中医湿证评估量表用于支气管哮喘慢性持续期患者的信度与效度——一项横断面调查  

Reliability and Validity of Dampness Syndrome Scale of Chinese Medicine Using for Persistent Asthma Patients:a Cross-Sectional Study

作　　者：池逸和 范斐婷 魏书珊 李月炜 肖晶旻 吴蕾 林琳 陈远彬 CHI Yinhe;FAN Feiting;WEI Shushan;LI Yuewei;XIAO Jingmin;WU Lei;LIN Lin;CHEN Yuanbin(State Key Laboratory of Dampness Syndrome of Chinese Mediceine,Guangzhou,510000;The Second Clinical College of Guangzhou University of Chinese Medicine;Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome;Guangdong-Hong Kong-Macao Joint Laboratory for Researeh of Traditional Chinese Medicine and Immune Diseases)

机构地区：[1]省部共建中医湿证国家重点实验室,广东省广州市510000 [2]广州中医药大学第二临床医学院 [3]广东省中医证候临床研究重点实验室 [4]粤港澳中医药与免疫疾病研究联合实验室

出　　处：《中医杂志》2024年第11期1132-1138,共7页Journal of Traditional Chinese Medicine

基　　金：省部共建中医湿证国家重点实验室项目(SZ2021ZZ42,SZ2023ZZ11);广东省科学技术厅科技创新战略专项资金(粤港澳联合实验室)项目(2020B1212030006);广东省科技计划项目(2023B1212060063);广州市中医药防治慢性咳喘病重点实验室(2023A03J0226);广东省中医药局科研项目(20221175,20233020);广东省中医药局林琳省名中医传承工作室(粤中医办函[2023]108号);广东省中医院中医药科学技术研究专项(YN2022MS02);广东省中医院周仲瑛学术经验传承工作室(中医二院[2014]89号)。

摘　　要：目的考察中医湿证评估量表(DSSCM)应用于支气管哮喘(简称哮喘)慢性持续期的信度及效度,探讨湿证与哮喘临床特征的相关性。方法采用横断面调查方法,采集206例哮喘慢性持续期患者基本信息、辅助检查结果以及DSSCM得分、哮喘控制测试问卷(ACT)、广泛性焦虑量表(GAD-7)、抑郁自评工具量表(PHQ-9)评分,评价DSSCM的信度及效度,并分析湿证与哮喘临床特征的相关性。结果206例患者DSSCM平均得分为(14.59±10.53)分,条目总体Cronbachα系数及Spearman-Brown分半信度系数均大于0.8,集合效度和区分效度的实验成功率均大于80%,验证性因子分析示,卡方自由度比值为2.309,近似误差均方根为0.08,均方根残差为0.049,而比较拟合指数、拟合优度指数、调整的拟合优度指数、规范拟合指数及增值拟合指数均<0.9。相关性分析提示,DSSCM得分与病程、GAD-7得分、PHQ-9得分呈正相关(P<0.05),与ACT评分呈负相关(P<0.01)。不同疾病严重程度分级患者间的DSSCM得分差异有统计学意义(H=10.92,P=0.01),过敏患者DSSCM得分高于非过敏患者,差异具有统计学意义(Z=-4.19,P<0.001)。结论DSSCM应用于哮喘慢性持续期患者具有可接受的信度和效度,其得分与哮喘患者病程、ACT得分、GAD-7得分、PHQ-9得分、疾病严重程度及过敏状态存在相关性。Objective To evaluate the reliability and validity of the Dampness Syndrome Scale of Chinese Medicine(DSSCM)among patients with persistent asthma,and to explore the correlation between dampness syndrome and clinical characteristics of persistent asthma.Methods A cross-sectional survey was conducted.Basic information,examination results,DSSCM,Asthma Control Test(ACT),Generalized Anxiety Disorder-7(GAD-7),and Patient Health Questionnaire-9(PHQ-9)scores were collected from 206 patients with persistent asthma to evaluate the reliability and validity of DSSCM and to explore the correlation between dampness syndrome and clinical characteristics.Results The mean score of DSSCM among 206 patients was 14.59±10.53.The overall Cronbachαcoefficient and Spearman-Brown split-half reliability coefficient of the scale were both greater than 0.8,and the success rate of scale convergent and discriminant validity calibration were greater than 80%.The confirmatory factor analysis showed that theχ^(2)/df was 2.309,and the root mean square error of approximation(RMSEA)was 0.08;the root mean square residual(RMR)was 0.049,whereas the comparative fit index(CFI),the goodness of fit index(GFI),the adjusted goodness of fit index(AGFI),the normed fit index(NFI)and the incremental fit index(IFI)were less than 0.9.Correlation analysis showed that DSSCM scores were positively correlated with disease duration,GAD-7 scores,and PHQ-9 scores(P<0.05),and negatively correlated with ACT scores(P<0.01).The DSSCM scores were significantly different between patients with different disease severity(H=10.92,P=0.01),and the DSSCM scores of allergic patients were higher than those of non-allergic patients(Z=-4.19,P<0.001).Conclusion DSSCM has acceptable reliability and validity for patients with persistent asthma.The scores of DSSCM correlated with the disease duration,ACT score,GAD-7 score,PHQ-9 score,disease severity and allergic status of persistent asthmatics.

关 键 词：支气管哮喘 慢性持续期 湿证 量表 

分 类 号：R259[医药卫生—中西医结合]