《7-14岁儿童中医体质量表》的编制研究

发布时间：2018-05-29 04:06

本文选题：中医体质 + 量表　；参考：《北京中医药大学》2015年博士论文

【摘要】：理论研究笔者基于小儿“纯阳之体”、“稚阴稚阳之体”、“少阳之体”、“五脏有余不足”等古代小儿体质学说,试从以阳为用、稚弱之体、动态变化三个角度阐述小儿体质特点,希望能对小儿体质研究提供理论参考。笔者根据从中国知网收集到的体质分类文献、临床流行病学文献证明了9种体质在儿童中确实存在。而后以“小儿”“中医”“体质”为主题词、通过CNKI数据平台共检索现代文献423篇,并从中筛选出21篇可用文献、通过词频整理初步完成儿童九种体质体质特征的表述。量表编制目的：自《中医体质分类与判定》标准于2009年4月9日正式由中华中医药学会发布起,现已被全国30个省、市(自治区)共有103家“治未病”中心应用。然而,该标准中的《中医体质量表》针对的是15-60岁人群,儿童体质与成人体质存在一定的差异,加之儿童语言理解能力的限制,故现有的《中医体质量表》并不适合广大儿童使用。为了对《中医体质分类与判定》标准进一步完善,我们需要修订儿童版《中医体质量表》。鉴于不同年龄段儿童的体质特点和理解能力不同,导师王琦教授将0-14岁儿童分为0-1岁、1-6岁、7-14岁三部分分别编制儿童版中医体质量表。本课题拟针对7-14岁儿童编制中医体质量表。加入7-14岁儿童版量表的《中医体质分类与判定标准》将更好地应用于儿科医生、科研人员及相关管理人员所开展的与中医体质相关的临床实践及科研工作,为儿童的中医体质辨识提供辨识标准,为评估我国儿童的健康状态提供服务。方法：1在充分考虑我国7-14岁儿童体质特点及学习生活特点后,以2009版《中医体质分类与判定》标准为基本框架,借鉴古籍中关于儿童体质的文献资料,参考前期文献研究为调整依据,编制《7-14岁儿童中医体质量表》；2进行两次北京市7-14岁儿童的体质调查,受调儿童包括城区和郊区。两次分别取257人和323人进行调查,并使用项目分析、信度分析和效度分析评价量表及其条目,根据统计分析结果对量表进一步修订；3在调查过程中,对部分受调儿童进行访谈,进而了解受调儿童对量表条目的理解程度、适用情况及是否存在条目的理解误区等情况,并根据该反馈信息对初测量表后的条目修订加以辅助。结果：1条目修订后生成的初测版《7-14岁儿童中医体质量表》由60个条目、9个亚量表组成。其中,平和质亚量表由8个条目组成；气虚质亚量表由8个条目组成；阳虚质亚量表由8个条目组成；阴虚质亚量表由6个条目组成；痰湿质亚量表由8个条目组成；湿热质亚量表由6个条目组成；血瘀质亚量表由7个条目组成；气郁质亚量表由7个条目组成；特禀质亚量表由7个条目组成。而平和质亚量表中有5个条目与其他体质重复,但需反向计分；2初测版《7-14岁儿童中医体质量表》项目分析不佳的条目依次是3、7、12、26、29、35、37、55、58、60；因素分析结果不佳的条目依次是2、7、12、13、19、28、37、40、56、60；内部一致性a系数为0.887,量表信度较为理想。其中气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质及平和质亚量表的内部一致性a系数依次为0.637、0.742、0.715、0.629、0.625、0.629、0.826、0.615、0.684；3初测修订后生成的二测版《7-14岁儿童中医体质量表》由51个条目、9个亚量表组成。其中,平和质亚量表由6个条目组成,气虚质亚量表由7个条目组成,阳虚质亚量表由6个条目组成,阴虚质亚量表由5个条目组成,痰湿质亚量表由7个条目组成,湿热质亚量表由5个条目组成,血瘀质亚量表由6个条目组成,气郁质亚量表由7个条目组成,特禀质亚量表由6个条目组成。而平和质亚量表中有4个条目与其他体质重复,但需反向计分；4二测版《7-14岁儿童中医体质量表》项目分析不佳的条目依次是6、23、24、25；因素分析结果不佳的条目依次是6、11；内部一致性a系数为0.865,量表信度较为理想。其中气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质及平和质亚量表的内部一致性a系数依次为0.632、0.713、0.642、0.600、0.661、0.622、0.774、0.634、 0.601。结论：1本研究编制的终版《7-14岁儿童中医体质量表》由9个亚量表、51个条目组成。其中,平和质亚量表包含5个反向计分条目；2《7-14岁儿童中医体质量表》经两次测试并进行了修订后,具有较高的信度和效度,符合7-14岁儿童体质状态,适用于该年龄人群,可以作为测量该年龄人群体质的有效工具并推广使用。
[Abstract]:The theoretical study is based on the children's "body of pure Yang", "the body of childish and young Yang", "the body of young Yang", "the deficiency of the five organs" and other ancient children's physique theory. The author tries to elaborate the characteristics of the children's physique from three angles: the use of Yang, the body and the dynamic change, and hope to provide the theoretical reference for the study of the children's constitution. The author is based on the knowledge of China. The clinical epidemiology literature has been collected by the network, and the clinical epidemiology literature has proved that 9 kinds of physique exist in children. Then "children" "Chinese medicine" and "constitution" are the theme words, and 423 articles are retrieved through the CNKI data platform, and 21 available literature are screened from them, and nine kinds of physical bodies are preliminarily completed through word frequency sorting. Objective: since the standard of classification and determination of Chinese medicine constitution was officially issued by the Chinese society of Chinese medicine in April 9, 2009, it has now been used in 30 provinces and 103 cities (autonomous regions). However, the standard of the standard of TCM is for 15-60 years old people, children's physique and There are certain differences in the physical fitness of adults, and the limitations of children's understanding of language comprehension, so the existing "TCM body quality list" is not suitable for the use of children. In order to further improve the classification and criteria of the constitution of Chinese medicine, we need to revise the children's Edition of the TCM body quality table >. Professor Wang Qi, the tutor, divided 0-14 years old children into 0-1 years old, 1-6 years old and 7-14 years old and three parts to compile the body mass scale of the children's traditional Chinese medicine. The subject is to prepare the body quality table for the 7-14 year old children. The classification of Chinese Medicine Constitution and the criteria for determination of the 7-14 year old children's edition will be better applied to the pediatrician, the scientific research personnel and the correlation. The clinical practice and scientific research work related to the physique of Chinese medicine were carried out by the managers to provide identification standards for the identification of Chinese Medical Constitution and to provide services for assessing the health status of children in China. Method: 1, after taking full consideration of the physical characteristics of 7-14 year old children in China and the characteristics of learning and life, the 2009 edition of the classification and judgment of Chinese Medicine Constitution and the standard of Chinese Medicine According to the basic framework, referring to the literature on children's physique in the ancient books and referring to the previous literature research as the basis for adjustment, the body quality table of Chinese children of <7-14 years old was compiled. 2 the two times of the physical investigation of 7-14 year old children in Beijing were investigated. The children were included in the city and the suburb. Two times, 257 and 323 people were investigated, and the project analysis was used. The reliability analysis and validity analysis evaluation scale and its entries were further revised according to the statistical analysis results. 3 during the investigation, some children were interviewed to understand the degree of understanding, the application and the misunderstanding of the article. Results: the items after the initial survey were revised. Results: the quality table of the Chinese traditional Chinese medicine for the first test version of <7-14 years after the revision of the 1 items was composed of 60 items and 9 subscales. Among them, the level and quality subscale consists of 8 items; the Qi deficiency subscale consists of 8 entries; the Yang deficiency subscale consists of 8 items; the subscale of yin deficiency quality It consists of 6 entries; the phlegm and moisture subscale consists of 8 entries; the hygrothermal subscale consists of 6 entries; the blood stasis subscale consists of 7 entries; the qi depression scale consists of 7 entries; the special temperament subscale consists of 7 items, and 5 items in the flat sum subscale are repeated with other physique, but the reverse score is required. 2 first test version of <7-14 years old children's Chinese medicine body quality table > items of poor analysis of the item is 3,7,12,26,29,35,37,55,58,60 in turn; the items with poor result analysis are 2,7,12,13,19,28,37,40,56,60, the internal consistency a coefficient is 0.887, the reliability of the scale is ideal. The internal consistency a coefficient of the blood stasis, Qi depressive substance, the quality and the level and quality subscale was 0.637,0.742,0.715,0.629,0.625,0.629,0.826,0.615,0.684, and the two version of the 3 year old children of <7-14 year old was composed of 51 items and 9 subscales. The table consists of 7 items. The subscale of Yang deficiency is composed of 6 items. The subscale of the yin deficiency is composed of 5 items. The subscale of phlegm and moisture is composed of 7 items. The subscale of the heat and heat is composed of 5 entries. The blood stasis subscale consists of 6 items. The qi depression scale consists of 7 items, and the subscale of the temperament is composed of 6 items. In the qualitative subscale, 4 items were repeated with other physique, but there was a reverse score; the 4 two <7-14 year old children's TCM body quality table was 6,23,24,25, and the items with poor results were 6,11 in turn; the internal consistency a coefficient was 0.865 and the scale reliability was ideal. The internal conformance a coefficient of the phlegm dampness, moisture and heat, blood stasis, Qi, Qi, Qi and quality subscale was 0.632,0.713,0.642,0.600,0.661,0.622,0.774,0.634, 0.601. conclusion: 1 the body quality table of the final version of <7-14 year old children was composed of 9 subscales and 51 items. 5 reverse score items, 2<7-14 years old children's body quality table, after two tests and revised, has high reliability and validity, which conforms to the physical state of 7-14 year old children. It is suitable for the population of this age and can be used as an effective tool to measure the body's physique of this age group.
【学位授予单位】：北京中医药大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R272

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