原发性骨质疏松症患者中医量表的信度及效度研究

Reliability & Validity Research on Measuring Scale of Traditional Chinese Medicine for Primary Osteoporosis Patients

目的评测并验证骨质疏松症中医量表。方法以历代医家对骨质疏松症的经验辨证作为量表构想框架,各证型的诊断标准作为条目编制大纲,通过小组讨论的形式确定量表条目池,以问卷调查形式,测评100例原发性骨质疏松患者,用验证性因子分析及Spearman相关分析验证。结果信度检验:各因子分的重测相关系数在0.823～0.897之间;量表总分重测相关系数是0.914;分半信度系数为0.832;中医量表内部一致性:α=0.829。效度检验:1结构效度:在Amos4.0中绘制通径图拟合模型,结果提示模型拟合合理。2关联效度:四个因子与总分的相关系数分别为:r=0.730(痰浊因子),r=0.714(肾虚因子),r=0.807(脾虚因子),r=0.742(血瘀因子);以西医骨质疏松生活质量量表(OQOLS)量表作为效标,观察到两个量表总分的相关系数为0.636。结论骨质疏松中医量表和OQOLS量表在骨质疏松患者生活质量的评价上有很好的相关性。同时,该量表还体现了中医辨证分型的特点。

Objective To establish the measuring scale for primary osteoporosis patients （POP） according to traditional Chinese medicine and inspect its reliability and validity. Methods The differentiation experience of doctors of past ages for osteoporosis was taken as the frame and the diagnosis criteria of different TCM syndromes as the outline of measuring scale. The item pool was established through group discussion. The questionnaire was used to evaluate the 100 primary osteoporosis patients. The reliability and validity of measuring scale were inspected through confirmatory factor analysis （CFA） and relevant analysis of Spearman. Results Reliability Inspection： The relevant coefficient of test-retest for all scores was 0. 823-0. 897, The relevant coefficient of test-retest for total score of measuring scale was 0. 914. The reliability coefficient of split-half was 0. 832. The internal consistency of measuring scale of traditional Chinese medicine was a= 0. 829. Validity Inspection ： ①Construct validity： protracting path diagram fitting models in Amos 4.0, the result was that model fitting was reasonable.②Criterion-related validity： relevant coefficient for 4 factors and total score in measuring scale was r= 0. 730 （factor of sputum-damp）, r = 0. 714 （factor of kidney deficiency）, r= 0. 807 （factor of spleen deficiency）, r=0. 742 （factor of blood stasis） ; taking the measuring scale of OQOLS of western medicine as criterion of curative effect, the relevant coefficient of the two measuring scales＇ total score was 0. 636. Conclusion The measuring scale and OQOLS scale have a good correlation on evaluating the life quality of POP. Meanwhile, this scale reflects well the characteristics of syndrome differentiation of Chinese medicine.