县域居民脾虚证量表的编制及信效度检验

Development of the Spleen Deficiency Evidence Scale for County Residentsand Test ofReliability and Validity

目的 本研究主要通过编制《县域居民脾虚证量表》并进行信效度检验,进一步通过脾虚证辨识为乡村和城镇居民慢病防控工作提供中医证候客观化工具。方法 基于团队前期基础等编制《县域居民脾虚证量表》,采用内部一致性信度和分半信度评价量表信度;采用结构效度、内容效度、校标效度和区分效度评价量表效度。结果 共纳入213名兰溪成年人,其中155名进行肠道菌群检测。(1)确定7条量表条目:疲惫、怕冷、口淡、纳差、腹泻、便无力、齿痕舌。(2)信效度检验中,Cronbach's α系数为0.828,McDonald'sω系数为0.825,其中“胃痛”和“食胀”条目不符合纳入要求建议删除;Spearman-Brown系数为0.839;探索性因子分析两个公因子时累积方差解释率为61.6%。脾虚证人群酸刺激前后唾液淀粉酶活性比值为0.826±0.253,脾虚证组和非脾虚证组人群在属水平Dialister、Shigella、Leuconostoc、Photobacterium、Trabulsiella和Parvimonas菌属中存在显著差异(P<0.05)。结论 县域居民脾虚证量表具有较好信效度。

Objective This study was to develop a"Spleen Deficiency Certificate Scale for County Residents"and test its reliability.It was then developed as an objective tool for Chinese medicine evidence and symptoms for the prevention and control of chronic diseases among county residents.Methods The scale was compiled based on the team's previous foundation.The reliability of the scale was evaluated using internal consistency reliability and split-half reliability,while its validity was evaluated using structural validity,content validity,calibration validity,and discriminant validity.Results The study included 213 adults from Lanxi,of whom 155 were tested for intestinal flora.Seven scale entries were identified:Fatigue,fear of cold,bland mouth,loss of appetite,diarrhea,weak bowel movements,and tooth-marked tongue.In the reliability test,Cronbach's alpha coefficient was 0.828 and McDonald'sωcoefficient was 0.825.The"stomach pain"and"bloating"entries did not meet the inclusion requirements and were recommended to be deleted.The Spearman-Brown coefficient was 0.839.The exploratory factor analysis of the two common factors explained 61.6%of the cumulative variance.The calibration validity indicated that the ratio of salivary amylase activity before and after acid stimulation was 0.826±0.253 in the group with spleen deficiency.Significant differences(P<0.05)in the genera Dialister,Shigella,Leuconostoc,Photobacterium,Trabulsiella,and Parvimonas between the spleen deficiency group and the non-spleen deficiency group.Conclusion The Spleen Deficiency Scale for County Residents demonstrates good reliability and validity.