《溃疡性结肠炎脾气虚证诊断量表》的研制及评价  

Development and evaluation of Chinese medicine diagnostic scale for spleen Qi deficiency syndrome in ulcerative colitis

作　　者：朱磊[1] 刘小娟 沈照峰 沈洪[1] ZHU Lei;LIU Xiaojuan;SHEN Zhaofeng;SHEN Hong(Department of Gastroenterology,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,210029,China;Department of Spleen and Stomach Diseases,Nanjing Gaochun Hospital of Traditional Chinese Medicine)

机构地区：[1]南京中医药大学附属医院消化科,南京210029 [2]南京市高淳中医院脾胃病科

出　　处：《中国中西医结合消化杂志》2025年第1期6-12,共7页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：国家重点研发计划项目(No:2017YEC1700104);国家中医药管理局全国名老中医药专家传承工作室项目。

摘　　要：目的:研制《溃疡性结肠炎脾气虚证诊断量表》,并评价量表的信效度,为溃疡性结肠炎脾气虚证的临床诊断提供参考。方法:通过专家咨询及文献参考构建候选条目池,制定临床病例信息采集表。采用横断面调查方法,运用频数法、区分度法、相关系数法和逐步回归法筛选条目;通过Fisher判别法、二元logistic回归方程对条目赋权,通过ROC曲线下面积及约登指数确定最佳诊断阈值;根据四分位法对量表进行程度划分;通过分半信度、同质性系数对量表的信度进行考评,通过内容效度和结构效度评价量表效度。结果:共采集346例溃疡性结肠炎患者的信息资料,最终筛选确定11个条目构成,条目及权重为大便次数增加(权重值2.2,下同)、大便性状(2.0)、排便状态(2.0)、脓血便(1.8)、肠道症状是否影响学习或生活或工作(1.4)、腹痛与环境关系(1.2)、腹胀(0.6)、神疲乏力(4.5)、舌质淡(2.0)、苔薄白(1.4)、脉细弱(1.2),诊断阈值为10.0。四分位法计算程度为:10.0≤总分<20.4为轻度,20.4≤总分<41.3为中度,总分≥41.3为重度。量表分半信度系数为0.692,同质性系数为0.725,KMO值为0.752,累计方差贡献度为52.4%。结论:《溃疡性结肠炎脾气虚证诊断量表》具有较好的诊断价值,可供临床参考。Objective To develop a Chinese medicine diagnostic scale for spleen Qi deficiency syndrome in ulcerative colitis,and to evaluate its reliability and validity.The goal is to provide a reference for the clinical diagnosis of this syndrome in patients with ulcerative colitis.Methods We constructed a pool of candidate items through expert consultation and literature review,and formulated a clinical case information collection form.A cross-sectional survey was conducted.We screened items using frequency analysis,discrimination analysis,correlation coefficient analysis,and stepwise regression analysis.Fisher's discriminant analysis and binary logistic regression equations were used to assign weights to the items.We determined the optimal diagnostic threshold using the area under the receiver operating characteristic(ROC)curve and the Youden index.The scale was categorized by severity using the quartile method.The reliability of the scale was assessed using split-half reliability and homogeneity coefficient analysis.We evaluated validity of the scale through content and structural validity analyses.Results We collected data from 346 ulcerative colitis patients and,through a rigorous screening process,identified 11 items for the diagnostic scale.The items and their corresponding weights are as follows:increased stool frequency(weight=2.2),stool character(2.0),defecation status(2.0),pus and blood in stools(1.8),interference of intestinal symptoms with study,life,or work(1.4),abdominal pain related to environmental factors(1.2),abdominal distension(0.6),fatigue(4.5),pale tongue(2.0),thin white tongue coating(1.4),and weak pulse(1.2).The diagnostic threshold was set at 10.0.Severity categories based on the quartile method were as follows:10≤total score<20.4(mild),20.4≤total score<41.3(moderate),and total score≥41.3(severe).The split-half reliability coefficient of the scale was 0.692,the homogeneity coefficient was 0.725,the Kaiser-Meyer-Olkin(KMO)value was 0.752,and the cumulative variance contribution was 52.4%.Conc

关 键 词：溃疡性结肠炎 脾气虚证 中医诊断量表 量表效度 

分 类 号：R256.3[医药卫生—中医内科学]