构建冠心病心绞痛中医病证结合疗效评价量表体系的构想

Conception and Framework of Developing A System of Disease-Syndrome Combined Angina Questionnaires for Tradtional Chinese Medicine Assessment

以量表为载体的生存质量已被引入中医药行业中,用于中医药临床疗效评价。但现有量表存在诸多不足,不能凸显中医特色优势。国内外学者开展探讨研制符合中医疗效评价的量表。通过回顾国内外中医量表的研究现状,发现无论是疾病特异性量表还是证候特异性量表,均存在不足之处。在前期通过改良西雅图心绞痛量表(SAQ),在其基础上加入中医痰瘀互结证候维度,建立了冠心病心绞痛中医病证结合评价量表(TCMSAQ),经临床应用,信度、效度、反应度良好。中医临床证候复杂多样,无法逐一研制相关病证量表。借鉴美国西北大学慢性病评价量表的研制方法,引入共性模块、特异性模块相结合的方法,在现有西雅图心绞痛量表(SAQ)的基础上,加入中医普适性症状,研制"冠心病心绞痛中医病证结合疗效评价量表共性模块(TCM-SAQ-GM)",并针对冠心病心绞痛常见中医基本证型,如气虚、痰浊、瘀血等,研制"证候特异性模块(TCM-SAQ-SM)",将TCM-SAQ-GM与TCM-SAQ-SM组合,构建冠心病心绞痛中医病证结合疗效评价量表体系。

We reviewed the current developed questinnaires for Traditional Chinese Medicine（TCM） and especially syndrome related questionnaires.Both disease specific or syndrome specific questionnaires have their shortness on TCM assessment.Disease-syndrome conmbination is the main module in the clinical efficacy assessment of TCM.In the former studies,we modified Settle Angina Quseionnaire（SAQ）,and developed Traditonal Chinese Medicine Syndrome of Angina Questionnaire（TCM-SAQ）,which combined the dissease specific and sydrome specific questionaaire together,and it has already been verified suitable in the clinical evaluation.However,there are various sydromes in the clinical practice,which cannot be covered totally.Therefore,we want to follow the methods of developing the Functional Assessment of Chronic Illness Therapy,using the conception of general module（GM） and specific module（SM） to develop the disease specific questionnaire and syndrome specific quesitionniares respecitvely.We concept the framework of extracting the universal parts of syndromes to establish the general module,and developing the speicfic modules such as＂Qi stagnation＂＂Yang deficiency＂＂Yin deficiency＂and so on which forms the TCM-SAQ-GM and TCM-SAQ-SM.Finally,we combined the TCM-SAQ-GM and the TCM-SAQ-SM together to establish the system of disease-syndrome combined angina questionnaires for TCM assessment.