本文選題：肺系病證　切入點(diǎn)：量表　出處：《福建中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：研制一個(gè)具有中醫(yī)特色的肺系病證自評(píng)量表,并對(duì)量表進(jìn)行信度、效度考評(píng),以初步制定用于評(píng)價(jià)肺系病證臨床療效的患者自評(píng)量表,為中醫(yī)肺系病證的辨別提供客觀規(guī)范化依據(jù),也為肺系病證患者在自我診斷和評(píng)價(jià)療效時(shí)提供一種量化工具。方法：參照國(guó)內(nèi)外量表的研制方法,通過(guò)文獻(xiàn)調(diào)研、專家組討論、術(shù)語(yǔ)規(guī)范等篩選出肺系病證相關(guān)癥狀,形成量表?xiàng)l目池。采用三輪德?tīng)柗茖＜易稍兎▽?duì)條目進(jìn)行主觀篩選：第一輪主要判斷篩選出的條目是否可作為肺系病證的診斷依據(jù)；第二輪主要判斷條目維度歸屬；第三輪主要評(píng)價(jià)條目與各維度的重要性。通過(guò)臨床預(yù)調(diào)查收集115例肺系病證患者病例,采用困難度分析、反應(yīng)特征分析和相關(guān)系數(shù)法對(duì)條目進(jìn)行進(jìn)一步客觀篩選,形成肺系病證自評(píng)量表。最后使用量表收集302例肺系病證患者及100例非肺系病證患者的臨床資料,采用分半信度、Cronbach's α系數(shù)對(duì)量表進(jìn)行信度考評(píng),用區(qū)分效度及結(jié)構(gòu)效度對(duì)量表進(jìn)行效度考評(píng)。結(jié)果：經(jīng)前期文獻(xiàn)調(diào)研等篩選出由257個(gè)癥狀組成的量表?xiàng)l目池；經(jīng)過(guò)三輪專家咨詢及臨床預(yù)調(diào)查初步編制出由肺的主要生理功能及肺與形、竅、液、經(jīng)絡(luò)的關(guān)系兩大領(lǐng)域下的6個(gè)維度(與主氣司呼吸功能相關(guān)、與肺主行水功能相關(guān)、與肺外合皮毛相關(guān)、與肺開(kāi)竅于鼻相關(guān)、與肺在液為涕相關(guān)、與肺與大腸相表里相關(guān)),共41個(gè)條目組成的肺系病證自評(píng)量表。經(jīng)過(guò)統(tǒng)計(jì)分析,量表的信度方面：總表和前4個(gè)維度的分半信度系數(shù)分別0.815、0.836、0.512、0.728、0.924；克朗巴赫a系數(shù)分別為0.912、0.852、0.403、0.783、0.886。效度方面：各維度得分差異都是顯著的,P值均0.05,具有統(tǒng)計(jì)學(xué)意義,具有較好的區(qū)分效度；因子分析提取出11個(gè)公因子,累積貢獻(xiàn)率達(dá)65.032%,因子的條目組成與理論構(gòu)想較符合。結(jié)論：初步編制的肺系病證自評(píng)量表具有較好的信度和效度,可為肺系病證中醫(yī)臨床診斷提供客觀規(guī)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偽 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.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R256.1

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1 王烈;小兒肺系常見(jiàn)病證的選方用藥[J];新疆中醫(yī)藥;2003年02期

2 張燦s，

本文編號(hào)：1653673