反流性食管炎证素诊断量表的编制研究  

The study of diagnosis scale for reflux esophagitis syndrome factors

作　　者：师宁[1,2] 陈建新[3] 刘敏[2] 李晓林[2] 李志红[2] 苏泽琦[2] 张寅[2] 刘福生[2] 丁霞[3] 

机构地区：[1]首都医科大学电力教学医院,北京100073 [2]北京中医药大学东直门医院 [3]北京中医药大学

出　　处：《现代中医临床》2014年第6期9-12,共4页Modern Chinese Clinical Medicine

基　　金：国家自然科学基金(No.81270466);教育部高等学校博士学科点专项科研基金(No.20120013110014)

摘　　要：目的运用量表学原理进行反流性食管炎证素诊断量表的编制研究。方法综合离散趋势法、集中趋势分析(频数分布法)、因子分析法、复杂网络法、复杂系统熵聚堆法、克朗巴赫系数法,筛选条目,以复杂系统熵聚堆法提取四诊条目并确定四诊信息对证候的贡献分值,对条目完成赋分。以ROC曲线确定证候诊断阈值,完成反流性食管炎证素诊断量表的编制。利用诊断试验完成量表的灵敏度、特异度和符合率评价。结果编制完成了反流性食管炎证素诊断量表,由气滞证、热证、痰湿证、气虚证、阳虚证、血瘀证6个分量表构成,其条目分别为9,8,4,5,2,2个,显示出较高的诊断价值。诊断试验评价显示各分量表灵敏度、特异度、准确率均较高。结论借助证素量表这个媒介,综合运用数理学统计方法研究疾病的中医辨证,可使中医证候诊断迅速、标准,并可以重复。Objective Scale principles are used to make a diagnosis scale for reflux esophagitis syndrome factor. Methods Combination of tendency of dispersion method, central tendency method, factor analysis method, complex network method, complex system entropy clustering method and Crowns Bach coefficient method were used for item screening. Complex system entropy clustering method was used to extract the four diagnostic methods and assure their contributive scores for syndrome in order to get a score. Receiver operating characteristic （ROC） curves was used to confirm the threshold value for syndrome diagnosis, thus to complete the diagnosis scale for reflux esophagitis syndrome factor. Diagnostic tests was used to evaluate the sensitivity, specificity and coincidence rate of the scale. Results The diagnosis scale for reflux esophagitis was composed of six scales, qi stagnation syndrome, heat syndrome, phlegm-dampness syndrome, qi deficiency syndrome, yang deficiency syndrome and blood stasis syndrome, with the number of item 9, 8, 4, 5, 2, 2, which had high diagnosis value. The sensitivity, specificity and coincidence rate of the scale were high in diagnostic test evaluation. Conclusion Combination of the syndrome factor and mathematical statistical method to study the syndrome differentiation of Chinese medicine could make a fast and accurate diagnosis, which can be repeated.

关 键 词：反流性食管炎 证素 诊断量表 

分 类 号：R256[医药卫生—中医内科学]