中医肝脏常见四证评定量表的初步研究  

Preliminary development and evaluation of scales for the four mainly syndromes in liver disease of traditional Chinese medicine

作　　者：陈泽奇[1] 郭全[1] 刘小珍[1] 傅擎宇[1] 

机构地区：[1]中南大学湘雅医院中西医结合研究所,湖南长沙410008

出　　处：《中国医学工程》2007年第8期660-664,共5页China Medical Engineering

基　　金：湖南省卫生厅中医药科研基金资助课题(No.24101);湖南省重点学科经费资助

摘　　要：目的编制中医肝脏常见四证(肝阳上亢证、肝胆湿热证、肝火上炎证、肝气郁结证)的评定量表,为四证提供有效的证候识别及疗效评定工具。方法根据心理学评定量表及WHO生活质量量表的研究方法,通过文献研究、大样本流行病学调查资料的回顾、专家讨论、条目分析及经验性筛选等方法建立量表,通过对448例患者的测试,对量表的信度和效度进行了考核。结果编制出由14项条目组成的肝阳上亢证评定量表,由13项条目组成的肝胆湿热证评定量表,由14项条目组成的肝火上炎证评定量表,由10项条目组成的男性肝气郁结证评定量表,和由14项条目组成的女性肝气郁结证评定量表。5个量表的分半信度系数介于0.683～0.863,克朗巴赫α系数介于0.8123～0.8992。因子分析显示量表的结构效度良好。结论初编中医肝脏常见四证的评定量表均具有较好的信度和效度,对于四证的证候识别和疗效评价有一定的临床应用价值。[Objective] To develop specific scales for the four mainly syndromes in Liver disease of traditional Chinese medicine and to offer effective instruments for differentiating and evaluating the syndromes. [Methods] According to the methods and theory of life quality scale of WHO and scale of psychology and according to relative researches, we established the scales through studying of the documents, reviewing the large scale investigation of clinical epidemiology of liver syndrome, discussion of the experts in TCM, item study and experienced selection. Through the test of 446 patients, we evaluated the reliability and validity of the scales. [Results] A 14-item Self-rating scale for excessive rise of liver - Yang syndrome （ERLYS）, a 13-item self-rating scale for damp-heat in liver and gallbladder syndrome （DHLGS）, a 14-item self-rating scale for liver-fire ascending syndrome, a 10-item self- rating scale for male patients with liver-qi stagnation syndrome, and a 14-item self-rating scale for female patients with liver-Qi stagnation syndrome were developed and showed good reliability and validity. The Cronbach＇s Alpha coefficients of the five scales were between 0.8123 and 0.8992. The split-half reliability coefficients were between 0.683 and 0.863. The structure of the scales were similar to the theory construction. [Conclusion] The scales for the four mainly syndromes in liver disease of traditional Chinese medicine are reliable and valid, and they can be used to differentiate and evaluate the four syndromes.

关 键 词：肝阳上亢证 肝胆湿热证 肝火上炎证 肝气郁结证 评定量表 

分 类 号：R256.4[医药卫生—中医内科学]