亚健康中医药干预效果评价体系的构建思路

Construction of effectiveness evaluation system for traditional Chinese medicine interventions in subhealth

亚健康对人们生活质量的影响及其高发生率,使得对亚健康状态有效干预措施的需求日益突显,同时,如何评价中医药对亚健康的干预效果也成为值得探索的问题。亚健康的概念宽泛,包括多种不同的类型,如躯体性亚健康和心理性亚健康等;或者以某一种不适症状表现为主,如疲劳性亚健康和疼痛性亚健康等。亚健康人群表现复杂多样,缺乏明确的实验室判定指标;一些主要症状容易受到情境的影响而产生波动。这些因素增加了亚健康干预效果评价的难度。以典型的亚健康状态类型作为研究的切入点,在针对常见中医证候类型而设立的中医药干预方案的基础上,以受试者最关注的中间结局指标为选择原则,确定主、次指标,选择多时点评价的多维度、多层次指标评价体系,是较为客观、可行的亚健康中医药干预效果评价的模式。

The demand of effective interventions in subhealth is growing with more and more people being in subhealth state and poor life quality. It is important to explore how to evaluate the effects of the traditional Chinese medicine （TCM） interventions in subhealth, but it is difficult to conduct such an evaluation because of the broad meaning and varied types of subhealth, such as physical or psychological subtypes. The subtypes may be characterized by one of the symptoms like fatigue or pain, etc. Many symptoms of subhealth have no clear laboratory markers for diagnosis, and some symptoms may fluctuate with psychological and environmental factors. All of the above factors would increase the difficulty of effectiveness evaluation. The typical subtype of subhealth state and the intermediate outcome should be chosen for multidimensionally evaluating the effects of TCM interventions in subhealth at different time points.