慢性便秘患者报告临床结局（CC-PRO）评估量表在中医治疗中的应用

发布时间：2018-09-09 08:47

【摘要】：目的：慢性便秘患者报告临床结局(CC-PRO)量表,为南京市中医院盆底中心自制量表。此研究通过在临床中使用,评价CC-PRO量表和便秘患者生活质量自评问卷(PAC-QOL)的相关性,以及研究两量表对慢性便秘患者生活质量的评价比较。通过两量表进行对比,对CC-PRO量表在中医临床中的作用进行评价。方法：在盆底诊疗中心专病门诊收集慢性便秘患者,共104例纳入研究。患者治疗前后分别填写CC-PRO和PAC-QOL量表,并同时填写便秘严重度评分(CSS)量表做基线。治疗根据患者的便秘分型及病情,由医生选择合适的治疗方法,包括中药、针灸、生物反馈治疗。统计量表的结果,用SPSS软件进行数据分析。结果：①对不同分型的便秘患者,临床上优先选择不同的治疗方案,其中功能性排便障碍患者61例,占比59%。93%的功能性排便障碍患者行针灸配合生物反馈治疗；慢传输型便秘患者25例,占比24%,88%的慢传输型便秘患者进中药治疗；功能性排便障碍合并慢传输型便秘患者17例,占比16%,其中60%的行中药配合针灸和生物反馈治疗。②104例患者治疗前的量表得分：CC-PRO治疗前vs治疗后：190.6±53.1vs131.4±79.3, P0.05; PAC-QOL治疗前vs治疗后：55.3±20.7vs55.3±20.7,P0.05; CSS治疗前vs治疗后：14.9±3.7vs9.0±4.7,P0.05；三个量表治疗前后的得分均有统计学差异。③三个量表间均有相关性,CC-PRO量表和PAC-QOL量表的相关系数r=0.855; CC-PRO与CSS的相关系数r=0.629; PAC-QOL与CSS的相关系数r=0.520。CC-PRO量表的各维度(生理维度、心理维度、社会维度和满意度)和PAC-QOL量表各维度(躯体不适、心理社会不适、担忧、满意度)间也具有相关性。④据治疗方案的不同,将104名患者分为两组：中药组,包括主要采取中药治疗的患者,共42名。非中药组,包括针灸和生物反馈治疗的患者,共62名。两组治疗前基线均无统计学差异,治疗后CSS量表和1PAC-QO L量表得分无统计学差异,CC-PRO量表的总分及CC-PRO的生理维度有统计学差异。结论：CC-PRO量表和PAC-QOL量表有较好相关性,在临床中可以全面反映出患者的疾病严重程度和生活质量状况,在比较中医药治疗方法的时候,CC-PRO可以反映出中医药治疗对患者生理维度改善的优势。
[Abstract]:Objective: to report the clinical outcome (CC-PRO) of patients with chronic constipation. The purpose of this study was to evaluate the correlation between CC-PRO scale and self-rating quality of life (PAC-QOL) questionnaire for patients with constipation and to compare the two scales in evaluating the quality of life of patients with chronic constipation. Through the comparison of the two scales, the function of CC-PRO scale in TCM clinic was evaluated. Methods: 104 patients with chronic constipation were collected in pelvic floor clinic. CC-PRO and PAC-QOL were completed before and after treatment, and constipation severity score (CSS) was used as baseline. According to the patient's constipation type and condition, the treatment is selected by the doctor, including Chinese medicine, acupuncture, biofeedback therapy. The results of the statistical scale were analyzed by SPSS software. Results for the patients with different types of constipation, different treatment schemes were given priority clinically. Among them, 61 patients with functional defecation disorder (59.93%) were treated with acupuncture and biofeedback therapy. Twenty-five patients with slow transit constipation, accounting for 24% of the patients with slow transit constipation, were treated with traditional Chinese medicine, 17 patients with functional defecation with slow transit constipation, 17 patients with functional defecation and slow transit constipation, 60% of them received traditional Chinese medicine combined with acupuncture and biofeedback therapy. The scores of 20% of them before and after vs treatment were 190.6 卤53.1vs131.4 卤79.3, P0.05; before and after PAC-QOL, vs was 55.3 卤20.7vs55.3 卤20.7 P0.05; before and after vs treatment, vs was 0.14.9 卤3.7vs9.0 卤4.7P 0.05; There were significant differences in the scores of the three scales before and after treatment. 3 the correlation coefficients of CC-PRO scale and PAC-QOL scale was 0.855; the correlation coefficient between CC-PRO and CSS was 0.629; the correlation coefficient between PAC-QOL and CSS was every dimension of r=0.520.CC-PRO scale (physiological dimension, P < 0.05). There was also correlation between psychological dimension, social dimension and satisfaction degree and PAC-QOL scale dimension (somatic discomfort, psychosocial discomfort, worry, satisfaction degree). According to the difference of treatment plan, 104 patients were divided into two groups: traditional Chinese medicine group. Including the main treatment of traditional Chinese medicine patients, a total of 42. There were 62 patients in non-TCM group, including acupuncture and biofeedback therapy. There was no statistical difference in baseline before treatment between the two groups, but there was no statistical difference in the scores of CSS scale and 1PAC-QO L scale after treatment. The total score of CC-PRO scale and the physiological dimension of CC-PRO were statistically different. Conclusion the ratio of CC-PRO scale to PAC-QOL scale has a good correlation, and it can reflect the severity of disease and quality of life of patients in clinic. CC-PRO can reflect the advantages of traditional Chinese medicine in improving the physiological dimension of patients.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R256.35

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