清远地区公立综合医院呼吸内科门诊慢性咳嗽患病率及对新型量表实用性评价

Exploration on prevalence of chronic cough in respiratory medicine clinics of public general hospitals in Qingyuan area and evaluation on practicability of the new scale

目的探讨清远地区公立综合医院呼吸内科门诊慢性咳嗽患病率及对新型量表实用性。方法收集2018年1~12月期间在清远地区四家二甲及以上公立综合医院呼吸内科门诊就诊的患者数据,根据中华医学会呼吸病学分会所制定的诊断标准并结合初诊医生的初步诊断,筛选出慢性咳嗽患者数量,计算出患病率。并随机选取其中200例作为研究对象,在首次就诊时(第1天)征得患者同意后让其填写问卷第一天来诊做一次问卷调查,包括咳嗽程度评分表、视觉模拟评分法(VAS)、咳嗽症状积分、中文版莱斯特咳嗽量表(LCQ-MC)。在给予针对性或经验性治疗1周即第8天再次让患者填写问卷,2周后,即第22天回门诊复诊,第3次进行问卷调查。评估新型量表的信度、效度及反应度。结果2018年全年在纳入研究的四家医院呼吸内科门诊就诊的患者总数为90879例次,慢性咳嗽患者为13686例次,患病率为15.06%。治疗前后新型量表评分和VAS评分间呈正相关(r=0.352,P<0.05),对新型量表各维度得分作因子分析,KMO统计量为0.905,Bartlett的球形检验P<0.01。新型量表3个方面的Cronbach'sα系数和总分的α系数都大于0.82。结论患病率数据为清远地区呼吸系统疾病的防治提供了理论依据。新型量表具有良好信度及效度,具有较高的实用性。

Objective To explore prevalence of chronic cough in respiratory medicine clinics of public general hospitals in Qingyuan area and practicability of the new scale.Methods Data of patients admitted to the outpatient department of respiratory medicine in four public general hospitals of grade 2 and above in Qingyuan area from January 2018 to December 2018 were collected.According to the diagnostic criteria established by the Chinese Medical Association Respiratory Diseases Branch and the initial diagnosis of the newly diagnosed doctor,the number of patients with chronic cough was screened and the prevalence rate was calculated.200 cases were randomly selected as the research objects.On the first visit to the doctor(day 1),the patients were asked to fill in the questionnaire after obtaining the patients’consent,including cough severity rating scale,visual analog scale(VAS),cough symptom score,Mandarin Chinese version of the Leicester Cough Questionnaire(LCQ-MC).Patients were asked to fill out the questionnaire again at day 8 or 1 week after receiving targeted or empirical treatment.Two weeks later,that is,on the 22nd day,the patient returned to the outpatient clinic for a follow-up visit,and a questionnaire survey was conducted for the third time.The reliability,validity and responsiveness of the new scale were evaluated.Results The total number of patients attending the respiratory medicine clinics of the four hospitals included in the study in 2018 was 90879.The number of patients with chronic cough was 13686,and the prevalence rate was 15.06%.There was a positive correlation between the new scale score and the VAS score before and after treatment(r=0.352,P<0.05).Factor analysis was performed on the scores of each dimension of the new scale.The KMO statistic was 0.905,and Bartlett’s spherical test was P<0.01.The Cronbach’s α coefficient and the total coefficient α coefficient of the three aspects of the new scale were both greater than 0.82.Conclusion The prevalence data provide a theoretical basis for the prevention and treatment of respiratory diseases in Qingyuan area.The new scale has good reliability and validity and has high practicability.