精神分裂症中医证候要素诊断量表初步研究  

Establishing traditional Chinese medicine pattern elements diagnostic scale of schizophrenia

作　　者：尹冬青[1] 黄芳 赵安全[3] 王群松[4] 马雁冰 陈进东 李宝君[6] 都弘[7] 贾竑晓[1] Yin Dongqing;Huang Fang;Zhao Anquan;Wang Qunsong;MA Yanbing;Chen Jindong;Li Baojun;Du Hong;Jia Hongxiao(Beijing Key Laboratory for Mental Disorders,Beijing100088,China;XianYue Hospital of Xiamen,Xiamen361012,Fujian Province,China;Mental Health Center of Tangshan,5th Hospital of Tangshan,Tangshan063000,Hebei Province,China;Mental Health Center of Wuxi,Wuxi214063,Jiangsu Province,China;5th People Hospital of LuoYang,Luoyang471000,Henan Province,China;Mental Health Center of Xian,Xian710061,China;Mental Health Center of Shenyang,Shenyang110168,China)

机构地区：[1]首都医科大学附属北京安定医院北京市中西医结合精神卫生研究所北京脑重大疾病研究院精神分裂症研究所精神疾病诊断与治疗北京市重点实验室,北京100088 [2]厦门市仙岳医院,福建厦门361012 [3]唐山市精神卫生中心唐山市第五医院,河北唐山063000 [4]无锡市精神卫生中心,江苏无锡214063 [5]洛阳市第五人民医院,河南洛阳471000 [6]西安市精神卫生中心,西安710061 [7]沈阳市精神卫生中心,沈阳110168

出　　处：《首都医科大学学报》2018年第6期821-827,共7页Journal of Capital Medical University

基　　金：北京市自然科学基金(7152069);首都卫生发展科研专项重点攻关项目(首发2018-1-2122);首都医科大学基础与临床合作课题(16JL84)~~

摘　　要：目的建立精神分裂症中医证候要素诊断量表,促进精神分裂症中医证候标准化研究。方法制定精神分裂症中医证候要素调查表,收集302例精神分裂症患者的四诊信息,对中医四诊信息进行频数分析,保留出现频率> 10%的四诊信息条目,利用因子分析提取中医证候要素和四诊信息条目,运用二项Logistic回归方法进行进一步的条目筛选和确定条目权重系数,不同四诊信息权重系数不同,对302例患者进行重新打分,以专家辨证所得的证候要素为状态变量(Y),以重新打分所获得的证候要素分值作为检测变量(X)进行受试者工作特征(receiver operating characteristic,ROC)曲线分析,确定各证候要素的诊断阈值。结果精神分裂症中医证候要素诊断量表包含病位类证候要素6项,分别为:火热、气虚、气滞/气郁、阴虚、血瘀和阳虚,病位类的证候要素4项,分别为:心、肝、脾、胆,每一证候要素诊断量表的总分为100分,诊断域值为60分。结论精神分裂症中医证候要素诊断量表的研制将促进精神分裂症中医证候标准化工作的开展。Objective To establish a traditional Chinese medicine(TCM)pattern element diagnostic scale of schizophrenia and promote the development of TCM syndrome standardization for schizophrenia.Methods The questionnaire of TCM pattern element of schizophrenia was designed,and TCM four diagnostic data from302schizophrenia cases were collected.The four diagnostic data were analyzed with occurrence frequency,the items of four diagnostic data with occurrence frequency>10%were retained.TCM pattern elements and the items of four diagnostic data were extracted based on factor analysis.Binary Logistic regression analysis was used to identify the items with different weight coefficient.Totally302schizophrenia cases were scored with these items.Then,TCM pattern elements diagnosed by TCM experts were set as variables(Y),the scores of TCM pattern elements obtained with the above items with different weight were set as variables(X),and diagnostic threshold was determined with receiver operating characteristic(ROC)curve.Results The TCM pattern element diagnostic scale for schizophrenia was established based on302schizophrenia cases.There were10pattern elements in the scale,including8TCM pattern elements of disease nature(fire-heat,Qi-deficiency,Qi-stagnation,Yin-deficiency,blood stasis,and Yang-deficiency)and4TCM pattern elements of disease location(Heart,Liver,Spleen,and Gallbladder).The total scale of every TCM pattern element diagnostic scale was100,with diagnostic threshold as60.Conclusion The establishment of TCM pattern elements diagnostic scale for schizophrenia will promote the standardization of TCM syndrome of schizophrenia.

关 键 词：精神分裂症 证候要素 诊断量表 

分 类 号：R749.3[医药卫生—神经病学与精神病学]