两分类项目反应理论在中医证候中的应用  

Application of Item Response Theory in Syndrome of Traditional Chinese Medicine

作　　者：陈炳为[1] 许碧云[2] 陈启光[1] 王澄淑[1] 申春悌[3] 陆岩[3] 郑建光[1] 

机构地区：[1]东南大学公共卫生学院,210009 [2]南京大学医学院附属鼓楼医院,210008 [3]南京中医药大学常州附属医院,213003

出　　处：《中国卫生统计》2011年第1期16-18,21,共4页Chinese Journal of Health Statistics

基　　金：国家自然科学基金(30600512);国家基础研究发展计划(2003CB517101)资助

摘　　要：目的应用项目反应理论研究中医证候量化中证候的效度并评价证候相应的两分类四诊信息的重要性。方法以1280例高血压病肝阳上亢证为例,利用单参数、双参数及三参数分别进行拟合,得到区分度系数、难度系数及信息函数的估计值。结果三个IRT模型中,两参数模型结果最佳。所筛选出的肝阳上亢证九个四诊信息的区分度均有统计学意义,测试信息函数在能力为0.6时达到最大,而且小便黄赤、面红两个指标在能力上信息量分别达到20.48%与19.82%。所筛选出的九个四诊信息能较好地反映肝阳上亢证,其中小便黄赤、面红是两个最重要的指标。结论在中医的证候规范标准研究中应用项目反应理论模型是可行的。Objective Item response theory （IRT） was used to explore the validity of syndrome, and evaluate the importance on binary items of information of four diagnostic methods quantitatively. Methods Taking hyperactivity of liver yang syndrome of hypertension as an exam- ple, one-, two- and three-parameter logistical IRT models were used to esti- mate discrimination and difficulty parameters. Results The two-parame- ter IRT exhibited the most superior goodness-of-fit model from three kinds of model. The model showed that nine discrimination parameters of infor- mation of four diagnostic methods were significant. Test information function reached maximum when ability was 0.6. The information of yellowish or reddish urine and flushed cheeks were about 20. 48% and 19. 82% of total item information function respectively. Nine items showed that the validityfor hyperactivity of liver yang, yellowish or reddish urine and flushed cheeks were the most important indicators of 9 items. Conclusion It is feasibility of IRT in the study of standardization of syndrome differentiation.

关 键 词：项目反应理论 信息函数 证候 四诊信息 

分 类 号：R241[医药卫生—中医诊断学]