陰虛證自評量表的初步研制及考評
發(fā)布時間：2019-03-11 18:34
【摘要】：目的：研制具有中醫(yī)特色的陰虛證自評量表；為臨床陰虛證診斷以及辨別病位提供測量工具,為陰虛證療效的評價提供參考依據(jù)。方法：根據(jù)量表研制的科學(xué)方法,通過文獻(xiàn)調(diào)研得出各類疾病中陰虛證的分布情況,并對其證候進(jìn)行術(shù)語規(guī)范化處理,形成備選條目池。將條目翻譯成各個問題,擬定專家問卷調(diào)查進(jìn)行德爾菲專家咨詢初步篩選條目,形成陰虛證自評量表(初稿)。專家咨詢后進(jìn)行語言調(diào)試,看看患者是否能夠理解各個條目,優(yōu)化量表,形成陰虛證自評量表(1版)進(jìn)入下一步的臨床預(yù)調(diào)查。采集福建省人民醫(yī)院、福建省第二人民醫(yī)院、國醫(yī)堂、福建省立醫(yī)院、福州市第二醫(yī)院、晉江市中醫(yī)院等醫(yī)院門診及住院病人100例進(jìn)行臨床預(yù)調(diào)查,結(jié)合運(yùn)用困難度分析法、反應(yīng)特征分析法及相關(guān)系數(shù)法等多種統(tǒng)計方法處理臨床數(shù)據(jù),更進(jìn)一步優(yōu)化篩選條目,形成陰虛證自評量表(2版)。最終對陰虛證自評量表(2版)進(jìn)行考評,采集400例患者的臨床資料,以檢驗其信度、效度和可行性,進(jìn)一步完善該量表。結(jié)果：1.經(jīng)過前期的文獻(xiàn)調(diào)研,得出232個陰虛證的癥狀,形成條目池。2.經(jīng)三輪專家咨詢,回收率均為100%。形成84條條目的陰虛證自評量表(1版),其中腎維度36條條目、肝維度29條條目、胃維度15條條目、肺維度22條條目、心維度10條條目、脾維度10條條目,協(xié)調(diào)系數(shù)為0.332(χ2值為505.903,p值為0.0000.005)。3.臨床預(yù)調(diào)查,根據(jù)困難度分析法、反應(yīng)特征分析法及相關(guān)系數(shù)法等客觀篩選方法,對84條條目進(jìn)行篩選得出56條條目,形成陰虛證自評量表(2版),其中腎維度20條條目、肝維度22條條目、胃維度13條條目、肺維度12條條目、心維度10條條目、脾維度10條條目。4.總量表分半信度為0.920,各維度分半信度均大于0.6；總量表的Cronbach's a系數(shù)為0.872,各維度的Cronbach's a系數(shù)均大于0.6,經(jīng)考評具有良好的信度。經(jīng)非參數(shù)檢驗提示量表具有良好的區(qū)分效度,因子分析提示量表具有良好的結(jié)構(gòu)效度。結(jié)論：1.通過陰虛證相關(guān)文獻(xiàn)調(diào)研,總結(jié)了陰虛證臨床常見的中醫(yī)疾病、西醫(yī)疾病、證型及證素等情況的分布規(guī)律。2.文獻(xiàn)調(diào)研為后續(xù)的量表研制提供了條目池,也為量表各維度的形成提供依據(jù),還為臨床調(diào)查選擇病例提供可靠依據(jù)。3.證候術(shù)語規(guī)范為建立備選條目池提供了規(guī)范化方法。4.結(jié)合德爾菲專家咨詢和預(yù)調(diào)查的方法對條目進(jìn)行了優(yōu)化篩選,形成了由56條條目組成的陰虛證自評量表(2版)。5.通過臨床調(diào)查,對陰虛證自評量表(2版)進(jìn)行可行性、信度和效度考評,結(jié)果表明此量表具有較好的可行性、信度以及效度,能為臨床陰虛證診斷以及辨別病位提供測量工具,為陰虛證療效的評價提供參考依據(jù)。
[Abstract]:Objective: to develop a self-rating scale for Yin deficiency syndrome with characteristics of traditional Chinese medicine, to provide a measurement tool for clinical diagnosis and identification of disease position, and to provide reference basis for evaluating the curative effect of Yin deficiency syndrome. Methods: according to the scientific method developed by the scale, the distribution of Yin deficiency syndrome in all kinds of diseases was obtained through literature investigation, and its syndrome was standardized in terms to form alternative item pool. The items were translated into various questions, and an expert questionnaire was drawn up to screen the items for Delphi expert consultation to form the self-rating scale for Yin deficiency Syndrome (preliminary draft). After expert consultation, language debugging was carried out to see if the patients could understand each item, optimize the scale, and form the self-rating scale of Yin deficiency Syndrome (version 1) to enter the next step of clinical pre-investigation. We collected 100 outpatients and inpatients from Fujian people's Hospital, Fujian second people's Hospital, National Medical Hall, Fujian Provincial Hospital, Fuzhou second Hospital, Jinjiang traditional Chinese Medicine Hospital and other hospitals for clinical pre-investigation, combined with difficulty analysis method. Many kinds of statistical methods, such as response characteristic analysis and correlation coefficient method, were used to process the clinical data, and the items were further optimized to form the self-rating scale of Yin deficiency Syndrome (version 2). Finally, the self-rating scale of Yin deficiency Syndrome (version 2) was evaluated and the clinical data of 400 patients were collected to test the reliability, validity and feasibility of the scale. Results: 1. After previous literature investigation, 232 symptoms of Yin deficiency syndrome were found, forming an entry pool. 2. After three rounds of expert consultation, the recovery rate was 100%. The self-rating scale for Yin deficiency Syndrome (version 1), which forms 84 items, includes 36 items in the kidney dimension, 29 items in the liver dimension, 15 items in the stomach dimension, 22 items in the lung dimension, 10 items in the heart dimension, and 10 items in the spleen dimension. The coordination coefficient is 0.332 (蠂 2 = 505.903, p = 0.0000.005). 3. Clinical pre-investigation, according to the objective screening methods such as difficulty analysis, response characteristic analysis and correlation coefficient method, 56 items were obtained by screening 84 items, forming self-rating scale of Yin deficiency Syndrome (version 2), of which 20 items were in kidney dimension, 20 items in kidney dimension, and 56 items were selected according to the methods of difficulty analysis, response characteristic analysis and correlation coefficient. Liver dimension 22 items, stomach dimension 13 items, lung dimension 12 items, heart dimension 10 items, spleen dimension 10 items. 4. The split-half reliability of the total scale was 0.920, and the split-half reliability of each dimension was more than 0.6. The Cronbach's a coefficient of the total scale was 0.872, and the Cronbach's-a coefficient of each dimension was more than 0.6. The results showed that the total scale had good reliability. The non-parametric test indicated that the scale had good discriminative validity and factor analysis showed that the scale had good structural validity. Conclusion: 1. Through the investigation of relevant literature of Yin deficiency syndrome, this paper summarizes the distribution regularity of common diseases of TCM, western medicine, syndrome type and syndrome element in clinical practice of Yin deficiency syndrome. 2. Literature investigation provides an entry pool for the subsequent development of the scale, also provides the basis for the formation of the dimensions of the scale, and provides a reliable basis for the clinical investigation and selection of cases. 3. The syndrome terminology specification provides a standardized method for creating pool of alternative entries. 4. Combined with Delphi expert consultation and pre-investigation, the items were optimized and screened, and the self-rating scale of Yin deficiency Syndrome (version 2) composed of 56 items was formed (version 2). Through the clinical investigation, the feasibility, reliability and validity of the self-rating scale for Yin deficiency Syndrome (version 2) were evaluated. The results showed that the scale had good feasibility, reliability and validity. It can provide a measurement tool for the diagnosis and identification of Yin deficiency syndrome, and provide reference basis for evaluating the curative effect of Yin deficiency syndrome.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R241
本文編號：2438513
[Abstract]:Objective: to develop a self-rating scale for Yin deficiency syndrome with characteristics of traditional Chinese medicine, to provide a measurement tool for clinical diagnosis and identification of disease position, and to provide reference basis for evaluating the curative effect of Yin deficiency syndrome. Methods: according to the scientific method developed by the scale, the distribution of Yin deficiency syndrome in all kinds of diseases was obtained through literature investigation, and its syndrome was standardized in terms to form alternative item pool. The items were translated into various questions, and an expert questionnaire was drawn up to screen the items for Delphi expert consultation to form the self-rating scale for Yin deficiency Syndrome (preliminary draft). After expert consultation, language debugging was carried out to see if the patients could understand each item, optimize the scale, and form the self-rating scale of Yin deficiency Syndrome (version 1) to enter the next step of clinical pre-investigation. We collected 100 outpatients and inpatients from Fujian people's Hospital, Fujian second people's Hospital, National Medical Hall, Fujian Provincial Hospital, Fuzhou second Hospital, Jinjiang traditional Chinese Medicine Hospital and other hospitals for clinical pre-investigation, combined with difficulty analysis method. Many kinds of statistical methods, such as response characteristic analysis and correlation coefficient method, were used to process the clinical data, and the items were further optimized to form the self-rating scale of Yin deficiency Syndrome (version 2). Finally, the self-rating scale of Yin deficiency Syndrome (version 2) was evaluated and the clinical data of 400 patients were collected to test the reliability, validity and feasibility of the scale. Results: 1. After previous literature investigation, 232 symptoms of Yin deficiency syndrome were found, forming an entry pool. 2. After three rounds of expert consultation, the recovery rate was 100%. The self-rating scale for Yin deficiency Syndrome (version 1), which forms 84 items, includes 36 items in the kidney dimension, 29 items in the liver dimension, 15 items in the stomach dimension, 22 items in the lung dimension, 10 items in the heart dimension, and 10 items in the spleen dimension. The coordination coefficient is 0.332 (蠂 2 = 505.903, p = 0.0000.005). 3. Clinical pre-investigation, according to the objective screening methods such as difficulty analysis, response characteristic analysis and correlation coefficient method, 56 items were obtained by screening 84 items, forming self-rating scale of Yin deficiency Syndrome (version 2), of which 20 items were in kidney dimension, 20 items in kidney dimension, and 56 items were selected according to the methods of difficulty analysis, response characteristic analysis and correlation coefficient. Liver dimension 22 items, stomach dimension 13 items, lung dimension 12 items, heart dimension 10 items, spleen dimension 10 items. 4. The split-half reliability of the total scale was 0.920, and the split-half reliability of each dimension was more than 0.6. The Cronbach's a coefficient of the total scale was 0.872, and the Cronbach's-a coefficient of each dimension was more than 0.6. The results showed that the total scale had good reliability. The non-parametric test indicated that the scale had good discriminative validity and factor analysis showed that the scale had good structural validity. Conclusion: 1. Through the investigation of relevant literature of Yin deficiency syndrome, this paper summarizes the distribution regularity of common diseases of TCM, western medicine, syndrome type and syndrome element in clinical practice of Yin deficiency syndrome. 2. Literature investigation provides an entry pool for the subsequent development of the scale, also provides the basis for the formation of the dimensions of the scale, and provides a reliable basis for the clinical investigation and selection of cases. 3. The syndrome terminology specification provides a standardized method for creating pool of alternative entries. 4. Combined with Delphi expert consultation and pre-investigation, the items were optimized and screened, and the self-rating scale of Yin deficiency Syndrome (version 2) composed of 56 items was formed (version 2). Through the clinical investigation, the feasibility, reliability and validity of the self-rating scale for Yin deficiency Syndrome (version 2) were evaluated. The results showed that the scale had good feasibility, reliability and validity. It can provide a measurement tool for the diagnosis and identification of Yin deficiency syndrome, and provide reference basis for evaluating the curative effect of Yin deficiency syndrome.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R241
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