3个不同条目版本中医体质量表的最小临床重要差值研究  

The minimum clinically important difference in three different versions of the Constitution in Chinese Medicine Questionnaire

作　　者：朱燕波[1,2] 丛建妮 史会梅[2] ZHU Yanbo;CONG Jianni;SHI Huimei(School of Management,Beijing University of Chinese Medicine,Beijing102488,China;Research Center for Quality of Life Assessment and Health Management,School of Management,Beijing University of Chinese Medicine,Beijing 102488,China;School of Chinese Medicine,Beijing University of Chinese Medicine,Beijing 102488,China)

机构地区：[1]北京中医药大学管理学院,北京102488 [2]北京中医药大学管理学院生命质量测评与健康管理研究中心 [3]北京中医药大学中医学院

出　　处：《北京中医药大学学报》2023年第5期681-688,共8页Journal of Beijing University of Traditional Chinese Medicine

基　　金：北京市自然科学基金面上项目(No.7222282);国家重点基础研究发展计划(973计划)项目(No.2011CB505403)。

摘　　要：目的估算3个不同条目版本中医体质量表的最小临床重要差值(MCID),以利于中医体质量表在临床的应用。方法纳入研究对象537例,均自愿完成中医体质综合干预(情志、饮食、起居、运动和穴位干预),干预前和干预3个月后均完成60条目中医体质量表和简明健康状况调查问卷(SF-36量表)的填写,41条目和30条目中医体质量表的结果根据60条目中医体质量表的调查结果纳入相应条目后计分得到。采用校标法结合分布法估算3个不同条目版本中医体质量表的MCID。校标法的校标为SF-36量表条目1,计算方法为均值变化法和多元线性回归;分布法采用标准化反应平均数。结果均值变化法和多元线性回归法计算结果的平均值,四舍五入取整数后估算中医体质量表平和质、气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质和特禀质各亚量表的MCID,60条目分别为5、-5、-3、-3、-4、-4、-4、-4和-2,41条目分别为4、-6、-4、-2、-4、-4、-4、-4和-2,30条目分别为5、-5、-4、-3、-4、-5、-4、-5和-2。校标法估算的3个不同条目版本的MCID,除特禀质外均高于标准化反应平均数为0.2时估算的结果。结论本研究估算的3个不同条目版本中医体质量表MCID反映了患者认为重要且有意义的中医体质量表的最小评分变化,有助于医生更好地解释中医体质干预的效果或设定干预目标。Objective We aimed to determine the minimum clinically important difference(MCID)of three different item versions of the Constitution in Chinese Medicine Questionnaire(CCMQ),to facilitate the clinical application of CCMQ.Methods In total,537 subjects were included in the analysis.All subjects voluntarily completed a comprehensive of traditional Chinese medicine(TCM)constitution intervention(mood,diet,daily living,exercise,and acupoints).The subjects filled out the 60-item CCMQ and the Short Form Health Questionnaire(SF⁃36)at baseline and 3 months after the intervention.The result of the 41⁃item and the 30⁃item CCMQ were scored according to the result of the 60⁃item CCMQ.An anchor⁃based approach and a distribution⁃based approach were used to estimate the MCID of the three versions of the CCMQ.The anchor of the anchor⁃based approach was SF⁃36 item 1,and the Journal of Beijing University of Traditional Chinese Medicine analysis method were the mean change method and multiple linear regression.The standardized response mean(SRM)was used for the distribution⁃based approach.Results The mean change method and multiple linear regression estimation result were averaged and rounded to whole numbers.The MCID values of the 60⁃item CCMQ of balanced type,qi⁃deficiency type,yang⁃deficiency type,yin⁃deficiency type,phlegm⁃dampness type,dampness⁃heat type,blood⁃stasis type,qi⁃depression type,and special diathesis type were 5,-5,-3,-3,-4,-4,-4,-4,and-2,respectively.The MCID values of the 41⁃item CCMQ were 4,-6,-4,-2,-4,-4,-4,-4,and-2,respectively.The MCID values of the 30⁃item CCMQ were 5,-5,-4,-3,-4,-5,-4,-5,and-2,respectively.The MCID values estimated by the anchor⁃based approach were higher than those estimated when SRM was 0.2,except for the special diathesis type.Conclusion The MCID values of three different versions of the CCMQ estimated in this study can reflect the minimum score change of the CCMQ considered important and meaningful by patients,which is helpful for doctors in explain

关 键 词：中医体质 中医体质量表 最小临床重要差值 生命质量 临床评价 

分 类 号：R2-03[医药卫生—中医学]