肺系病证自评量表的初步研制及考评

发布时间：2018-03-23 13:34

本文选题：肺系病证　切入点：量表　出处：《福建中医药大学》2016年硕士论文

【摘要】：目的：研制一个具有中医特色的肺系病证自评量表,并对量表进行信度、效度考评,以初步制定用于评价肺系病证临床疗效的患者自评量表,为中医肺系病证的辨别提供客观规范化依据,也为肺系病证患者在自我诊断和评价疗效时提供一种量化工具。方法：参照国内外量表的研制方法,通过文献调研、专家组讨论、术语规范等筛选出肺系病证相关症状,形成量表条目池。采用三轮德尔菲专家咨询法对条目进行主观筛选：第一轮主要判断筛选出的条目是否可作为肺系病证的诊断依据；第二轮主要判断条目维度归属；第三轮主要评价条目与各维度的重要性。通过临床预调查收集115例肺系病证患者病例,采用困难度分析、反应特征分析和相关系数法对条目进行进一步客观筛选,形成肺系病证自评量表。最后使用量表收集302例肺系病证患者及100例非肺系病证患者的临床资料,采用分半信度、Cronbach's α系数对量表进行信度考评,用区分效度及结构效度对量表进行效度考评。结果：经前期文献调研等筛选出由257个症状组成的量表条目池；经过三轮专家咨询及临床预调查初步编制出由肺的主要生理功能及肺与形、窍、液、经络的关系两大领域下的6个维度(与主气司呼吸功能相关、与肺主行水功能相关、与肺外合皮毛相关、与肺开窍于鼻相关、与肺在液为涕相关、与肺与大肠相表里相关),共41个条目组成的肺系病证自评量表。经过统计分析,量表的信度方面：总表和前4个维度的分半信度系数分别0.815、0.836、0.512、0.728、0.924；克朗巴赫a系数分别为0.912、0.852、0.403、0.783、0.886。效度方面：各维度得分差异都是显著的,P值均0.05,具有统计学意义,具有较好的区分效度；因子分析提取出11个公因子,累积贡献率达65.032%,因子的条目组成与理论构想较符合。结论：初步编制的肺系病证自评量表具有较好的信度和效度,可为肺系病证中医临床诊断提供客观规范化工具。
[Abstract]:Objective: to develop and evaluate the reliability and validity of a self-rating scale for lung diseases with the characteristics of traditional Chinese medicine (TCM) so as to establish a self-rating scale for evaluating the clinical efficacy of lung diseases. It also provides a quantitative tool for the diagnosis and evaluation of the curative effect of lung disease syndrome. Methods: referring to the development method of the scale at home and abroad, through literature investigation, the expert group discussed, The term norm was used to screen out the symptoms related to lung diseases and syndromes and to form a pool of items in the scale. Three rounds of Delphi expert consultation were used to screen the items subjectively: the first round mainly judged whether the selected items could be used as the diagnostic basis for lung diseases and syndromes; The second main judgment item dimension, the third main evaluation items and the importance of each dimension. 115 cases of lung disease and syndrome cases were collected through clinical pre-investigation, and the difficulty degree analysis was used. Response characteristics analysis and correlation coefficient method were used to screen the items objectively to form the self-rating scale for lung diseases. Finally, the clinical data of 302 patients with lung diseases and 100 patients with non-pulmonary diseases were collected by using the scale. The reliability of the scale was evaluated with split reliability and Cronbachs伪 coefficient, and the validity of the scale was evaluated by distinguishing validity and structural validity. After three rounds of expert consultation and clinical preliminary investigation, the main physiological functions of lung and the relationship between lung and shape, orifice, fluid and meridian were preliminarily worked out. It is related to the outer coat of the lung, the orifices of the lung to the nose, the liquid of the lung to snot, and the lung to the large intestine. A total of 41 items are included in the self-rating scale for lung diseases. The reliability of the scale: the split-half reliability coefficient of the total table and the first four dimensions were 0.815 / 0.836 / 0.512 / 0.728 / 0.924, respectively, and the kronbach's coefficient were 0.912 / 0.852/ 0.4030.783/ 0.886respectively. The validity of the scale was as follows: the difference of the scores of each dimension was significant (P = 0.05), which was statistically significant and had good distinguishing validity. Eleven common factors were extracted by factor analysis, and the cumulative contribution rate was 65.032. The item composition of the factor was in good agreement with the theoretical conception. Conclusion: the self-rating scale for lung diseases developed preliminarily has good reliability and validity. It can provide an objective and standardized tool for the clinical diagnosis of lung diseases.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R256.1

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