Huang Zhongyu, Hou Zhengkun, Liu Xianhua, Liu Fengbin, Wu Yuefeng
Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Evid Based Complement Alternat Med. 2018 Feb 12;2018:6467135. doi: 10.1155/2018/6467135. eCollection 2018.
This study aims to offer a new approach for quantifying severity of traditional Chinese medicine pattern with multidimensional analysis methods.
A scale and theoretical models were constructed based on the definition of liver stagnation spleen deficiency pattern. Clinical data of 344 IBS-D patients from a cross-sectional study was used for feature validation of the model. Confirmatory factor analysis was used for evaluating the models. Also, multidimensional item response model was used for assessing multidimensional psychometric properties of the scale.
Detecting two latent traits, the Cronbach's alpha of the 9-item scale was 0.745. Multidimensional model was evaluated with significant goodness of fit indices while the unidimensional model was rejected. The multidimensional item response model showed all the items had adequate discrimination. Parameters presented adequate explanation regarding mental syndromes having high factor loading on the liver stagnation factor and abdominal discomfort syndromes highly related to the spleen deficiency factor. Test information function showed that scale demonstrated the highest discrimination power among patients with moderate to high level of severity.
The application of the multidimensional analysis methods on the basis of theoretical model construction provides a useful and rational approach for quantifying the severity of traditional Chinese medicine patterns.
本研究旨在提供一种采用多维度分析方法量化中医证型严重程度的新途径。
基于肝郁脾虚证的定义构建量表及理论模型。来自一项横断面研究的344例腹泻型肠易激综合征(IBS-D)患者的临床数据用于该模型的特征验证。采用验证性因子分析评估模型。此外,使用多维度项目反应模型评估量表的多维度心理测量特性。
该9项量表检测出两个潜在特质,其Cronbach's α系数为0.745。多维度模型经评估具有显著良好的拟合指数,而单维度模型被拒绝。多维度项目反应模型显示所有项目均具有充分的区分度。参数对在肝郁因子上具有高因子负荷的精神综合征以及与脾虚因子高度相关的腹部不适综合征给出了充分解释。测试信息函数表明,该量表在中重度患者中显示出最高的区分能力。
在理论模型构建基础上应用多维度分析方法为量化中医证型严重程度提供了一种有用且合理的途径。