Malnutrition and Quality of Life in Chinese Cancer Patients: a Clinical Study of 23,994 Subjects

Background Malnutrition is common in patients with cancer,and can negatively impact their quality of life(QoL)and even survival.However,there is currently no large data available on the prevalence of malnutrition in Chinese cancer patients.This study evaluated the prevalence of malnutrition and the QoL of Chinese patients with locoregional,recurrent or metastatic cancer.Methods We conducted a nationwide observational,multi-center,hospital-based cross-sectional study within the Chinese Society of Nutritional Oncology(CSNO)Network.All of the patients were diagnosed with one of the following 18 different types of malignant tumors:lung cancer,gastric cancer,liver cancer,colorectal cancer,breast cancer,esophageal cancer,cervical cancer,endometrial cancer,nasopharyngeal carcinoma,malignant lymphoma,leukemia,pancreatic cancer,ovarian cancer,prostate cancer,bladder cancer,brain cancer,biliary tract malignant tumors or gastrointestinal stromal tumors.These patients were enrolled from 72 hospitals located in different regions of China.The patients’nutritional status was evaluated based on the body mass index(BMI),loss of bodyweight,laboratory measurements and patient generated-subjective global assessment(PG-SGA)scores.The cancer patients’physical status and QoL were assessed by the Karnofsky Performance Status(KPS)questionnaire and the European Organization for Research and Treatment of Cancer(EORTC)QLQ-C30 questionnaire,respectively.Results From December 2013 to April 2016,23,994 patients hospitalized for cancer treatment(such as surgery,chemotherapy or radiotherapy)were enrolled in the study.The patients included 12,494(52.9%)males and 11,124(47.1%)females.The mean age was 55.8±13.7 years.The proportions of patients in cancer stagesⅠ,Ⅱ,Ⅲ,Ⅳand uncertain were 11.5%,20.3%,27.5%,30.2%and 10.5%,respectively.Among the 23,994 inpatients,the proportions of patients who were underweight(BMI<18.5 kg/m2),normal(18.5 kg/m2<BMI<24 kg/m2),overweight(24 kg/m2≤BMI<28 kg/m2)and obese(BMI≥28 kg/m2)were 9.3%,59.9%,26.1%and 4.7%,respectively.A total of 18.3%(4,101/22,424)of patients had lost 5%or more of their bodyweight within the past month and 19.6%(2,463/12,538)of patients had lost 10%or more of their bodyweight within the past 6 months.According to the PG-SGA scores,26.6%of the patients were severely malnourished(score≥9),31.3%were moderately malnourished(scores 4~8).A total of 22.2%of patients had a serum albumin level lower than 35g/L.Only 8.6%(2056/23,991)of the patients had severe KPS scores(≤60).The patients with these severe KPS scores were most frequently among those with cancers of the brain(19.7%),prostate(18.0%),pancreas(15.5%)and bladder(15.0%).Based on the QLQ-C30 score,11.6%of patients had a poor QoL.The PG-SGA score and global QoL were correlated(r=-0.593,P<0.001).Conclusion The prevalence of malnutrition in patients with cancer is relatively high,and is related to a poorer QoL.The present findings should be kept in mind when assessing cancer patients,because addressing the patient’s problems in nutritional status would be expected to improve both the clinical outcomes and QoL in cancer patients with malnutrition.

Eficacy of Electro-acupuncture in Treatment of Functional Constipation: A Randomized Controlled Trial

Functional constipation(FC)is a chronic discasc that significantly afcts the life quality of patients.Acupuncture has been used for the treatment of FC for many years,but its effectiveness has not been scientifcally assessed.The present study aimed to evaluate the efficacy of electro-acupuncture(EA)in relieving the symptoms,mental states and quality of life(QOL)of FC patients.A total of 96 FC patients were randomly allocated into EA,mosapride&sham EA group(MS)and mosapride control group(MC).In the EA group,patients were treated with 16 sessions of needling at Quchi(LI1I)and Shangjuxu(ST37)bilaterally,5 times a week in the first 2 weeks,and 3 times a.week in the last 2 weeks.In the MC group,patients were treated with 5 mg mosapride citrate three times a day for 4 weeks.In the MS group,patients underwent sham EA and the same mosapride citrate treatment as in the MC group.The primary outcome was the number of weekly spontaneous bowel movements(SBMs).The secondary outcomes included stool consistency,intensity of defecating difficulty,36-Item Short-Form Health Survey(SF-36),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),and the validated Patient Assessment of Constipation-Quality of Life(PAC-QOL).The results showed that as compared with the baseline,EA significantly improved the weekly SBMs,stool consistency and intensity of defecating difficulty(P<0.05).It also partly ameliorated the PAC-QOL,SF-36,SDS and SAS scores when compared with MC or MS group(P<0.05).However,no significant difference was observed between MS and MC groups in bowel function outcomes and QOL scores.It was concluded that EA could effectivcly improve bowel function,mental states and QOL of FC patients.

Literature review and analysis of the development of health outcomes assessment instruments in Chinese medicine

OBJECTIVE： To evaluate the development of health outcomes assessment instruments in Chinese medicine. METHODS： A comprehensive literature search for all published articles in China National Knowledge Infrastructure Database, Chongqing VIP Database and WANFANG Data was conducted. The studies that met the inclusion and exclusion criteria were used to extract information according to a predesigned assessment instrument. RESULTS： A total of 97 instruments for health outcome assessment in Chinese medicine were identified. Of these questionnaires, 7 were generic, 12 were condition-specific and 78 were disease-specific. All instruments were suitable for adults, children, and both men and women. These instruments aimed to evaluate the health-related quality of life, signs and symptoms as well as patient satisfaction and doctor-reported outcome. However, the descriptions were poorly constructed for some of the most basic parameters, such as the domains and items, administrative mode, response options, memory recall periods, burden evaluation, format, copyright, content validity, and other properties. CONCLUSION： The instrument development for health outcomes assessment in Chinese medicine is increasing rapidly; however, there are many limitations in current methodologies and standards, and further studies are needed.

Literature review and analysis of the application of health outcome assessment instruments in Chinese medicine

OBJECTIVE： To evaluate the application of health assessment instruments in Chinese medicine. METHODS： According to a pre-defined search strategy, a comprehensive literature search for all articles published in China National Knowledge Infrastructure databases was conducted. The resulting articles that met the defined inclusion and exclusion criteria were used for analysis. RESULTS： A total of 97 instruments for health outcome assessment in Chinese medicine have been used in fundamental and theoretical research, and 14 of these were also used in 29 clinical trials that were randomized controlled trials, or descriptive or cross-sectional studies. In 2 152 Chinese medicine-based studies that used instruments in their methodology, more than 150 questionnaires were identified. Among the identified questionnaires, 51 were used in more than 10 articles （0.5%）. Most of these instruments were developed in Western countries and few studies （4%） used the instrument as the primary evidence for their conclusions. CONCLUSION： Usage of instruments for health outcome assessment in Chinese medicine is increasing rapidly; however, current limitations include selection rationale, result interpretation and standardization, which must be addressed accordingly.

分析步行运动联合正念干预对卵巢癌患者睡眠质量的影响

目的:分析步行运动联合正念干预对卵巢癌患者睡眠质量的影响,寻求能够提升化疗期卵巢癌患者生命质量的护理措施。方法:选取2022年6月至2023年6月厦门大学附属第一医院妇产科收治的确诊为卵巢癌患者68例作为研究对象,按照随机数字表法分为对照组和观察组,每组34例。对照组给予常规护理干预,观察组给予步行运动联合正念干预。采用匹兹堡睡眠质量指数(PSQI)比较2组患者干预前后睡眠质量的变化,采用中文版Piper疲乏修订量表(PFS-R)比较2组患者干预前后的疲乏状态,采用生命质量测定量表(EORTC QLQC30)比较2组患者干预前后生命质量的变化。结果:干预后,观察组PSQI评分显著低于对照组,观察组癌因性疲乏Piper量表评分显著低于对照组,患者生命质量测定量表QLQC30评分显著高于对照组,差异均有统计学意义(均P<0.05)。结论:卵巢癌患者在化疗期间展开步行运动联合正念干预,与治疗措施之间可产生良好的辅助配合效果,能够有效提高患者的睡眠质量和生命质量,增加对抗癌症、化疗的信念,值得临床推广应用。

基于患者自评-主观全面评定量表的个性化营养干预在胃癌术后化疗患者中的应用效果

目的探讨基于患者自评-主观全面评定量表(PG-SGA)的个性化营养干预在胃癌术后化疗患者中的应用效果。方法根据干预方式的不同将132例胃癌术后化疗患者分为对照组(n=65)和观察组(n=67),对照组患者采取常规干预,观察组患者在对照组的基础上采取基于PG-SGA的个性化营养干预。比较两组患者的胃肠功能恢复指标、营养指标[血红蛋白(Hb)、白蛋白(ALB)、总蛋白(TP)]、免疫功能指标[免疫球蛋白(Ig)A、IgM、IgG、CD3^(+)、CD4^(+)、CD8^(+)]、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]以及不良反应发生情况。结果观察组患者腹胀改善时间、首次排气时间及肠鸣音恢复时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。干预后,两组患者Hb、ALB、TP水平均高于本组干预前,观察组患者Hb、ALB、TP水平均高于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者IgA、IgG、IgM、CD3^(+)、CD4^(+)水平均高于本组干预前,CD8^(+)水平均低于本组干预前,观察组患者IgA、IgG、IgM、CD3^(+)、CD4^(+)水平均高于对照组,CD8^(+)水平低于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者EORTC QLQ-C30各维度评分均高于本组干预前,观察组患者EORTC QLQ-C30各维度评分均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的不良反应总发生率低于对照组(P﹤0.05)。结论基于PG-SGA的个性化营养干预应用于胃癌术后化疗患者,能够改善患者的营养状态及免疫功能,促进患者胃肠功能恢复,提高患者生活质量,降低不良反应发生率。

急性白血病患者自我报告结局评估工具的研究进展

对国内外现有的急性白血病患者自我报告结局评估工具进行综述,概述急性白血病患者普适性、特异性自我报告结局评估工具的主要内容、应用效果及局限性等,为我国急性白血病患者自我评估工具的开发及临床护士选择合适的评估工具等提供参考依据。

便秘患者生存质量自评量表PAC-QOL中文版的信度、效度及反应度

目的:测定评价Mapi Research Trust授权的便秘患者生存质量自评量表PAC-QOL中文版的信度、效度和反应度.方法:通过测定283例罗马Ⅲ标准诊断的功能性便秘患者的生存质量对PAC-QOL中文版进行评价.结果:通过探索性因子分析,量表可分为生理、社会心理、担忧和满意度4个公因子,与原版量表基本一致;各条目与其所属领域的相关性有显著统计学意义(P<0.01);各领域及总分的内在信度Cronbachα系数除生理维度为0.69外,其余均在0.70以上;治疗1mo后与治疗前相比,各维度得分和总分有显著统计学差异(P<0.01);便秘患者治疗前与健康人群相比,各维度得分和总分有显著统计学差异(P<0.01).结论:PAC-QOL中文版具有较好的信度、效度和反应度,可用于中国便秘患者生存质量的测定.

针灸治疗结肠慢传输性便秘30例

目的评估针灸治疗结肠慢传输性便秘的疗效及作用特点。方法通过建立结肠慢传输性便秘的临床路径,以患者报告结果(patient-reported outcomes,PROs)为疗效评估的主要方法,30例慢传输性便秘患者,共采用两组穴位:第一组天枢、大横、腹结、气海、关元、足三里、上巨虚;第二组大肠俞、肾俞、八髎、四神聪,对腹部和背部穴位深刺,灸四神聪,两组穴位隔日交替使用,20次为1个疗程。采用患者评价便秘生活质量问卷(PAC-QOL问卷)评估法,比较治疗前、治疗后1、2、3周便质评分、便意感次数、排便次数、腹胀程度和生活质量。结果治疗前与治疗后1、2、3周比较,开塞露或泻药使用例数减少,Bristol便质评分达正常例数比例上升;便意感次数增多;排便次数增多;腹胀减轻(P<0·01)。治疗前后PAC-QOL比较,治疗后患者身体不适、心理不适、便秘相关的焦虑和关心、满意度4方面分值及总分差值均明显下降(P<0·01)。治疗期间未发生不良事件。治疗结束时临床痊愈13例,好转9例,无效8例;治疗后1月随访临床痊愈10例,好转7例,无效13例。治疗后3月随访临床痊愈7例,好转8例,无效15例。结论在建立临床路径的基础上,采用PROs疗效评估法,凸显了针灸改善便秘症状同时提高患者生活质量的特点。

癌症患者生活质量调查表的编制及试测

随着癌症患者生存期的延长，癌症患者生活质量（ＱＯＬ）研究越来越引起人们的关注。因此，在引进、修订国外有关ＱＯＬ问卷（量表）的同时，编制、评估我国自己的ＱＯＬ问卷将有助于我国在这一年轻领域的研究工作。本文简介了中国癌症化疗患者生活质量调查问卷（ＱＬＱ－ＣＣＣ）的编制、试测及应用情况，初步研究结果表明ＱＬＱ－ＣＣＣ在评价中国癌症化疗患者ＱＯＬ时具有可靠、有效、灵敏及实用等特点。但尚需通过进一步调查研究来验证其有效性及实用性。最后，文章指出我们在该领域研究工作中存在的一些问题及今后努力方向。

固定矫治中青少年及成人患者口腔健康生活质量的比较

目的:比较青少年及成人患者在固定矫治过程中口腔健康生活质量的不同变化特点。方法:选择81例于2013年9月—2015年8月就诊于山东大学口腔医院正畸科的患者,年龄15~25岁,分为青少年组(43例)和成人组(38例)。在矫治前及矫治中3个阶段完成填写口腔健康影响程度量表(OHIP-14)。采用SPSS20.0软件包对数据进行Friedman双向方差分析、Wilcoxon秩和检验和Bonferroni校正检验。结果:矫治过程中,青少年及成人患者的总得分及除社交障碍、社会功能障碍外5个维度得分均呈下降趋势,差异具有显著性。社交障碍维度仅成人患者得分差异显著。社会功能障碍维度2组得分无显著差异。结论:口腔正畸医师应重视青少年及成人患者矫治中生活质量的变化特点,并根据其特点加强与患者的交流。

住院患者肿瘤相关营养不良现况分析:一项横断面调查研究

目的对我国住院肿瘤患者进行营养不良现状调查。方法采用欧洲通用调查问卷,从医院、科室及患者三个层面调查住院肿瘤患者的营养状况、干预措施、生活质量等内容。结果全国共35家医院、48个科室参与,658例住院患者完成调查。74.3%的医院能将营养治疗作为总体治疗的一部分,但实际接受营养干预（包括营养咨询）的患者不足40%,其中患者主动要求营养治疗者占42.3%,纳入肿瘤常规治疗的仅38.4%;未监测患者体重变化的医院占5.7%,能做到定期及必要时测量患者人体学指标的医院分别是28.6%和45.7%。未接受任何形式营养干预的患者达62.0%,提供营养咨询和个体化膳食指导的仅12.6%。患者调查认为导致食欲或摄食量发生改变的最常见原因分别是恶心、呕吐（27%）,食欲缺乏、早饱（20%）和疼痛（16%）。75%的患者认可肿瘤整体治疗的可执行性,并认可癌症治疗中增加营养治疗能够获益。与确诊前相比,69.1%的患者有体重减轻,其中98.3%是非自主性体重下降;按体重减轻程度分组患者,大于10%的占41.2%,介于5%-10%为29.1%,减轻不超过5%者为29.6%,三组间患者对疼痛的感受及日常活动、自觉虚弱及需要休息、情绪、食欲和治疗方案耐受情况均差异有显著性（P〈0.05）。营养干预后,患者的身体感受（疼痛、虚弱）、食欲及情绪相比于1周前状态均有不同程度改善。结论目前我国多数医院能将营养治疗纳入肿瘤患者的整体治疗,但具体营养干预未能有效落实,对患者的营养咨询不够重视,营养评估和监测不及时。此外,恶性肿瘤患者普遍存在体重减轻,且减轻程度与患者生活质量及对治疗方案耐受情况明确相关。恰当的营养干预,可在一定程度上缓解患者对癌痛的感受,有益于维持体力、改善情绪,维持患者生活质量。

养阴润肠方治疗慢性传输型便秘32例

目的观察养阴润肠方治疗慢性传输型便秘临床疗效。方法符合纳入标准的32例慢性传输型便秘患者,使用养阴润肠方治疗3个疗程,每个疗程7d,分别记录治疗前、2个疗程后、3个疗程后、停药1个月后便秘患者生活质量自评量表(patient assessment of constipation quality of life questionnaire,PAC-QOL)评分及Cleveland便秘评分。结果治疗结束时治愈17例,显效8例,有效4例,无效3例,总有效率为90.6%。治疗前后PAC-QOL比较,在治疗2个疗程后、3个疗程后、停药1个月后,生理积分、担忧度积分、满意度积分、总分均显著减少(P<0.01);3个疗程后、停药1个月后,心理积分显著减少(P<0.01);与治疗前比较,治疗2个疗程后、3个疗程后、停药1个月后Cleveland评分均显著减少(P<0.01)。结论养阴润肠方治疗慢性传输型便秘在全身整体性调节和提高生活质量等方面疗效确切。

益生菌对维持性血液透析的慢性便秘患者肠道菌群及生存质量的影响

目的探究益生菌对维持性血液透析(maintenance hemodialysis,MHD)治疗的慢性便秘(chronic constipation,CC)患者肠道菌群及生存质量(patient assessment of constipation quality of life questionnair,PAC-QOL)的影响研究。方法选90例患者,随机分为观察组与对照组,各45例,检测并分析治疗前及治疗1月PAC-QOL及肠道菌群、血清炎性因子、肾功能指标。结果①2组患者Scr、BUN、UA治疗后较治疗前均下降(对照组t=7.933、13.190、4.176,均P<0.001;观察组t=7.721、12.722、5.948,均P<0.001),治疗后观察组BUN低于对照组(t=3.217,P=0.002),2组间Scr、UA无统计学意义(t=0.003、0.258,P=0.997、0.776)。②2组患者治疗后肠道双歧杆菌、乳杆菌数量均增加,大肠埃希菌、肠球菌数量均下降,且观察组改善明显(t=-9.367、-22.573、35.796、6.124,均P<0.001);同组比较,对照组患者肠道双歧杆菌数量治疗后无统计学意义(t=1.984,P=0.054),同组治疗后于治疗前比较均有改善(对照组t=-4.239、6.633、7.466,均P<0.001,观察组t=-10.759、-30.592、37.157、9.010,均P<0.001)。③2组患者治疗后IL-6、CRP治疗后明显下降(t=122.371、3.489,均P<0.001)。④2组治疗后观察组PAC-QOL躯体不适、心理社会不适、担心与焦虑、满意度评分及总分数改善更明显(t=6.342、7.146、6.261、10.575、13.159,均P<0.001)。结论益生菌能改善MHD的CC患者肠道菌群失衡,对微炎症状态有改善作用,对肾功能无明显改善作用。益生菌能使MHD的CC患者PAC-QOL评分降低,能改善CC症状,提高生活质量。

穴位埋线治疗帕金森病便秘疗效观察

目的观察穴位埋线治疗帕金森病便秘的临床疗效。方法将80例帕金森病便秘患者随机分为治疗组和对照组,每组40例。治疗组采用穴位埋线治疗,对照组采用假刺激治疗(针刺治疗组相同穴位,留针10 s后拔针)。观察两组治疗前后便秘患者症状自评量表(patient assessment of constipation symptoms,PAC-SYM)各项评分及便秘患者生存质量量表(patient assessment of constipation quality of life,PAC-QOL)评分的变化,并比较两组临床疗效。结果治疗组治疗后PAC-QOL评分均较治疗前降低(P<0.05);治疗组治疗后PAC-SYM中直肠症状评分及PAC-QOL评分明显低于对照组(P<0.05)。治疗组总有效率为77.5%,明显高于对照组的30.0%(P<0.01)。治疗组治疗前后PAC-SYM评分与PAC-QOL评分呈正相关(P<0.01)。结论穴位埋线是一种治疗帕金森病便秘的有效方法,能改善患者排便次数、排便费力症状及生活质量。

癌痛随访评估体系的构建与实施

目的探讨癌痛随访评估体系动态评估出院癌痛患者疼痛控制,提高其生活质量。方法将120例出院癌痛患者按出院先后顺序分为观察组和对照组各60例;对照组采用常规干预方法,观察组建立与实施癌痛随访评估体系,对出院癌痛患者定期评价癌痛控制效果、及时采取干预措施,团队合作随访等。于出院和出院后2个月测量患者疼痛评分及其生活质量。结果两组干预后患者疼痛评分、生活质量比较,差异有统计学意义(均P<0.01)。结论对癌痛出院患者实施癌痛随访评估,能有效控制患者的疼痛,提高患者的疼痛控制效果和生活质量。

康复护理对老年性便秘患者临床症状及生活质量的影响

目的:探讨康复护理对老年性便秘患者临床症状及生活质量的影响。方法:对92例老年性便秘患者进行系统规范的康复护理,应用临床症状积分量表和汉化版简明健康调查量表(SF-36),对92例老年性便秘患者康复护理前及1个月后的临床症状和生活质量进行评估,记录并比较干预前后的评分。结果:康复护理前老年性便秘患者的生活质量明显下降,与中国常模相比,除生理功能和躯体疼痛外,其余6个纬度均有显著性差异(P<0.05),患者便秘临床症状明显;康复护理1个月后,老年性便秘患者临床症状明显改善(总有效率为78.3%);总生活质量显著提高(P<0.05),除生理功能和活力等2个生活质量指标外,其余6个指标与康复护理前相比,差异均有统计学意义(P<0.05)。结论:康复护理不仅能改善患者的临床症状,还能提高患者的生活质量。

冠桥固定松动牙对重症牙周炎及口腔健康相关生活质量的影响

目的探讨冠桥固定松动牙对重症牙周炎和口腔健康相关生活质量的影响。方法选重症慢性牙周炎患者104例,初诊(T0)时测定牙龈指数(GI)、菌斑指数(PLI),行口腔健康影响程度量表(OHIP-14)和牙周健康自我评价表调查,对患者行牙周洁治和刮治,对松动牙行根管治疗后烤瓷冠桥固定,在固定后1个月(T1)、6个月(T2)及12个月(T3)再次测定GI、PLI及调查OHIP-14和口腔健康自我评价表。结果患者在T1时OHIP-14平均得分(15.6±3.0),与T0时(33.7±3.1)有非常显著性差异(P<0.01),T2时OHIP-14得分(10.3±2.8),与T1时得分有显著性差异(P<0.05),T3时得分(7.9±2.5)与T2无显著性差异(P>0.05)。治疗后各时间点OHIP-14各条目分值及阳性反应患者比率与治疗前比明显降低,牙周健康有关症状所占比率显著降低。治疗后各观测点的GI和PLI与T0比有显著性差异(P<0.01)。结论冠桥固定对重症牙周炎有显著疗效,可明显改善牙周健康有关症状和口腔健康影响程度,提高口腔健康相关生活质量。

老年综合评估干预模式在老年住院患者中的应用

目的:探讨老年综合评估(CGA)干预模式在老年住院患者中的应用效果。方法:选取2017年10月1日~2018年10月1日在宁夏医科大学总医院住院的老年患者100例为研究对象,随机分为研究组和对照组各50例,对照组给予常规护理干预,研究组给予CGA干预模式;比较两组干预前后营养状况[采用微型营养评定量表(MNA)]、认知功能[采用简易精神状态检查量表(MMSE)]、日常生活能力[采用日常生活活动能力量表(ADL)]、生活质量[采用健康调查简表(SF-36)]。结果:干预后,研究组营养状况优于对照组(P<0.05),MMSE评分显著高于对照组(P<0.05),ADL评分显著低于对照组(P<0.05);干预后,研究组SF-36各维度评分高于干预前和对照组(P<0.01,P<0.05)。结论:CGA干预模式可有效降低老年住院患者营养不良的发生风险,提高生活质量,改善患者的认知功能及日常生活能力,具有较高的应用价值。

中医主观复合性指标体系的概念及意义

中医药诊疗理论自成系统,评价方法与现代医学存在差异,对现代医学评价技术和方法的简单套用在中医药临床研究中并不可行,因此迫切需要建立符合中医药自身规律和特点的评价技术体系。随着生存质量、病人报告结局等工具的引入和研究的逐步深入,中医药临床评价的理念和方法面临新的发展契机。本文提出主观复合性指标的概念,即来自病人自身、医生和病人看护者的对于疾病改善状况的主观反映指标,它区别于实验室指标,是多维的、复合的健康相关生存质量,强调疾病评价信息的来源途径,并结合实际研究案例"中医治疗慢性阻塞性肺疾病的主观复合指标评价方法的建立",介绍中医主观复合性指标体系和评价方法的适用范围和局限性,以期抛砖引玉,启迪同道。