原发性肝癌中医证候诊断量表的研制

摘要

Objective To develop a TCM syndrome-based Diagnostic Scale for Primary Liver Cancer to classify the TCM syndromes in primary liver cancer(PLC) ,and based on this,to determine the therapeutic regimen.Methods The item pool of the TCM syndrome-based Diagnostic Scale for Primary Liver Cancer were determined based on the review of the literature and works about TCM syndrome and features of TCM symptoms related to PLC and the interview of the patients,as well as subsequent assessment of experts and PLC patients.The scale was formally used for the survey conducted in PLC patients receiving treatment selected from Changhai Hospital,the Second Military Medical University and the Affiliated Hospitals of Guangxi Medical University.The reliability and validity of the scale were assessed after the item analysis.Results Through the entry pool screening and evaluation from experts and patients,we determined 22 items of the TCM syndrome-based Diagnostic Scale for Primary Liver Cancer.The Cronbach's α and split-half reliability coefficient of the scale was 0.933,and 0.902, respectively.According to the purpose of this study,the first three common factors were extracted by factor analysis,and the eigenvalue of them was 10.619,2.181 and 1.860 respectively,which explained 48.864% of the total variance.Conclusion The TCM syndrome-based Diagnostic Scale for Primary Liver Cancer has a good reliability and validity.Based on the scale,the PLC patients can be divided into two types,Qi-yin deficiency and Damp-stasis depression accumulation.The scale provides a reference for formulating therapeutic regimen and clinical medication for PLC.%目的 尝试建立原发性肝癌(PLC)中医证候诊断量表,依据PLC患者中医证型而确定治疗方案.方法 检索PLC中医证候学和症状学特征的相关文献、著作,以及患者访谈,确定PLC中医证候诊断量表条目池,由专家、患者对各条目的重要性进行评价.选取第二军医大学附属长海医院、广西医科大学附属医院正在接受治疗的PLC患者进行正式调查,经条目分析后,评价该量表的信效度.结果 通过对条目池筛选及专家、患者的评价,初步确定22个条目的PLC中医证候诊断量表.PLC中医证候诊断量表Cronbach's α系数为0.933,分半信度系数为0.902.根据本研究目的,提取因子分析的前3个公因子,特征值分别为10.619、2.181、1.860,累积解释方差贡献率48.864%.结论本研究建立的PLC中医证候诊断量表具有良好的信效度,通过该量表确定PLC患者存在气阴两虚证型、湿郁互结证型两大证候群,为治疗方案和指导临床用药提供了依据.