血瘀证中医疗效评价量表的研制与考评

发布时间：2018-07-31 06:42

【摘要】：目的:研究并编制血瘀证中医疗效评价量表,对其可行性、信度、效度以及反应度进行考评,从而建立用于对中医血瘀证患者进行临床疗效评价的自评量表,从而为血瘀证患者在自我评价与疗效评价方面提供相对明确的量化工具。方法:参照国际上现行的量表研究标准及方法,参考相关研究,通过文献回顾、教材梳理、标准收集、患者深度访谈,结合专家讨论以形成条目池。召开专家会议,结合理论框架,分类整理条目池中的内容并设置问题,进行小范围患者访谈及预调查对量表进行语言调试,在选题小组达成共识后形成初选量表。基于深度访谈法和临床调查法对初选量表中的条目进行筛选。再次通过临床调查,运用指标体系对量表进行信度、效度和反应度检验,在对量表进行修订后,最终确立血瘀证中医疗效评价量表。结果:对42位患者进行深度访谈,搜集资料总结整理形成条目池,结合专家讨论、临床调查法(100位患者)进行条目筛选,删除不满意的条目,从而编制出由活动、睡眠、情绪、加重组成的4个维度,10个条目组成的血瘀证中医疗效评价量表。经考评后总表、活动维度、睡眠维度、情绪维度、加重维度的重测信度分别为0.954、0.945、0.976、0.924、0.959;克朗巴赫α系数分别为0.829、0.813、0.614、0.675;各条目与总表的相关系数均大于0.4;因子分析显示5个因子,贡献率达到了80.0%,因子的条目组成符合理论构想。与长海痛尺的疼痛评分相关系数为0.741,P为0.000,具有较高的相关性;量表的反应度良好,可以明确区分患者组与健康组。结论:本研究研制的血瘀证中医疗效评价量表均具有较好的可行性、信度、效度、反应度,其临床应用价值有待进一步的大样本多中心的临床研究。本量表也存在一些不足之处,仍需要在后续的研究中进行修改和完善。
[Abstract]:Objective: to study and compile the Chinese medicine curative effect evaluation scale of blood stasis syndrome and evaluate its feasibility, reliability, validity and reaction degree, so as to establish a self-rating scale for clinical efficacy evaluation of patients with blood stasis syndrome of traditional Chinese medicine. Thus provides a relatively clear quantitative tool for self-evaluation and efficacy evaluation of patients with blood stasis syndrome. Methods: referring to the current international research standards and methods of the scale, referring to the relevant studies, through literature review, teaching materials combing, standard collection, patients in-depth interviews, combined with expert discussions to form a pool of entries. Holding an expert meeting, combining the theoretical framework, sorting out the contents of the item pool and setting up problems, conducting a small range of patient interviews and pre-investigation to debug the language of the scale, and forming the primary scale after the group of topics reached a consensus. The items in the primary scale were screened based on depth interview and clinical investigation. Again through the clinical investigation, using the index system to test the reliability, validity and response of the scale, after the revision of the scale, the final establishment of the blood stasis syndrome evaluation scale of traditional Chinese medicine. Results: 42 patients were interviewed in depth, collected data were summarized and sorted into an item pool, combined with expert discussion, the clinical investigation method (100 patients) was used to screen items and delete dissatisfied items, so as to compile the items by activity, sleep, emotion, etc. Four dimensions of aggravation and 10 items of TCM therapeutic evaluation scale of blood stasis syndrome. After evaluation, the test-retest reliability of activity dimension, sleep dimension, emotional dimension and aggravation dimension were 0.954 / 0.945 / 0.976/ 0.924 / 0.959 respectively; the kronbach 伪 coefficient was 0.829 / 0.8130.6140.675; the correlation coefficient between each item and the summary table was greater than 0.4; the factor analysis showed five factors, respectively. The contribution rate reached 80. 0%, and the item composition of the factor was in accordance with the theoretical conception. The correlation coefficient with the pain score of Changhai pain ruler was 0.741 (P = 0.000), and the response of the scale was good, which could clearly distinguish the patient group from the healthy group. Conclusion: the Chinese traditional medicine curative effect evaluation scale of blood stasis syndrome developed in this study has good feasibility, reliability, validity, reaction degree, and its clinical application value needs to be further large sample multi-center clinical research. This scale also has some shortcomings, still need to be revised and improved in the follow-up research.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R255.7

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