摘要
目的建立膝关节骨关节炎辨证要素积分表并评价其信度和效度。方法依据《中医临床路径实用指南》、《中医诊断学》和《中药新药临床研究指导原则》,结合膝关节骨关节炎的特点制定KOA中医辨证要素诊断标准和辨证要素积分表。符合标准的患者按辨证结果分配到风寒湿痹组、风湿热痹组、瘀血闭阻组、肝肾亏虚组,分别于治疗前后以JOA膝关节骨性关节炎治疗效果判定标准、WOMAC指数、中医辨证总分评定。结果86例患者完成试验。各因子克朗巴赫α系数在0.531~0.846之间,但因子苔白而干涩所得总分为0分;4个维度的克朗巴赫α系数均大于0.7。中医辨证总分与JOA得分各组的相关系数在-0.544^-0.877之间,总相关系数为-0.650(P<0.01)。中医辨证总分与WOMAC指数得分各组的相关系数分别在0.529~0.903之间,总相关系数为0.656(P<0.01)。各组积分表的效应尺度均大于-0.489(P<0.05);积分表的总效应尺度为-0.782(P<0.01)。结论 KOA辨证要素积分表的信度和效度较高,部分条目需要进一步的修正和调试。
Objective：To preliminarily establish KOA differentiation factors integral table and to assess its reliability and validity.Methods：Referring to A Practical Guide to The Clinical Pathway of Chinese Medicine,Diagnostics of Chinese Medicine,and Clinical Research Guiding Principle of TCM New Drug and the characteristics of KOA,the TCM diagnostic criteria and KOA differentiation factors integral table were formulated.The patients who met the criteria were arranged to wind-cold-dampness arthralgia group,wind-fever-dampness arthralgia group,syndrome of blood stasis group,and deficiency of liver and kidney group.Total score of JOA knee osteoarthritis curative effect criteria,WOMAC index and TCM were observed before and after treatment.Results：86 patients completed the trial.Cronbach＇s alpha coefficients were between 0.531 to 0.846.The score of ＂white and dry fur＂ was 0.Cronbach＇s alpha coefficients of 4 syndrome dimensions were greater than 0.700.The correlation coefficient of TCM total score and JOA score in each group were between-0.544 to-0.877 with total correlation score -0.650（P＜0.01）.The correlation coefficient of TCM total score and WOMAC index score in each group were between 0.529 to 0.903 with total correlation score 0.656 （P＜0.01）.The effect sizes of TCM total score in 4 groups were smaller than-0.489（P＜ 0.05） with total effect size-0.782（P＜ 0.01）.Conclusion：KOA differentiation factors integral table has good reliability and validity.Some items need to be further modified and debugged.
出处
《中国中医急症》
2014年第3期447-450,共4页
Journal of Emergency in Traditional Chinese Medicine
基金
湖北医药学院优秀中青年科技创新团队资助计划项目(2011CXZ03)
关键词
膝关节骨性关节炎
量表
中医药
Knee osteoarthritis
Scale
Traditional Chinese medicine
