糖尿病肾脏病肾精亏虚证诊断量表的制定与验证

The development of a diagnostic scale for diabetic nephropathy and kidney-sperm deficiency syndrome based on Delphi method

目的制定糖尿病肾脏病肾精亏虚证诊断量表并进行验证。方法在数据挖掘的基础上建立糖尿病肾脏病肾精亏虚证症状条目池,通过德尔菲法进行调查以筛选条目,然后纳入糖尿病肾脏病患者126例,运用频率分析法、相关系数法、克朗巴赫ɑ系数法、因子分析法进一步筛选条目,并对各条目进行赋权、确定阈值以及程度分级,最终得到糖尿病肾脏病肾精亏虚证诊断量表。在此基础之上收集糖尿病肾脏病患者52例验证该量表的准确率、灵敏度和特异性。结果糖尿病肾脏病肾精亏虚证量表,共包含乏力,腰膝酸软、足跟痛、健忘、头晕、耳鸣、耳聋(听力减退)、牙齿松动、性欲减退9个条目,通过赋权计算,其诊断阈值为38.5分,38.5≤总分<62为轻度,62≤总分<124.5为中度,总分≥124.5为重度。通过临床小样本验证,量表的灵敏度95.2%、特异度80%、准确率92.3%。结论该量表可以对糖尿病肾脏病肾精亏虚证进行量化诊断,有利于进一步研究和临床推广。

Objective Develop and verify the diagnostic scale of diabetic kidney disease(DKD)deficiency of kidney essence.Methods Based on data mining of diabetic kidney disease symptoms of kidney essence deficiency syndrome item pool,through the Delphi method to investigate filter entries,then through in 126 patients with DKD using the frequency analysis method,correlation coefficient method,ɑcrowns Bach coefficient method,factor analysis method to further filter entries,assign weights to each item,determine thresholds and grade levels,and finally obtain the DKD renal essence deficiency syndrome diagnostic scale.Fifty-two patients with DKD were collected to verify the accuracy,sensitivity and specificity of the scale.Results The scale of DKD and deficiency of kidney and fine syndrome includes 9 items,including fatigue,lumbar and knee tenderness,heel pain,amnesia,dizziness,tinnitus,deafness(hearing loss),loose teeth,and loss of libido.By weight calculation,the diagnostic threshold is more than 38.5 points,38.5≤total score<62 is mild,62≤total score<124.5 is moderate,and the total score>124.5 is severe.The sensitivity,specificity and accuracy of the scale were 95.2%,80%and 92.3%,respectively.Conclusion This scale can be used for the quantitative diagnosis of DKD and deficiency of kidney essence,which is beneficial to further research and clinical promotion.