腰椎间盘突出症疗效评定中国量表的研制与验证  

The development and validation of Chinese scale for the efficacy evaluation of lumbar disc herniation

作　　者：姜晓涵 孙涛[1] 李石耀 卞晓恩 陈阳 王珺楠[1] Jiang Xiaohan;Sun Tao;Li Shiyao;Bian Xiaoen;Chen Yang;Wang Junnan(Department of Painology,Shandong Provincial Hospital Affiliated to Shandong University,Jinan City,Shandong Province 250021,China)

机构地区：[1]山东大学附属省立医院疼痛科,济南市250021

出　　处：《中华疼痛学杂志》2023年第3期396-407,共12页Chinese Journal Of Painology

基　　金：国家自然科学基金(81972145);山东省自然科学基金(ZR2020MH283)。

摘　　要：目的制订并验证适合中国国情的腰椎间盘突出症疗效评定中国量表。方法(1)构建预量表,根据腰椎间盘突出症的常见临床特征,参照国际量表制作流程,编写量表题项,构建适用于我国的腰椎间盘突出症疗效评定中国量表的初稿,经小范围调查和预试验修订后形成预量表;(2)预量表的验证,暂定版量表的形成,采用预量表对148例在山东省立医院疼痛科住院治疗的已被明确诊断为腰椎间盘突出症的患者进行较大范围临床调查,通过条目分析筛选条目,并通过信度、效度检验形成暂定版量表。经反应度、认可度测评,考评量表的科学性和可行性,并进行诊断性评价。结果量表的信效度良好,其中,标准化后的Cronbach'sα系数为0.784;KMO值为0.730,Bartlett球形检验P均<0.05,探索性因子分析共提取出3个公共因子,累计方差贡献率54.840%,各条目因子载荷介于0.335与0.884之间;治疗前后与JOA下腰痛评分系统的Pearson相关系数分别为0.643、0.669,P均<0.05;AUC值为0.875,灵敏度为62.3%,特异度为100.0%,截断值为0.75,约登指数0.623;认可度为99.3%;量表在治疗前后效应大小(ES)为2.46,标准化反应均数(SRM)为2.56。结论本研究制订的腰椎间盘突出症疗效评定中国量表信度与效度良好,量表结构稳定,诊断价值良好,认可度、反应度较高。Objective To develop and validate a Chinese scale of the efficacy evaluation for lumbar disc herniation suitable for China's national conditions.Methods Firstly,design a pre-scale:according to the common clinical features of lumbar disc herniation and referring to the international scale development process and the scale entries,the preliminary draft of the Chinese scale for the efficacy evaluation of lumbar disc herniation was constructed,and a pre-scale was formed after a small range of investigation and pre-test revision.Secondly,validation of the pre-scale and formation for the tentative version of the scale:a large range of clinical investigations were conducted on 148 patients with lumbar disc herniation in the Pain ology Department of Shandong Provincial Hospital.The entries were screened through entry analysis,and a tentative version of the scale was formed by reliability and validity tests.The scientific and feasibility of the scale were evaluated by the responsiveness and recognition,and the diagnostic evaluation was carried out.Results The validity and reliability of the scale were positive,the standardized Cronbach's α was 0.784;the KMO value was 0.730,the P value of Bartlett spherical test<0.05,with the exploratory factor analysis extracting three common factors with a cumulative variance contribution of 54.840%and factor loadings ranging between 0.335 and 0.884 for each entry;the Pearson correlation coefficients with JOA low back pain scoring system were 0.643 and 0.669 respectively before and after treatment(all P<0.05);the AUC value was 0.875,with a sensitivity of 62.3%,a specificity of 100.0%,a cut-off value of 0.75 and a Youden's index of 0.623;the recognition rate was 99.3%;the effect size and standardized response means values were 2.46 and 2.56 respectively before and after treatment.Conclusion The Chinese scale for assessment efficacy of lumbar disc herniation designed has high reliability,validity and stable structure.The diagnostic value of the scale is positive,and the recognition and re

关 键 词：腰椎间盘突出症 量表 疼痛科 中国版 疗效评定 

分 类 号：R681.53[医药卫生—骨科学]