中医杂志

目的研制缺血性中风证候要素诊断量表并探讨其研制的方法学。方法在对证候诊断和证候评价进行界定基础上,通过分析两轮专家问卷调查数据和14880例次临床信息采集数据,提取内风、内火、痰湿、瘀、气虚和阴虚6个证候要素,采用Cronbach's α系数评价各证候要素相关条目专家评分的一致性,Spearman秩相关系数评价四诊信息条目对证候要素的诊断重要性,采用Logistic判别法构造量表诊断模型并为量表条目赋权。结果缺血性中风证候要素诊断量表适合于对急性期和恢复早期患者的证候诊断,在特异性、敏感性和判断准确率方面明显优于1994年《中风病辨证诊断标准》。结论缺血性中风证候要素诊断量表临床可操作性强,其研制方法可为病证结合临床评价体系的研究提供借鉴。

Objective To establish Ischemic Stroke TCM Syndrome Diagnostic Scale(ISTCMDS) and to study on the methodology.Methods Based on the judgement of syndrome diagnosis and syndrome evaluation,by analyzing data from two rounds of expert questionare and clinical information of 14 880 cases,six TCM syndrome factors including inner-wind,inner-fire,phlegm-dampness,blood stasis,qi-deficiency and yin-deficiency were Abstracted.Cronbach's α coeffecient was used to evaluate consistency of expert scores for syndrome factor related items.Spearman correlation coefficient was used to evaluate the importance of TCM four-diagnosis information for syndrome factor diagnosis.Logistic judgement was used to make model of diagnositic scale,and to empower for items.Results The ISTCMDS is serviceable in the diagnosis of acute stage and early recovery stage of stroke patients,and was significantly superior to the Stroke Syndrome Differentiation Diagnostic Criterion(SSDDC) made in 1994 in specificity,sensitivity,and diagnosing accuracy.Conclusion The ISTCMDS is operable in clinical practice,and the establishing method could provide reference for the study on clinical evaluation system of disease-syndrome combination.