精品夜色国产| 一区二区av电影网| 久久亚洲国产成人精品v| 久久精品国产综合久久久 | 欧美成人精品欧美一级黄| 国产一区亚洲一区在线观看| 欧美激情国产日韩精品一区| 国产精品久久久久成人av| 黄片无遮挡物在线观看| 青春草视频在线免费观看| av在线播放精品| 亚洲一码二码三码区别大吗| 内地一区二区视频在线| 欧美国产精品一级二级三级| 欧美日韩综合久久久久久| 99热全是精品| 桃花免费在线播放| 99国产精品免费福利视频| 免费日韩欧美在线观看| 成人国产麻豆网| 精品人妻在线不人妻| 咕卡用的链子| 成人毛片a级毛片在线播放| 免费黄色在线免费观看| 成人免费观看视频高清| 如日韩欧美国产精品一区二区三区| 建设人人有责人人尽责人人享有的| 国产精品偷伦视频观看了| 成人二区视频| 婷婷色综合大香蕉| 高清毛片免费看| 免费播放大片免费观看视频在线观看| 蜜桃国产av成人99| 日本av免费视频播放| 欧美日韩亚洲高清精品| 日本wwww免费看| 免费少妇av软件| 中文字幕最新亚洲高清| 国产一区二区激情短视频 | 久久99精品国语久久久| 国产精品久久久久久久久免| 久久这里只有精品19| 成人综合一区亚洲| 男女高潮啪啪啪动态图| 亚洲国产日韩一区二区| 我要看黄色一级片免费的| 亚洲精品视频女| 国产欧美日韩一区二区三区在线| 又大又黄又爽视频免费| 亚洲三级黄色毛片| 91久久精品国产一区二区三区| 国产精品不卡视频一区二区| xxxhd国产人妻xxx| 99视频精品全部免费 在线| www日本在线高清视频| 2022亚洲国产成人精品|