慢性阻塞性肺疾病中医三维主观报告结局量表的构建及其临床适用性  

Construction and Clinical Applicability of Chinese Medicine Three Domains Report Outcomes Scale for Chronic Obstructive Pulmonary Disease

作　　者：任明[1] 郝娟娟[2] 孙增涛[3] 张虹[3] 封继宏[3] 郭利平[2] REN Ming;HAO Juanjuan;SUN Zengtao;ZHANG Hong;FENG Jihong;GUO Liping(Baokang Hospital, Tianjin University of Chinese Medicine, Tianjin, 300193;Tianjin University of Chinese Medicine;Second Affiliated Hospital to Tianjin University of Chinese Medicine)

机构地区：[1]天津中医药大学附属保康医院,天津市南开区玉泉路88号300193 [2]天津中医药大学 [3]天津中医药大学第二附属医院

出　　处：《中医杂志》2018年第8期654-658,共5页Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局中医药行业科研专项(201107006);天津市科技计划(15ZXLCSY00020);天津市滨海新区卫生计生委科技项目(2016BWKZ001)

摘　　要：目的形成慢性阻塞性肺疾病(COPD)的中医三维主观报告结局(TDROs)量表,并对其临床适用性进行评价。方法通过德尔菲法对TDROs量表中4个子量表的计分权重进行专家意见咨询,进行内部一致性检验,形成统一计分方法。纳入COPD患者40例,在西医规范治疗的基础上给予清肺化痰汤加减,每日1剂,治疗7天。于入院第1、7天进行慢性阻塞性肺疾病评估测试(CAT)问卷评分,并由其医生、护士、家属及患者本人完成TDROs量表。记录40例患者入院时的肺功能数值。通过观察TDROs量表接受率、完成率、完成时间评价其可行性。通过比较患者治疗前后量表的总得分测量量表区分度。分析TDROs量表与CAT问卷及生理指标(肺功能)的相关性。结果设定TDROs量表系统计分权重为患者子量表0.4、医生子量表0.4、护理子量表0.1、家属子量表0.1。通过临床验证,TDROs量表接受率、完成率均为100%,平均完成时间(22.45±3.94)min,具可行性。不同测量时间及不同干预方式的患者状况区分度良好。相关性分析显示,TDROs量表与CAT问卷、肺功能相关性不强,可分别反映COPD患者的不同方面。结论形成的TDROs量表适用于COPD的中医药疗效评价。Objective To construct a Chinese medicine three domains report outcomes（ TDROs） scale for chronic obstructive pulmonary disease（ COPD） and evaluate its clinical applicability. Methods Delphi method was used to conduct expert opinion consultation on the scoring weights of the 4 subscales in the TDROs scale,and internal consistency tests were conducted to form a unified scoring method. Forty patients with COPD were evaluated on the first and seventh day of admission by the Chronic Obstructive Pulmonary Disease Assessment Test（ CAT） questionnaire,and their doctors,nurses,family members,and patients themselves completed the TDROs scale. The pulmonary function values of the 40 patients at admission were recorded. The feasibility was evaluated by observing the acception rate,completion rate and the completion time of the TDROs scale. Distinction was measured by comparing the difference in the total score before and after treatment. The correlation between TDROs scale and CAT questionnaire as well as physiological index（ pulmonary function） were analyzed. Results The weights for the TDROs scale system were set to be 0. 4 for the patient scale,0. 4 for the doctor scale,0. 1 for the nursing scale,and 0. 1 for the family scale. Through clinical verification,the acception and the completion rate of the TDROs scale were both100%,and the average completion time was（ 22. 45 ± 3. 94） min,which is feasible. Patients with different measurement times and different interventions had good differentiation. The correlation analysis showed that the correlation between TDROs scale and CAT questionnaire and lung function was not strong,which could reflect different aspects of COPD patients. Conclusion The formed TDROs scale is applicable to the efficacy evaluation of COPD in Chinese medicine.

关 键 词：慢性阻塞性肺疾病 疗效评价 三维主观报告结局量表 

分 类 号：R259[医药卫生—中西医结合]