原发性骨质疏松症患者中医量表的初步编制

Preliminary Design of Chinese Medicine Scale for Primary Osteoporosis

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150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0.821~0.902之间;量表总分重测相关系数为0.904;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：4个因子与总分的相关系数分别为：痰浊因子r=0.830,肾虚因子r=0.891,脾虚因子r=0.833,血瘀因子r=0.879;以西医骨质疏松生活质量量表（OQOLS）作为效标,2个量表总分的相关系数为0.752。结论：骨质疏松中医量表和OQOLS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 evaluate and testify Chinese medicine scale for primary osteoporosis（PO）. Methods With the syndrome types for PO summarized by the ancient experienced physicians as the design frame, and with the criteria of syndrome types as the item outline, item pool of the scale was established through group discussion. The questionnaire was applied in 150 PO patients for the verification after confirmatory factor analysis（CFA） and relevant analysis of Spearman. Results： （1） The results of reliability test showed that the test-retest relevant coefficient for the scores of each factor was 0.821 - 0.902, and the test-retest for the total scores of the scale was 0.904. The split-half reliability coefficient was 0.832. The results of the internal consistency of the CM scale showed that Cronbach＇s α coefficient was 0.829.（2） The results of construct validity analysis showed that model fitting was reasonable presented by path diagram fitting models in Amos4.0. The results of criterion-related validity analysis showed that relevant coefficient of 4 factors of phlegm turbidity, kidney deficiency, spleen deficiency and blood stasis with the total scores was 0.830, 0.891, 0.833, 0.879, respectively. With Osteoporosis Quality of Life Scale（OQOLS） of western medicine as the criterion of curative effect, the relevant coefficient of the total scores of the two measuring scales was 0.752. Conclusion： The Chinese medicine scale for primary osteoporosis and OQOLS scale have good correlation on evaluating the life quality of PO patients. Moreover, Chinese medicine scale for primary osteoporosis reflects the characteristics of syndrome differentiation of Chinese medicine.