本文選題：中醫(yī)體質(zhì) + 量表�。� 參考：《北京中醫(yī)藥大學(xué)》2015年博士論文

【摘要】：理論研究筆者基于小兒“純陽之體”、“稚陰稚陽之體”、“少陽之體”、“五臟有余不足”等古代小兒體質(zhì)學(xué)說,試從以陽為用、稚弱之體、動態(tài)變化三個(gè)角度闡述小兒體質(zhì)特點(diǎn),希望能對小兒體質(zhì)研究提供理論參考。筆者根據(jù)從中國知網(wǎng)收集到的體質(zhì)分類文獻(xiàn)、臨床流行病學(xué)文獻(xiàn)證明了9種體質(zhì)在兒童中確實(shí)存在。而后以“小兒”“中醫(yī)”“體質(zhì)”為主題詞、通過CNKI數(shù)據(jù)平臺共檢索現(xiàn)代文獻(xiàn)423篇,并從中篩選出21篇可用文獻(xiàn)、通過詞頻整理初步完成兒童九種體質(zhì)體質(zhì)特征的表述。量表編制目的：自《中醫(yī)體質(zhì)分類與判定》標(biāo)準(zhǔn)于2009年4月9日正式由中華中醫(yī)藥學(xué)會發(fā)布起,現(xiàn)已被全國30個(gè)省、市(自治區(qū))共有103家“治未病”中心應(yīng)用。然而,該標(biāo)準(zhǔn)中的《中醫(yī)體質(zhì)量表》針對的是15-60歲人群,兒童體質(zhì)與成人體質(zhì)存在一定的差異,加之兒童語言理解能力的限制,故現(xiàn)有的《中醫(yī)體質(zhì)量表》并不適合廣大兒童使用。為了對《中醫(yī)體質(zhì)分類與判定》標(biāo)準(zhǔn)進(jìn)一步完善,我們需要修訂兒童版《中醫(yī)體質(zhì)量表》。鑒于不同年齡段兒童的體質(zhì)特點(diǎn)和理解能力不同,導(dǎo)師王琦教授將0-14歲兒童分為0-1歲、1-6歲、7-14歲三部分分別編制兒童版中醫(yī)體質(zhì)量表。本課題擬針對7-14歲兒童編制中醫(yī)體質(zhì)量表。加入7-14歲兒童版量表的《中醫(yī)體質(zhì)分類與判定標(biāo)準(zhǔn)》將更好地應(yīng)用于兒科醫(yī)生、科研人員及相關(guān)管理人員所開展的與中醫(yī)體質(zhì)相關(guān)的臨床實(shí)踐及科研工作,為兒童的中醫(yī)體質(zhì)辨識提供辨識標(biāo)準(zhǔn),為評估我國兒童的健康狀態(tài)提供服務(wù)。方法：1在充分考慮我國7-14歲兒童體質(zhì)特點(diǎn)及學(xué)習(xí)生活特點(diǎn)后,以2009版《中醫(yī)體質(zhì)分類與判定》標(biāo)準(zhǔn)為基本框架,借鑒古籍中關(guān)于兒童體質(zhì)的文獻(xiàn)資料,參考前期文獻(xiàn)研究為調(diào)整依據(jù),編制《7-14歲兒童中醫(yī)體質(zhì)量表》；2進(jìn)行兩次北京市7-14歲兒童的體質(zhì)調(diào)查,受調(diào)兒童包括城區(qū)和郊區(qū)。兩次分別取257人和323人進(jìn)行調(diào)查,并使用項(xiàng)目分析、信度分析和效度分析評價(jià)量表及其條目,根據(jù)統(tǒng)計(jì)分析結(jié)果對量表進(jìn)一步修訂；3在調(diào)查過程中,對部分受調(diào)兒童進(jìn)行訪談,進(jìn)而了解受調(diào)兒童對量表?xiàng)l目的理解程度、適用情況及是否存在條目的理解誤區(qū)等情況,并根據(jù)該反饋信息對初測量表后的條目修訂加以輔助。結(jié)果：1條目修訂后生成的初測版《7-14歲兒童中醫(yī)體質(zhì)量表》由60個(gè)條目、9個(gè)亞量表組成。其中,平和質(zhì)亞量表由8個(gè)條目組成；氣虛質(zhì)亞量表由8個(gè)條目組成；陽虛質(zhì)亞量表由8個(gè)條目組成；陰虛質(zhì)亞量表由6個(gè)條目組成；痰濕質(zhì)亞量表由8個(gè)條目組成；濕熱質(zhì)亞量表由6個(gè)條目組成；血瘀質(zhì)亞量表由7個(gè)條目組成；氣郁質(zhì)亞量表由7個(gè)條目組成；特稟質(zhì)亞量表由7個(gè)條目組成。而平和質(zhì)亞量表中有5個(gè)條目與其他體質(zhì)重復(fù),但需反向計(jì)分；2初測版《7-14歲兒童中醫(yī)體質(zhì)量表》項(xiàng)目分析不佳的條目依次是3、7、12、26、29、35、37、55、58、60；因素分析結(jié)果不佳的條目依次是2、7、12、13、19、28、37、40、56、60；內(nèi)部一致性a系數(shù)為0.887,量表信度較為理想。其中氣虛質(zhì)、陽虛質(zhì)、陰虛質(zhì)、痰濕質(zhì)、濕熱質(zhì)、血瘀質(zhì)、氣郁質(zhì)、特稟質(zhì)及平和質(zhì)亞量表的內(nèi)部一致性a系數(shù)依次為0.637、0.742、0.715、0.629、0.625、0.629、0.826、0.615、0.684；3初測修訂后生成的二測版《7-14歲兒童中醫(yī)體質(zhì)量表》由51個(gè)條目、9個(gè)亞量表組成。其中,平和質(zhì)亞量表由6個(gè)條目組成,氣虛質(zhì)亞量表由7個(gè)條目組成,陽虛質(zhì)亞量表由6個(gè)條目組成,陰虛質(zhì)亞量表由5個(gè)條目組成,痰濕質(zhì)亞量表由7個(gè)條目組成,濕熱質(zhì)亞量表由5個(gè)條目組成,血瘀質(zhì)亞量表由6個(gè)條目組成,氣郁質(zhì)亞量表由7個(gè)條目組成,特稟質(zhì)亞量表由6個(gè)條目組成。而平和質(zhì)亞量表中有4個(gè)條目與其他體質(zhì)重復(fù),但需反向計(jì)分；4二測版《7-14歲兒童中醫(yī)體質(zhì)量表》項(xiàng)目分析不佳的條目依次是6、23、24、25；因素分析結(jié)果不佳的條目依次是6、11；內(nèi)部一致性a系數(shù)為0.865,量表信度較為理想。其中氣虛質(zhì)、陽虛質(zhì)、陰虛質(zhì)、痰濕質(zhì)、濕熱質(zhì)、血瘀質(zhì)、氣郁質(zhì)、特稟質(zhì)及平和質(zhì)亞量表的內(nèi)部一致性a系數(shù)依次為0.632、0.713、0.642、0.600、0.661、0.622、0.774、0.634、 0.601。結(jié)論：1本研究編制的終版《7-14歲兒童中醫(yī)體質(zhì)量表》由9個(gè)亞量表、51個(gè)條目組成。其中,平和質(zhì)亞量表包含5個(gè)反向計(jì)分條目；2《7-14歲兒童中醫(yī)體質(zhì)量表》經(jīng)兩次測試并進(jìn)行了修訂后,具有較高的信度和效度,符合7-14歲兒童體質(zhì)狀態(tài),適用于該年齡人群,可以作為測量該年齡人群體質(zhì)的有效工具并推廣使用。
[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.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2015
【分類號】：R272

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