支气管哮喘的中医临床信息评价:中医症状问卷的研制

Evaluation of TCM clinical information in asthma: development of a TCM symptom questionnaire of Asthma

目的研制轻中度支气管哮喘中医症状问卷(traditional Chinese medicine symptoms questionnaire of asthma,TCMSQOA),以补充现代医学支气管哮喘问卷内容,为中医药治疗支气管哮喘临床评价提供一个工具。方法在文献研究和专家咨询的基础上确定支气管哮喘中医症状条目,按照纳入和排除标准从6个临床中心采集支气管哮喘患者中医症状信息,然后分析问卷的信度、效度,以及TCMSQOA与Juniper哮喘生命质量问卷(asthma quality of LifeQuestionnaire,AQLQ)的相关性。结果 TCMSQOA包含28项中医症状条目,概括为5个维度,分别表示哮喘程度(疾病特征)、痰饮、寒、外感、热5个方面。TCMSQOA问卷的内部一致性评价结果 Cronbach’sα系数为:综合分0.90,疾病特征0.88,痰饮0.87,寒0.75,外感0.64,热0.45。TCMSQOA的疾病特征与AQLQ活动受限、哮喘症状和总分相关性较好,相关系数均大于0.7,但两者其他领域之间的相关系数均较小。结论 TCMSQOA能反映轻中度支气管哮喘患者中医症状特征,具有较好的信度和效度,并可补充哮喘疗效评价时痰饮、寒、热及外感方面的信息。

Objective To develop a traditional Chinese medicine symptoms questionnaire of asthma（TCMSQOA）,to complement the content of modern medicine questionnaire of asthma,and to offer a tool to the clinical evaluation of the treatment over asthma.Methods Based on literature research and expert consultant to decide the TCM symptoms＇ item of asthma,and according to specified eligibility and elimination criteria to collect the TCM symptoms of asthma from 6 clinical units,and then analyze the reliability and validity of this questionnaire and the dependability between TCMSQOA and asthma quality of life questionnaire（AQLQ）.Results TCMSQOA included 28 items of TCM symptom,and summarized to 5 dimensions which denoted disease attributes,phlegm retention,cold,exogenous disease and heat.The Cronbach＇sαcoefficient of TCMSQOA in internal conformance assessment were as follow： total score was 0.90,disease attributes was 0.88,phlegm retention was 0.87,cold was 0.75,exogenous disease was 0.64 and heat was 0.45.The relation between the disease attributes of TCMSQOA and limitation of activity,symptoms of asthma and total score of AQLQ has better dependability,which all correlation coefficient were greater than 0.7,but other dimensions has lower correlation coefficient.Conclusion TCMSQOA can reflect the TCM symptoms＇ feature of slight and middle degree asthma and has good reliability and validity,which can complement the information of phlegm retention,cold,heat and exogenous disease in evaluating asthma effect.