摘要
目的 初步研制慢性阻塞性肺疾病急性加重期证候疗效评价量表。方法 基于前期已构建的理论框架及条目池,于全国13家中医院展开临床调查;采用SPSS 20.0软件,根据经典测量理论的重复测量法、离散趋势法、Cronbach’s α系数法及相关系数法分析并筛选条目;采用MULTILOG 7.03软件,选用Samejima等级反应模型,参数估计方法选用边际极大似然估计法,分析条目的区分度参数(a)、难度参数(b)、项目特征曲线、项目信息曲线分析并筛选条目;综合以上两种方法,同时优化条目表达形式,将中医症状术语转化为通俗易懂的问题形式,初步形成慢性阻塞性肺疾病急性加重期证候疗效评价量表。结果 发放调查表400份,收回390份,有效387份。根据经典测量理论,风寒证、寒饮证、痰热证、痰湿证、血瘀证分别建议删除4、5、4、3、3个条目;根据项目反应理论,风寒证、寒饮证、痰热证、痰湿证、血瘀证分别建议删除3、4、1、10、4个条目。上述方法结合小组讨论,初步建立包含5个基础证候、41个条目的慢性阻塞性肺疾病急性加重期证候疗效评价量表:风寒证包含咳嗽、痰色白、痰清稀等13个条目,寒饮证包含喘息、痰色白、痰清稀等7个条目,痰热证包含咳嗽、咳痰、痰色黄等15个条目,痰湿证包含咳痰、胸闷、喘息等12个条目,血瘀证包含咳嗽、喘息、胸闷等8个条目。结论 本研究初步研制出慢性阻塞性肺疾病急性加重期证候疗效评价量表,可为下一步条目权重的确定提供依据。
Objective To preliminarily develop syndrome therapeutic evaluation scale of acute exacerbation of chronic obstructive pulmonary disease.Methods Based on the constructed theoretical framework and item pool,clinical investigations were conducted in 13 Chinese medicine(CM)hospitals.The SPSS 20.0 software was applied to analysis and screen items by repeated measurement method,discrete trend method,Cronbach'sαcoefficient method,and correlation coefficient method of classical test theory.The discrimination parameter(a),difficulty parameter(b),item characteristic curve,and item information curve were used to analysis and screen items with Samejima graded response model(GRM)and marginal maximum likelihood estimation of item response theory based on MULTILOG 7.03 software.The expression forms of items were optimized by transforming CM symptom terms into common questions.Thus,syndrome therapeutic evaluation scale of acute exacerbation of chronic obstructive pulmonary disease was initially established.Results Totally 400 questionnaires were distributed,390 were recovered and 387 were valid.According to the classical test theory,4,5,4,3 and 3 items of wind-cold syndrome,cold fluid retention syndrome,phlegm-heat syndrome,phlegm dampness syndrome and blood stasis syndrome were deleted respectively;according to the item response theory,3,4,1,10 and 4 items of wind-cold syndrome,cold fluid retention syndrome,phlegmheat syndrome,phlegm dampness syndrome and blood stasis syndrome were deleted respectively.The above methods combined with group discussion initially established syndrome therapeutic evaluation scale of acute exacerbation of chronic obstructive pulmonary disease,which including 5 basic syndromes and 41 items.Among them,wind cold syndrome included 13 items such as cough,white phlegm and thin phlegm,cold fluid retention syndrome included 7 items such as wheezing,white phlegm and thin phlegm,phlegm-heat syndrome included 15 items such as cough,expectoration and yellow phlegm,phlegm dampness syndrome included 12 items such as expectoration,chest tightness and wheezing,and blood stasis syndrome included 8 items such as cough,wheezing and chest tightness.Conclusion This study initially established syndrome therapeutic evaluation scale of acute exacerbation of chronic obstructive pulmonary disease,and could provide basis for determination of item weight.
作者
冯贞贞
何雯青
谢洋
王佳佳
李建生
FENG Zhen-zhen;HE Wen-qing;XIE Yang;WANG Jia-jia;LI Jian-sheng(Respiratory Department,First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,450000;Henan University of Chinese Medicine,Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan&Education Ministry of P.R.,Zhengzhou,450046)
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2023年第5期564-571,共8页
Chinese Journal of Integrated Traditional and Western Medicine
基金
国家自然科学基金资助项目(No.81830116,No.82004500)
中医药传承与创新“百千万”人才工程—岐黄工程首席科学家项目(No.国中医药人教函[2020]219号)。
关键词
中医
证候
疗效评价
慢性阻塞性肺疾病
量表
条目
Chinese medicine
syndrome
therapeutic evaluation
chronic obstructive pulmonary disease
scale
item
