原发性高血压肝阳上亢证评定量表的初步编制及考评  

Preliminary development and evaluation of the scale for primary hypertension with excessive rise of liver-yang

作　　者：郭全[1] 陈泽奇[1] 刘小珍[1] 申定珠[1] 

机构地区：[1]中南大学湘雅医院中西医结合研究所,湖南省长沙市410008

出　　处：《中国临床康复》2006年第43期20-23,共4页Chinese Journal of Clinical Rehabilitation

基　　金：湖南省卫生厅中医药科研基金资助项目(24101)~~

摘　　要：目的:编制原发性高血压肝阳上亢证评定量表,为该证提供有效的证候识别及疗效评定工具。方法:对2005-08/2006-07中南大学湘雅医院门诊和住院患者128例进行肝阳上亢证自评量表测试,考核量表的信度、效度、反应度和可接受性。原发性高血压肝阳上亢证患者98例,为肝阳上亢组;肝肾阴虚患者30例,为肝肾阴虚组。此表根据心理学评定量表及WHO生活质量量表的研究方法,参考相关研究,通过文献研究、大样本流调资料的回顾、专家讨论、条目分析及经验性筛选等方法建立,各条目按其等级指标依次计0～4分,绝大多数条目采用5级评分方法个别难以细分的条目采用3～4级评分法。根据WHO推荐的筛选条目的标准及有关条目筛选方法,以实测数据采用以下6种方法进行联合筛选:①变异度法。②t检验法。③反应度分析。④相关系数法。⑤因子分析法。⑥克朗巴赫α系数法。结果:参与者128例均进入结果分析。编制出由阳亢、阴虚2个维度共14个条目组成的肝阳上亢证自评量表。①量表的信度:阳亢纬度、阴虚纬度及总量表的复本信度系数分别为0.973、0.952和0.976,分半信度系数分别为0.8588、0.7823和0.8632,克朗巴赫α系数分别为0.8992、0.8123和0.8925。②量表的结构效度和区分效度:因子分析提取2个公因子累积方差贡献率为56.121%,量表结构与理论构想相符。肝阳上亢组与肝肾阴虚组的量表测试结果间有极显著性差异(t=12.858,P<0.001)。③量表的反应度:30例肝阳上亢患者治疗前后的量表评测结果间有极显著性差异(t=14.630,P<0.001)。结论:原发性高血压肝阳上亢证评定量表具有较好的信度、效度和反应度,可用于该证的证候识别和疗效评价。AIM： To develop a specific scale for primary hypertension with type of excessive rise of liver-yang （ERLY） and offer an effective instrument for differentiating and evaluating the syndrome. METHODS： A total of 128 out-patients or inpatients, including 98 primary hypertension patients with ERLY and 30 patients with deficiency of the liver and kidney yin, were selected from Xiangya Hospital of Central South University between August 2005 and July 2006, and received the test of ERLY to evaluate the reliability, validity, response and acceptability of scale. This scale adopted the psychological rating scale, life quality scale of WHO, relative researches, reviews of large samples investigation of clinical epidcmiology, discussion of the experts, item study and experienced selection. And each item of scale was ranked as 0-4 grades, except that 3-4 grades for some specific items that were difficult to distinguish. Measured data were screened out with the following methods： ①degree of variation;②t test;③degree of reaction;④correlation coefficient; ⑤factor analysis;⑥crenbach-α coefficient. RESULTS： All 128 subjects were involved in the result analysis. An 14-item scale for primary hypertension with type of ERLY was adopted, including two domains （deficiency of yin and excess of yang）. ①The alternative-form reliability coefficients of the scale for excess of yang, deficiency of yin and the overall scale were 0.973, 0.952 and 0.976 respectively. The cronbach-α coefficients were 0.899 2, 0.812 3 and 0.892 5 respectively. The split-half reliability coefficients were 0.858 8, 0.782 3 and 0.863 2 respectively. ②Construct validity and discrimination validity： Twocommon factors were extracted and accounted for the accumulative variance contnbution of 56.121%. The structure of the scale was similar to the theory construction. There were extremely significant differences between the test results of ERLY obtained from the two syndromes （t=12.858, P 〈 0.001）.③Degree of reaction： The r

关 键 词：高血压 肝阳上亢 证候 辨证分型 

分 类 号：R554.1[医药卫生—血液循环系统疾病]