在中医理论指导下建立生存质量量表的必要性分析  

On the necessity of developing quality of life instruments in traditional Chinese medicine

作　　者：侯政昆[1] 刘凤斌[1] 梁颖瑜[1] 庄昆海[1] 林楚华[1] 李丽娟[1] 

机构地区：[1]广州中医药大学第一附属医院脾胃病科,广东广州510405

出　　处：《中西医结合学报》2011年第5期468-482,共15页Journal of Chinese Integrative Medicine

基　　金：国家自然科学基金面上项目(No.30873215);"十一五"国家科技支撑计划项目(No.2006BAI04A12)

摘　　要：在中医理论指导下建立的生存质量量表日益增多,作者从理论和实践两个方面探讨其建立的必要性并分析跨医学体系应用时是否需要调适。理论分析显示,中西医量表有共同的测评目标,中医量表能更好地反映国内人群的期待和习惯;在实践层面,从数据库中检索到47个中医量表,其中17个中医量表有18个对应的西医量表。比较中西医量表发现,在领域层次,除共同关注生理、心理、社会因素外,中医量表更关注形神统一、人与自然和社会的统一、体质等;在方面层次,中医量表更关注情绪、主动的社会交际、中医症状和证候特点、饮食口味、睡眠、大小便等。另外,对共同关注的领域其条目询问角度也有明显差别,其他方面两者无明显差异。跨医学体系使用时若无明显的学科特色术语则无需调适,但需注意文化差异可能的影响。因此,理论分析认为中医量表可弥补西医量表在国内应用时的局限,实践分析显示中医量表有卓越的信息覆盖和挖掘能力,中西医量表需要也有能力相辅相成,共同服务于大中华文化体系。在相同文化背景下跨中西医学体系使用对方量表时原则上不需调适,但期待基于严谨设计下的临床试验数据支持。The development of health-related quality of life （HRQL） instrument in traditional Chinese medicine （TCM） is increasing rapidly in China,but few studies focus on their necessity. This study explores the necessity of the development of TCM instruments from both theoretical and practice perspectives,and aims to explain whether the adoption of the cross-medical style is valid. Through theoretical analysis,both TCM and Western medicine instruments show the same objectives,whereas TCM instruments are more suitable for the Chinese social behavior,customs and expectations. In practical analysis,47 TCM instruments were identified,among which 17 had 18 corresponding Western medical instruments. In the domains layer,except for physiological,psychological and social factors,TCM instruments focus more on the harmony between body and spirit,humanity and nature or human and society and the constitution,etc. In the facts layer,TCM instruments focus on the emotions,initiative social intercourse,TCM symptoms,diet,sleep,taste,feces and urine,etc. In addition,significant differences existed in the methods of information selection. There is no need to modify cross-medical style research except when TCM characteristic terms exist,but attention must be paid to the influence of culture in different areas. Therefore,the TCM instruments can resolve the limitations of the application of Western medical instruments to the Chinese setting,while also having remarkable abilities of information coverage and detection. Both forms of instruments have the capacity and requirement to inter-communicate with each other in order to serve the whole Chinese cultural system. Generally speaking,there is no need to modify the instruments in cross-medical style research. But this point requires further demonstration in the rigorous designed clinical trials.

关 键 词：患者报告结局 生存质量 量表 中医 

分 类 号：R195[医药卫生—卫生统计学]