基于项目反应理论的中风病证候要素评价量表的条目筛选  

Items Selection of Stoke Syndrome Factor Evaluation Scale:Based on Item Response Theory

作　　者：张杨[1] 高颖[2] 马斌[2] 钟海珍[3] 柳伟伟[4] 王琪[4] 

机构地区：[1]首都医科大学附属北京朝阳医院,北京市朝阳区工体南路8号100020 [2]北京中医药大学东直门医院 [3]南京医科大学第二附属医院 [4]中国军事科学院生物信息统计咨询中心

出　　处：《中医杂志》2016年第8期649-652,共4页Journal of Traditional Chinese Medicine

基　　金：国家科技重大专项(2009ZX09502-028)

摘　　要：目的基于项目反应理论对中风病证候要素评价量表条目进行筛选与优化。方法收集410例中风病患者临床信息,在前期研究所形成的条目池基础上,采用两参数的Logistic项目反应模型分别计算各条目的项目信息函数,以删除项目信息函数值<0.1的条目为标准进行条目筛选。结果内风证分量表中项目信息函数值≥0.1的条目数过少,故将其条目按项目信息函数值<0.01进行删除,共删除近48 h内病情加重或波动、瞳神异常(瞳孔缩小、散大或不等)、口噤、项强、肢体僵硬状态、舌短缩、弦脉7个条目;按照筛选标准内火证删除滑脉1个条目;痰湿证删除恶心呕吐、胖大舌或齿痕舌、厚苔、腻苔4个条目;血瘀证删除肌肤不仁、涩脉2个条目;气虚证删除大便或小便失禁、缓脉或弱脉、细脉3个条目;阴虚证删除耳鸣、腰膝酸软、弦脉、细脉4个条目。结论形成了含76个条目的基于项目反应理论的中风病证候要素评价量表(初表),其中内风证8个条目、内火证24个条目、痰湿证12个条目、血瘀证8个条目、气虚证15个条目、阴虚证9个条目。Objective Selecting and optimizing items of Stoke Syndrome Factor Evaluation Scale based on item response theory. Methods Clinical information of 410 cases of stroke was collected. Logistic item response model of two parameters was adopted to calculate item information function of each item respectively,based on the item pool formed in the previous study. Items were selected based on the standard of deleting items with item information function value smaller than 0. 1. Results There were too little amount of items with item information function value greater than or equal to 0. 1 in sub-scale of endogenous wind syndrome. Consequently,its items were deleted on the standard of item information function value smaller than 0. 01. Totally 7 items were deleted,including items of aggravation or unstable condition within the current 48 h,abnormal pupil god（ myosis,mydriasis or anisocoria）,lockjaw,stiff neck,rigidity of the limbs,ankyloglossia,and string-like pulse; One item（ slippery pulse） was deleted in subscale of endogenous fire syndrome according to the selecting standard; Four items（ nausea and vomiting,enlarged tongue or tooth-printed tongue,thick fur,and greasy fur） were deleted in sub-scale of phlegm-dampness syndrome;Two items of numbness of skin and muscle,and uneven pulse were deleted in sub-scale of blood stasis syndrome;Three items of incontinence of urine or feces,moderate pulse,weak pulse or thready pulse were deleted in sub-scale of Qi deficiency syndrome; And four items of tinnitus,soreness and weakness of waist and knees,string-like pulse and thready pulse were deleted in sub-scale of Yin deficiency syndrome. Conclusion The Stroke Syndrome Factor Evaluation Scale（ a preliminary scale） is formed based on item response theory. It contains 76 items,among which there are8 items of endogenous wind syndrome,24 items of endogenous fire syndrome,12 items of phlegm-dampness syndrome,8 items of blood stasis syndrome,15 items of Qi deficiency syndrome,and 9 items of Yin deficiency syndrome.

关 键 词：项目反应理论 中风病 证候评价量表 条目筛选 

分 类 号：R277.7[医药卫生—中医学]