基于ICD-11传统医学章节的消渴病伤残权重研究  

Research on Disability Weights of Wasting Thirst Disorder Based on ICD-11 Traditional Medicine Chapter

作　　者：赵兰慧 高婧 周尚成 ZHAO Lanhui;GAO Jing;ZHOU Shangcheng(School of Management,Henan University of Chinese Medicine,Zhengzhou 450046,China;School of Public Health and Management,Guangzhou University of Chinese Medicine,Guangzhou 510006,China)

机构地区：[1]河南中医药大学管理学院,河南省郑州市450046 [2]广州中医药大学公共卫生与管理学院,广东省广州市510006

出　　处：《中国全科医学》2024年第33期4190-4195,共6页Chinese General Practice

基　　金：国家自然科学基金资助项目(81973979,71774049);广东省自然科学基金(2019A1515011496);广东省社科基金(GD19CSH04)。

摘　　要：背景《国际疾病分类第十一次修订本(ICD-11)》的审议通过,首次将包括中医药在内的传统医学章节纳入其中。伤残权重是量化非致死性疾病和伤害对健康损失的权重系数,是衡量疾病负担的重要参数。目的基于ICD-11传统医学章节,调查消渴病伤残权重,为中医疾病负担测算提供参考,为建立与国际标准相衔接并体现中医药卫生服务信息的统计网络奠定基础。方法于2020-06-01—2021-06-01,运用视觉模拟法(VAS)在临床中医师、健康人群中进行消渴病各下位类伤残权重调查。运用带有VAS标尺的欧洲生命质量量表(EQ-5D-3L)在患者中进行伤残权重调查,并对调查结果进行专家意向论证。结果对中医师调查的VAS权重显示,上消0.300(0.185,0.380),中消0.430(0.368,0.568),下消0.585(0.510,0.738),消渴厥0.725(0.660,0.908)。对患者调查的消渴病伤残权重显示,患者VAS转换权重为上消0.310(0.225,0.373),中消0.395(0.335,0.453),下消0.445(0.360,0.513),消渴厥0.590(0.550,0.698);调查员赋值权重为上消0.152(0,0.311),中消0.240(0,0.275),下消0.380(0.186,0.622),消渴厥0.484(0.311,0.814)。对健康人调查的VAS权重显示上消0.210(0.150,0.390),中消0.345(0.260,0.510),下消0.425(0.313,0.748),消渴厥0.640(0.380,0.898)。各调查方式得到的上消、中消、下消、消渴厥伤残权重不同,差异有统计学意义(H=153.883、76.561、34.575、74.014,P<0.001)。上消、中消、下消、消渴厥的对中医师调查的VAS权重、患者VAS转换权重、调查员赋值权重、对健康人群调查的VAS权重比较,差异有统计学意义(H=10.543、35.692、19.924、16.327,P<0.05)。通过专家意向论证,认同了消渴病在标准化框架下按照上消、中消、下消、消渴厥的分类进行伤残权重测算的方法;定性认同了上消、中消、下消、消渴厥伤残权重逐渐加重;基本认同了对中医师调查的伤残权重。结论初步探索了基于ICD-11传统医学章节以及中Background The approval of the International Classification of Diseases 11th Revision(ICD-11) has for the first time included a chapter about traditional medicines that includes TCM.Disease weight(DW) is a weight coefficient that quantifies the health loss caused by non-fatal diseases and injuries,and is an important parameter to measure the burden of disease.Objective Based on the traditional medicine chapter of ICD-11,this study investigates the DW of wasting thirst disorder,which provides a reference for the measurement of TCM disease burden,and lays a foundation for establishing a statistical network that is consistent with international standards and reflects TCM health service information.Methods From June 1,2020 to June 1,2021,the Visual Analogue Scale(VAS) method was adopted to conduct a survey on the DW of each lower category of wasting thirst disorder among clinical Chinese medicine practitioners and healthy people.The EQ-5D-3L with VAS scale was adopted to conduct a DW survey among patients.In addition,the survey results were demonstrated with expert intentions.Results The survey on DW of wasting thirst disorder among TCM practitioners shows that the DWs were 0.300(0.185,0.380) for wasting thirst disorder involving the upper-jiao,0.430(0.368,0.568) for wasting thirst disorder involving the middle-jiao,0.585(0.510,0.738) for wasting thirst disorder involving the lower-jiao,and 0.725(0.660,0.908) for consciousness loss caused by wasting thirst disorder.The survey on DW of wasting thirst disorder among patients shows that the VAS conversion weights of patients were 0.310(0.225,0.373) for diabetes involving the upper-jiao,0.395(0.335,0.453)for wasting thirst disorder involving the middle-jiao,0.445(0.360,0.513) for wasting thirst disorder involving the lowerjiao,and 0.590(0.550,0.698) for consciousness loss caused by wasting thirst disorder;the investigator assigned weights are 0.152(0,0.311) for wasting thirst disorder involving the upper-jiao,0.240(0,0.275) for wasting thirst disorder involving the middl

关 键 词：国际疾病分类第十一次修订本 消渴 伤残权重 中医药信息学 

分 类 号：R-056[医药卫生]