中医证候临床评价的探讨

Clinical Evaluation in Traditional Chinese Medicine (TCM)

证候是中医辨证的核心,中医证候的疗效评价是中药新药临床研究的重要内容之一。常用的症状分级量化表虽然将证候疗效评价以客观计分的形式呈现,但仍存在不足之处:其一,采用分级赋分法,原始信息有损失;其二,症状评分属于等级资料,使用定量资料统计分析方法不合理;其三,主症、次症权重受症状个数影响,存在不合理性;其四,以主证、次证的合计评分,综合评价中医证候疗效,科学性有待探讨;其五,研究者应用现有等级评价方法,容易导致系统误差偏大,影响评分的准确性。探讨在不改变原有评价思维的基础上,对原方法进行改进,建议将分级赋分法与90 mm刻度法相结合,旨在对原中医证候临床评价方法进行改进探讨,为实现中医证候科学量化评价提供一种新的思路和模式。

Syndrome is the core of treatment by differentiation of syndromes （ TDS）, and the therapeutic effect evaluation on syn- drome plays an important role in clinical research of TCM. Commonly used symptom classification quantization table represents the syndrome curative effect evaluation in a form of objective scoring, however, there are shortages, such as the hierarchical scoring method may lose information, the limitation in quantitative statistical analysis methods for hierarchical data, the unscientific of comprehensive evaluation of primary and minor symptoms, and that the systematic errors from researchers may affect the accuracy of the score. Therefore, exploring ways to improve the original method without changing the origin idea and aiming to provide a new idea of the quantification and modernization of the curative effect of TCM, it is suggested to combine hierarchical scoring method with 90 mm scale method.