腰椎管狭窄症神经性跛行相关量表的测量学性能评价  

Psychometric properties of outcome measurements of walking limitation with neurogenic claudication due to lumbar spinal stenosis

作　　者：孙亚男[1] 翁志文[2] 苑艺 陈千吉 周彦吉 刘长信[2] 刘焰刚[2] 李多多[2] 王锡友[2] 于长禾[2] SUN Yanan;WENG Zhiwen;YUAN Yi;CHEN Qianji;ZHOU Yanji;LIU Changxin;LIU Yangang;LI Duoduo;WANG Xiyou;YU Changhe(Traditional Chinese Medicine Department,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Tuina and Pain Management Department,Dongzhimen Hospital Affiliated to Beijing University of Chi-nese Medicine,Beijing 100700,China;Dongzhimen Hospital Affiliated to Beijing University of Chinese Medi-cine,Beijing 100700,China)

机构地区：[1]首都医科大学宣武医院中医科,北京100053 [2]北京中医药大学东直门医院推拿疼痛科,北京100700 [3]北京中医药大学第一临床医学院,北京100700

出　　处：《中国疼痛医学杂志》2021年第5期354-361,共8页Chinese Journal of Pain Medicine

基　　金：国家自然基金青年项目(81803956);首都卫生发展科研专项青年优才项目(首发2020-4-4195)。

摘　　要：目的:评价和比较腰椎管狭窄症神经性跛行(neurogenic claudication,NC)量表的测量学性能。方法:系统检索6个中英文数据库,构建腰痛结局测量工具性能研究的文献库,纳入腰痛人群的效度研究。在量表心理测量学性能及其研究方法学质量评价的基础上,综合评价量表的证据等级。结果:数据库包含123篇文献,纳入量表效度研究10篇,包含11个测量工具。根据基于共识选择健康测量工具的标准COSMIN,7个研究的方法学质量被评为优秀,4个好,6个一般,2个差。综合证据结果:内部一致性评价证据为好的量表包括瑞士脊柱狭窄问卷(Swiss Spinal Stenosis Questionnaire,SSSQ)的生理功能维度(physical functional scale,PFS),重复性评价证据为好的量表包括PFS、PFS步行条目(PFS walk)、Oswestry残障指数(Oswestry disability index,ODI)步行条目(ODI walk),结构效度评价证据为好的量表包括健康效用指数步行条目(health utilities index mark 3 ambulation,HUI3 AMb)、牛津跛行量表(Oxford claudication scale,OCS)步行速度条目(OCS-speed)、自我评估步行距离(self-predicted walking,SPW)、ODI walk,效标效度评价证据为好的量表包括HUI3 AMb,反应度尚未有证据好的量表。结论:现有证据推荐使用ODI walk作为评价腰椎管狭窄症神经性跛行的测量工具。Objective:To compare the measurement performance of the neurogenic claudication(NC)scale for lumbar spinal stenosis.Methods:We searched 6 databases and constructed a document database of the study on the performance of the measurement tools for low back pain outcomes,and included the validity study of low back pain population to evaluate the measurement performance.Evaluation criteria of the measurement properties and study quality,the evidence level of the scale was evaluated based on the consistency of all the research results of each measurement performance and the quality of the research methodology.Results:A database containing 123 articles was established.After full text reading,10 studies which assessed the properties of scales were extracted,including 11 measurements.According to the COSMIN standard,the methodological quality of 7 studies was rated as excellent,4 good,6 fair,and 2 poor.The overall evidence showed that the scale with good internal consistency included PFS,the scale with good test-retest reliability included PFS,PFS walk,ODI walk,and the scale with good structure validity included HUI3 AMb,OCS-spd,Self-predicted walking short and ODI walk.The scale with good criterion validity included HUI3 AMb,and the response validity was affected by the quality of research methodology,so there is no good scale.Conclusion:Available evidence recommends that clinicians and researchers use ODI Walk as a measurement tool to evaluate neurogenic claudication in lumbar spinal stenosis.

关 键 词：腰椎管狭窄症 神经性跛行 信度 效度 腰痛 功能受限 

分 类 号：R681.5[医药卫生—骨科学]